Metformin May Improve Cardiovascular Function in Adolescents With Type 1 Diabetes

From our sister publication, Contemporary Pediatrics.

Alexander Nguyen, PhD, from the University of Colorado School of Medicine, led a study showing how metformin, an oral drug traditionally used for controlling type 2 diabetes, can also help with adolescent type 1 diabetes.

Dr. Nguyen discussed how type 1 diabetes (T1D) causes higher rates of cardiovascular disease (CVD) and is the number 1 cause of T1D-related mortality, that CV dysfunction presents much earlier in T1D than previously expected, and while acute mortality rates have decreased in T1D, longer-term prevention of CVD is needed to further reduce morbidity and mortality. With this, the investigators hypothesized that metformin would improve cardiac function in youth with T1D.

The researchers used a randomized, placebo-controlled, doubled-blinded trial. They enlisted 43 T1D youth who were randomized 1:1 to 3 months of 1000 mg of metformin BID daily or placebo. Inclusion criteria included those aged 12 to 21 years, with a diabetes duration of more than 1 year, and positive T1D-associated antibodies. Methods included resting echocardiographic exams and echocardiograms obtained during exercise on a graded cycle supine ergometer. Additionally, HbA1c and lipid panel were obtained during fasting.

The study concluded that metformin may be beneficial in improving or reversing early CV dysfunction in T1D youth. It appears to improved cardiac structure and function. The investigators also suggested that a better understanding of T1D-related CVD and the benefits of improving insulin action in T1D longer-term should be investigated as a target for new treatment modalities.

Reference

Nguyen A. Metformin improves cardiac and aortic parameters in adolescents with type 1 diabetes. American Diabetes Association Scientific Sessions 2021; June 26, 2021; virtual. Accessed June 26, 2021.