Metformin May Not Help Overweight Adolescents With Type 1 Diabetes

Metformin is the most widely prescribed diabetes medicine in the world, with more than 61 million prescriptions filled in 2012 in the United States alone. But according to a recent study, the drug may not improve blood sugar levels in overweight teens with Type 1 diabetes.

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Metformin works by decreasing the amount of glucose made by the liver and by improving insulin sensitivity in the liver, muscle, and fat cells. To assess how safe and effective the medicine is in overweight adolescents with Type 1, researchers from the Jaeb Center for Health Research randomly assigned 140 youth ages 12 to 19 who’d had diabetes for an average of seven years to take either metformin (2,000 milligrams a day or less) or placebo (inactive treatment) along with their insulin for six months.

Although there was a small benefit on HbA1c (a measure of blood sugar control over 2–3 months) early on in those taking metformin, the researchers found that this benefit disappeared by the study’s end, with participants in both groups ultimately experiencing an HbA1c increase of approximately 0.2%. The researchers suggest that it seems unlikely that different results would have been achieved with a longer treatment period. Additionally, metformin did not improve various heart health markers, such as blood pressure and cholesterol levels, and it was associated with increased gastrointestinal issues compared to placebo.

“These results do not support prescribing metformin to adolescents to improve glycemic control,” according to the researchers.

However, according to endocrinologist Spyros Mezitis, MD, PhD, who was not involved with the study, the medicine did offer the youth some benefits, including decreasing the amount of insulin they used and being associated with weight loss. Metformin also reduces insulin resistance and appetite and lessens glucose production by the liver, he notes, suggesting that more trials are necessary to evaluate the effects of the drug in overweight adolescents with Type 1 diabetes before prescribing practices are changed.

For more information, read the article “Metformin May Not Help Obese Teens With Type 1 Diabetes” or see the study abstract in The Journal of the American Medical Association. And for more information about metformin, see the article “Metformin: The Unauthorized Biography,” by diabetes educator Wil Dubois.

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