Moon R J, Bascombe L-A, Holt R I G
Diabetes Obes Metab. 2007 Jan;9(1):143-5. doi: 10.1111/j.1463-1326.2006.00599.x.
As many overweight people with T1DM are insulin resistant, adjuvant therapy with insulin sensitising agents, such as metformin, may be beneficial. This study evaluated the effect of adjuvant metformin in T1DM on insulin sensitivity, diabetic control, body composition, quality of life (QOL) and treatment satisfaction.
A 3-month prospective open-labelled pilot study of 16 patients aged 18-40 with T1DM and body mass index (BMI) >25 kg/m(2) was performed. The patients received 500-850 mg metformin twice daily. Insulin sensitivity, assessed by a frequently sampled intravenous glucose tolerance test [n=5], body composition, HbA(1c) and quality of life (QOL) were measured before and after treatment. A retrospective review of 30 patients with T1DM treated with metformin for at least 4 months was also performed. BMI, HbA(1c) and insulin requirements during metformin treatment was compared to pre-metformin data, and to patients treated with insulin only.
In the pilot study, insulin sensitivity increased significantly from 0.86 +/- 0.33 x 10(-4)/min/(microU/ml) to 1.17 +/- 0.48 x 10(-4)/min/(microU/ml) after 3 months adjuvant therapy (p = 0.043). This was associated with a decreased insulin requirement and mean daily blood glucose. There were no significant changes in HbA(1c) or body composition. QOL significantly improved (p < 0.002). The retrospective review revealed an initial reduction in HbA(1c) (0.8 +/- 1.4%, p = 0.001). This effect diminished with prolonged treatment. BMI decreased in patients remaining on metformin for a 2-year period (0.5 +/- 0.5kg/m(2), p = 0.042).
Adjuvant metformin can improve QOL, insulin sensitivity and glycaemic control in overweight adults with T1DM.
由于许多1型糖尿病超重患者存在胰岛素抵抗，使用胰岛素增敏剂（如二甲双胍）进行辅助治疗可能有益。本研究评估了辅助使用二甲双胍治疗1型糖尿病对胰岛素敏感性、血糖控制、身体成分、生活质量（QOL）和治疗满意度的影响。
对16例年龄在18 - 40岁、1型糖尿病且体重指数（BMI）>25 kg/m²的患者进行了一项为期3个月的前瞻性开放标签试验研究。患者每天两次服用500 - 850毫克二甲双胍。在治疗前后测量胰岛素敏感性（通过频繁采样静脉葡萄糖耐量试验评估[n = 5]）、身体成分、糖化血红蛋白（HbA1c）和生活质量（QOL）。还对30例接受二甲双胍治疗至少4个月的1型糖尿病患者进行了回顾性研究。将二甲双胍治疗期间的BMI、HbA1c和胰岛素需求量与使用二甲双胍前的数据以及仅接受胰岛素治疗的患者进行比较。
在试验研究中，经过3个月的辅助治疗后，胰岛素敏感性从0.86±0.33×10⁻⁴/min/（微单位/毫升）显著增加至1.17±0.48×10⁻⁴/min/（微单位/毫升）（p = 0.043）。这与胰岛素需求量和每日平均血糖的降低相关。HbA（1c）或身体成分无显著变化。生活质量显著改善（p < 0.002）。回顾性研究显示糖化血红蛋白（HbA1c）最初有所降低（0.8±1.4%，p = 0.001）。随着治疗时间延长，这种效果逐渐减弱。持续服用二甲双胍2年的患者体重指数（BMI）下降（0.5±0.5kg/m²，p = 0.042）。
辅助使用二甲双胍可改善超重1型糖尿病成人的生活质量、胰岛素敏感性和血糖控制。
