A Study On The Effect Of Metformin Combined With Insulin In Overweight Patients With Type 1 Diabetes Mellitus

Dr. Rana R.K.Singh; Dr.(Prof.) M.P.Singh

Volume : VIII, Issue : IV, April - 2019

A Study On The Effect Of Metformin Combined With Insulin In Overweight Patients With Type 1 Diabetes Mellitus

Dr. Rana R. K. Singh, Dr. Prof. M. P. Singh

Abstract :

Many patients with type–1 diabetes (T1DM) have longstanding inadequate glycemic control, despite intensive insulin treatment. Metformin is an Oral Hypoglycaemic Agent that improves insulin action in Patients with type– 2 diabetes. In a randomized double blind cross over study , We investigated the effect of a 24 wk treatment with Metformin versus Placebo in overweight patients with T1DM and persistent Inadequate Glycemic control. Methods: Double–blinded intervention with 850 mg thrice daily Metformin or Placebo daily in 108 overweight type 1 diabetic patients as adjunct to intensive insulin therapy. Primary endpoint was HbA1c, while secondary endpoints were profile of body weight, frequency of Hypoglycaemia, Blood pressure, Lipids, Total Insulin dosage and self–monitored Blood Glucose . Results: After 24 weeks, HbA1c was significantly lower after treatment with Metformin (7.6 ± 1.0% ) compared with baseline( 8.3± 1.2%, p <0.005) and Placebo (8.4±1.1% , p<0.005). Fasting blood glucose were significantly lower in Metformin group after 24 wks (8.4± 2.8 mmol/l) in comparison with baseline 12.3± 3.0 mmol/l; p<0.01) and Placebo after 24 weeks (12.6± 3.4 mmol/l; p<0.01). The Total Daily Insulin dose (IU) was significantly reduced in the Metformin group compared to placebo after 24 weeks (53.1 ±10units vs. 57.1± 14; p<0.05). A reduction in body weight was found using Metformin compared to Placebo (3.5 ± 1.2 vs. 0.9 ± 1.2, p<0.05). Lipids and Blood pressure did not differ significantly after intervention. Metformin, as adjunct to intensive Insulin therapy, was associated with a reduction in the total daily insulin dose and a significant weight loss in patients with type 1 diabetes mellitus. Conclusion: Metformin can improve Glycemic control effectively, reduce Total Insulin dose and cause weight reduction in overweight people with type 1 diabetes mellitus