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The DOI matches its Crossref record; 75 of the 77 references it cites were found in a registry or an index.

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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Research works printed but not linked: 11

  1. The National Collaborating Centre for Chronic Conditions (2008) Type 2 diabetes. National clinical guidelines for management in primary and secondary care (update). Royal College of Physicians, London
  2. International Diabetes Federation Clinical Guidelines Task Force (2005) Global guidelines for type 2 diabetes. International Diabetes Federation, Brussels
  3. Walravens PA, Chase PH, Klingensmith GJ, Ellison M, Cornell C, Monahan K (2000) Low dose metformin in adolescents with type 1 diabetes mellitus: a double blind, controlled study. Diabetes 49(Suppl 1):A128 (Abstract)
  4. Keen H, Collins ACG, Bending JJ (1987) Metformin increases response to insulin in type-1 (insulin-dependent) diabetes. Diabetologia 30:A538 (Abstract)
  5. Ahmed AE, Home PD, Marshall SM (2001) Effect of metformin in blood glucose control on people with type 1 diabetes. Diabetes 50(Suppl 2):A430 (Abstract)
  6. Melga P (1989) Usefulness and rationale of combined therapy with insulin and metformin in insulin-dependent diabetes (type I). G Ital Diabetol 9:247–253
  7. Tan AB, Bandyopadhyay S, Brake J, Weston PJ (2006) Effects of metformin in type 1 diabetes mellitus. Diab Med 23(Suppl 2):111 (Abstract)
  8. Alves C (2006) Metformin as an adjunctive therapy to insulin in adolescents with type 1 diabetes mellitus. Revista Brasileira de Medicina 63:539–543
  9. Tagliaferro V, Pagano G, Carta Q, Vitelli F, Pisu E, Cocuzza E (1981) Insulin sparing effect of metformin on insulin requirement of IDDM assessed by artificial pancreas (Biostator Ames). Diabetologia 21:333 (Abstract)
  10. Meyer L, Delbachian I, Lehert P, Cugnardey N, Drouin P, Guerci B (1999) Continuous subcutaneous insulin infusion in type 1 diabetes: insulin-sparing effect of metformin. Diabetologia 42(Suppl 1):A226 (Abstract)
  11. Jacobsen PK, Lund SS, Tarnow L et al (2007) Impact of metformin treatment on glycaemic control and cardiovascular risk-factors in patients with poorly controlled type 1 diabetes (T1DM). Diabetologia 50(Suppl 1):S107 (Abstract)

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Metadata

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
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
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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