March 02, 2020
2 min read
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Metformin add-on ameliorates weight gain, lowers insulin requirements in type 1 diabetes

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Chinese adults with type 1 diabetes can avoid insulin-related weight gain and use less insulin by adding metformin to treatment regimens, according to findings published in the Journal of Diabetes.

“This is the first study to explore the current status and efficacy of additional metformin therapy in patients with type 1 diabetes mellitus under real-life conditions in China,” Jinhua Yan, MD, associate professor of endocrinology at the Guangdong Provincial Key Laboratory of Diabetology at the Third Affiliated Hospital of Sun Yat‐sen University in Guangzhou, China, told Healio. “Metformin is initiated more in type 1 diabetes patients with dyslipidemia or higher body mass index in current practice in China. Additional metformin has no effect on glycemic control, but it helps maintain body weight and reduce insulin dosage in adult patients with type 1 diabetes.”

Yan and colleagues used data from 76 adults who began a combination of metformin and insulin therapy (mean age, 33.7 years; 67.1% women) and 655 adults who continued to take insulin alone (mean age, 33.9 years; 57.6% women) to assess variations between baseline and 1 year in weight, height, BMI, HbA1c and insulin dosages.

Participants who took metformin with insulin weighed 56.2 kg, on average, and participants who took insulin alone weighed 53.7 kg, on average, at baseline (P < .001). Participants who took metformin with insulin had a mean BMI of 21.7 kg/m2, and participants who took insulin alone had a mean BMI of 20.4 kg/m2 at baseline (P < .001). In addition, 17.6% of those taking metformin and insulin and 9% of those taking insulin alone had dyslipidemia at baseline (P = .006).

Metformin Adobe 2019 
Chinese adults with type 1 diabetes can avoid insulin-related weight gain and use less insulin by adding metformin to treatment regimens.
Source: Adobe Stock

At 1 year, HbA1c reductions were similar for both groups. Participants on metformin plus insulin needed 0.02 IU/kg less of insulin per day vs. baseline (P = .029). Participants on insulin alone experienced no difference in dosing. BMI and body weight remained stable for participants taking metformin plus insulin at 1 year vs. a mean 0.5 kg/m2 rise in BMI and a 1.3 kg rise in body weight vs. baseline for those taking insulin alone (P < .001 for both).

“Our study showed that metformin was initiated more in type 1 diabetic patients with dyslipidemia or higher BMI in current practice in China,” the researchers wrote. “Additional metformin therapy had no effect on the glycemic control, but it could keep body weight and reduce the insulin dosage in the adult patients with type 1 diabetes.” – by Phil Neuffer

For more information:

Jinhua Yan, MD, can be reached at yanjh79@163.com.

Disclosures: The authors report no relevant financial disclosures.