Cited by 201Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

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The use of metformin in type 1 diabetes: a systematic review of efficacy

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Vella, S., Buetow, L., Royle, P., Livingstone, S., Colhoun, H. M., Petrie, J. R.·2010·Diabetologia

DOI 10.1007/s00125-009-1636-9

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Abstract

Aims/hypothesis As adding metformin to insulin therapy has been advocated in type 1 diabetes, we conducted a systematic review of published clinical trials and clinical trial databases to assess the effects on HbA(1c), weight, insulin-dose requirement and adverse effects.Methods We constructed evidence tables and fitted a fixed-effects model (inverse variance method) in order to assess heterogeneity between studies and give a crude measure of each overall treatment effect.Results Of 197 studies identified, nine involved randomisation with informed consent of patients with type 1 diabetes to metformin (vs placebo or comparator) in either a parallel or crossover design for at least 1 week. We noted marked heterogeneity in study design, drug dose, age of participants and length of follow-up. Metformin was associated with reductions in: (1) insulin-dose requirement (5.7-10.1 U/day in six of seven studies); (2) HbA(1c) (0.6-0.9% in four of seven studies); (3) weight (1.7-6.0 kg in three of six studies); and (4) total cholesterol (0.3-0.41 mmol/l in three of seven studies). Metformin was well tolerated, albeit with a trend towards increased hypoglycaemia. Formal estimates of combined effects from the five trials which reported appropriate data indicated a significant reduction in insulin dose (6.6 U/day, p < 0.001) but no significant reduction in HbA(1c) (absolute reduction 0.11%, p = 0.42). No reported trials included cardiovascular outcomes.Conclusions/interpretation Metformin reduces insulin-dose requirement in type 1 diabetes but it is unclear whether this is sustained beyond 1 year and whether there are benefits for cardiovascular and other key clinical outcomes.

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Authors: Vella, S., Buetow, L., Royle, P., Livingstone, S., Colhoun, H. M., & Petrie, J. R.
Affiliations: University of Dundee (GB)
University of Aberdeen (GB)
Corresponding author: Petrie, J. R.
ORCID: Buetow, L.
Royle, P.
Livingstone, S.
Colhoun, H. M.
Petrie, J. R.
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2010-01-08
Volume: 53
Issue: 5
Pages: 809-820
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-009-1636-9
OpenAlex: W1965620761
Cited by: 201
References: 77
Citations by year: 2026: 1 · 2025: 6 · 2024: 7 · 2023: 11 · 2022: 12 · 2021: 8 · 2020: 14 · 2019: 10 · 2018: 17 · 2017: 27 · 2016: 21 · 2015: 19 · 2014: 12 · 2013: 13 · 2012: 11
FWCI: 1.63
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Discovery Research Portal (University of Dundee) (submittedVersion)
ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
Funders: Pfizer
University of Aberdeen
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: metformin, type 1 diabetes, insulin dose reduction, HbA1c, body weight, total cholesterol, hypoglycemia, adverse effects
MeSH terms: Clinical Trials as Topic, Diabetes Mellitus, Type 1, Drug Therapy, Combination, Humans, Hypoglycemic Agents, Insulin, Metformin, Treatment Outcome

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The use of metformin in type 1 diabetes: a systematic review of efficacy

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