Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial
Introduction: Metformin has been demonstrated to enhance cardioprotective be nefits in type 1 diabetes (T1DM). Although glycemic variability (GV) is associated with increased risk of CVD in diabetes, there is a scarcity of research evalua ting the effect of metformin on GV in T1DM. Objectives: In...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2021-09-01
|
| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | https://ec.bioscientifica.com/view/journals/ec/10/9/EC-21-0146.xml |
| _version_ | 1818787901085843456 |
|---|---|
| author | Xiuzhen Zhang Dan Xu Ping Xu Shufen Yang Qingmei Zhang Yan Wu Fengyi Yuan |
| author_facet | Xiuzhen Zhang Dan Xu Ping Xu Shufen Yang Qingmei Zhang Yan Wu Fengyi Yuan |
| author_sort | Xiuzhen Zhang |
| collection | DOAJ |
| description | Introduction: Metformin has been demonstrated to enhance cardioprotective be nefits in type 1 diabetes (T1DM). Although glycemic variability (GV) is associated with increased risk of CVD in diabetes, there is a scarcity of research evalua ting the effect of metformin on GV in T1DM.
Objectives: In the present study, the effects of adjuvant metformin therapy on GV and metabolic control in T1DM were explored.
Patients and methods: A total of 65 adults with T1DM were enrolled and subjected to physical examination, fasting laboratory tests, and continuous glucose monitoring, and subsequently randomized 1:1 to 3 months of 1000–2000 mg metformin daily add-on insulin (MET group, n = 34) or insulin (non-MET group, n = 31). After, baseline measurements were repeated.
Results: The mean amplitude of glycemic excursions was substantially reduced in MET group, compared with non-MET group (–1.58 (–3.35, 0.31) mmol/L vs 1.36 (–1.12, 2.24) mmol/L, P = 0.004). In parallel, the largest amplitude of glycemic excursions (–2.83 (–5.47, –0.06) mmol/L vs 0.45 (–1.29, 4.48) mmol/L, P = 0.004), the s.d. of blood glucose (–0.85 (–1.51, 0.01) mmol/L vs –0.14 (–0.68, 1.21) mmol/L, P = 0.015), and the coefficient of variation (–6.66 (–15.00, 1.50)% vs –1.60 (–6.28, 11.71)%, P = 0.012) all demonstrated improvement in the MET group, compared with the non-MET group. Significant reduction in insulin dose, BMI, and body weight was observed in patients in MET, not those in non- MET group.
Conclusion: Additional metformin therapy improved GV in adults with T1DM, as well as improving body composition and reducing insulin requirement. Hence, metformin as an adjunctive therapy has potential prospects in reducing the CVD risk in patients with T1DM in the long term. |
| first_indexed | 2024-12-18T14:15:08Z |
| format | Article |
| id | doaj.art-ef1d315f15274b6ab16f295d1a1ff28f |
| institution | Directory Open Access Journal |
| issn | 2049-3614 |
| language | English |
| last_indexed | 2024-12-18T14:15:08Z |
| publishDate | 2021-09-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrine Connections |
| spelling | doaj.art-ef1d315f15274b6ab16f295d1a1ff28f2022-12-21T21:05:03ZengBioscientificaEndocrine Connections2049-36142021-09-0110910451054https://doi.org/10.1530/EC-21-0146Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trialXiuzhen Zhang0Dan Xu1Ping Xu2Shufen Yang3Qingmei Zhang4Yan Wu5Fengyi Yuan6Department of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaDepartment of Endocrinology and Metabolism, Shenzhen People’s hospital, The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, ChinaIntroduction: Metformin has been demonstrated to enhance cardioprotective be nefits in type 1 diabetes (T1DM). Although glycemic variability (GV) is associated with increased risk of CVD in diabetes, there is a scarcity of research evalua ting the effect of metformin on GV in T1DM. Objectives: In the present study, the effects of adjuvant metformin therapy on GV and metabolic control in T1DM were explored. Patients and methods: A total of 65 adults with T1DM were enrolled and subjected to physical examination, fasting laboratory tests, and continuous glucose monitoring, and subsequently randomized 1:1 to 3 months of 1000–2000 mg metformin daily add-on insulin (MET group, n = 34) or insulin (non-MET group, n = 31). After, baseline measurements were repeated. Results: The mean amplitude of glycemic excursions was substantially reduced in MET group, compared with non-MET group (–1.58 (–3.35, 0.31) mmol/L vs 1.36 (–1.12, 2.24) mmol/L, P = 0.004). In parallel, the largest amplitude of glycemic excursions (–2.83 (–5.47, –0.06) mmol/L vs 0.45 (–1.29, 4.48) mmol/L, P = 0.004), the s.d. of blood glucose (–0.85 (–1.51, 0.01) mmol/L vs –0.14 (–0.68, 1.21) mmol/L, P = 0.015), and the coefficient of variation (–6.66 (–15.00, 1.50)% vs –1.60 (–6.28, 11.71)%, P = 0.012) all demonstrated improvement in the MET group, compared with the non-MET group. Significant reduction in insulin dose, BMI, and body weight was observed in patients in MET, not those in non- MET group. Conclusion: Additional metformin therapy improved GV in adults with T1DM, as well as improving body composition and reducing insulin requirement. Hence, metformin as an adjunctive therapy has potential prospects in reducing the CVD risk in patients with T1DM in the long term.https://ec.bioscientifica.com/view/journals/ec/10/9/EC-21-0146.xmlcontinuousglucosemonitoringglycemic variabilitymetformintype 1 diabetes mellitus |
| spellingShingle | Xiuzhen Zhang Dan Xu Ping Xu Shufen Yang Qingmei Zhang Yan Wu Fengyi Yuan Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial Endocrine Connections continuous glucose monitoring glycemic variability metformin type 1 diabetes mellitus |
| title | Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial |
| title_full | Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial |
| title_fullStr | Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial |
| title_full_unstemmed | Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial |
| title_short | Metformin improves glycemic variability in adults with type 1 diabetes mellitus: an open-label randomized control trial |
| title_sort | metformin improves glycemic variability in adults with type 1 diabetes mellitus an open label randomized control trial |
| topic | continuous glucose monitoring glycemic variability metformin type 1 diabetes mellitus |
| url | https://ec.bioscientifica.com/view/journals/ec/10/9/EC-21-0146.xml |
| work_keys_str_mv | AT xiuzhenzhang metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial AT danxu metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial AT pingxu metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial AT shufenyang metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial AT qingmeizhang metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial AT yanwu metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial AT fengyiyuan metforminimprovesglycemicvariabilityinadultswithtype1diabetesmellitusanopenlabelrandomizedcontroltrial |