The use of metformin as an add-on therapy to insulin in the treatment of poorly controlled type 1 diabetes mellitus in adolescents

Abstract

The aim of this integrative literature review was to evaluate the efficacy and safety of Metformin as an add-on therapy to insulin in poorly controlled overweight adolescents with type 1 diabetes mellitus. The research problem centered on providing optimum disease management during the most critical growth period and reducing the potential for cardiovascular-related morbidity and mortality in the future. The findings suggested that Metformin, in conjunction with insulin therapy, helped patients to achieve better metabolic control. The quality of metabolic control varied between studies according to differences in study design, exclusion and inclusion criteria, and methods. Adjunctive Metformin therapy has a positive effect on diabetes management, treatment, and prevention of cardiovascular-related complications with a minimal risk of side effects. Suggestions for further exploration of the research results and clinical implications are included in the review.

Multi-Faceted Influence of Obesity on Type 1 Diabetes in Children – From Disease Pathogenesis to Complications

“…which also show a beneficial effect of metformin on insulin sensitivity, BMI and body composition in young people with type 1 diabetes ( 150 ). Metformin is found to be safe for adolescent children, with only a risk of minor gastrointestinal side effects, while acute side effects were not present in the conducted studies ( 149 ).…”

“…In adult patients with type 2 diabetes, this drug has been demonstrated to reduce the risk of cardiovascular disease and improve their body composition ( 147 ). Results from multiple studies show the promising potential of metformin as an insulin adjunctive therapy for poorly controlled overweight youth with type 1 diabetes to reduce cardiovascular disease risk ( 149 ). The findings of a randomized, double-blinded and controlled trial performed by Bjornstad et al.…”

Growth Factors, Reactive Oxygen Species, and Metformin—Promoters of the Wound Healing Process in Burns?

“…Metformin reduces lipogenesis [175] and increases the rate of protein synthesis [176,183]. It has been proved that metformin administration decreases insulin resistance in liver, fat, and skeletal muscle with overall reduction of the hypercatabolic state of severely burned patients [184][185][186]. Better control of the prolonged hypercatabolic state in severe burns accelerates the wound healing, diminishes the rate of infection, and improves the survival [174,187].…”

Drugs Interfering with Insulin Resistance and Their Influence on the Associated Hypermetabolic State in Severe Burns: A Narrative Review

“…Its action of augmenting insulin sensitivity in peripheral tissues was initially doubted: some authors considered that metformin acts predominantly upon the liver and has little effect upon skeletal muscle, which is the main glucose consumer [159]. During recent years, it has been proven that metformin decreases insulin resistance in the liver, muscle, and adipose tissue, too [160][161][162][163][164].…”