- Young people with type 1 diabetes (T1D) experience improved insulin resistance (IR) after 3 months of taking metformin, regardless of BMI, aortic/carotid factors, or insulin dose.
- These youth have early signs of cardiovascular disease (CVD) compared with their unaffected peers in the EMERALD trial.
Why this matters
- The authors say their findings point to metformin as CVD protective.
- T1D group had altered aortic measures vs control group.
- Glucose infusion rate/insulin (M/I)/kg better with drug vs placebo, adjusted for sex, puberty, BMI change:
- 11.5±3.4 vs −1.3±3.91 mg/kg/minute (P=.03).
- M/I also improved per lean kilogram with metformin vs placebo, with adjustment:
- 7.4±9.6 vs −14.3±9.8 mg/lean kg/minute (P=.01).
- Metformin offered improvements vs placebo in:
- body weight (−0.5±0.5 vs 1.6±0.5 kg; P=.004),
- BMI (−0.2±0.15 vs 0.4±0.15 kg/m2; P=.005), and
- fat mass (−0.7±0.3 vs 0.6±0.4 kg; P=.01).
- Groups did not differ for HbA1c, BP, cholesterol, triglycerides.
- Aortic parameters improved with metformin vs placebo:
- stiffness: P=.04; and
- wall shear stress: P=.03.
- Adherence 93% in both groups.
- Adverse events: minor gastrointestinal complaints.
- N=48 with T1D (ages 12-21 years) vs 24 without T1D.
- Outcomes: IR, aortic parameters, lipids, body weight.
- Funding: NIH; others.
- Brief, small, limited population.