Effect Of Metformin As An Add On Therapy To Type 1 Diabetes Mellitus Biology Research Paper
ADVERTISEMENT
1
2Original Research Paper
VOLUME-6 | ISSUE-2 | FEBRUARY-2017 • ISSN No 2277 - 8179 | IF : 3.508 | IC Value : 78.46
Medicine
EFFECT OF METFORMIN AS AN ADD ON
KEYWORDS:
THERAPY TO TYPE 1 DIABETES MELLITUS
ASSISTANT PROFESSOR DEPT OF MEDICINE GOVT MEDICAL COLLEGE
Dr.Shiji.P.V
CALCIUT.
ABSTRACT
AIM OF THE STUDY To evaluate whether the addition of metformin to insulin and standard diabetic
management in uncontrolled type 1 diabetic patients will results in lower insulin dosage, lower glycosylated
haemoglobin, and fasting glucose. METHODOLOGY In a prospective randomized conrol study 52 patients with uncontrolled type 1 diabetes
with no contraindication for metformin therapy who attended diabetic clinic and medicine OP of Medical College, Trivandrum, were divided
into 2 groups. One group received the usual insulin regime for the control of DM and the other group received metformin in addition to the
insulin treatment. e primary outcome was effective control of fasting and post prandial blood sugar. RESULTS Analysis of all the subjects
completing the trial demonsrated significant (P<0.05) improvement in HbA1c of 0.5% in the metformin group. Compared to insulin only
group. ere was decrease in glycosylated haemoglobin of 1.8 +o 0.68 units in the metformin group. Compared to the insulin in only group and
a decrease 1.382 + 0.741 in the insulin only group. CONCLUSION us the present study indicate that metformin when added to insulin in
uncontrolled type 1 diabetes mellitus improves insulin sensitivity.
INTRODUCTION
weighing <50kg and 1500 mg/day for those weighing 50 to 75mg,
during the 2 weekly visits fasting and post prandial blood sugars
Diabetes mellitus is one of the oldest diseases affecting man. Ever
since its description this disease and the widening spectrum of its
(after insulin and food) were measured and insulin dosage was
complications have been the field of intense interest and study. In
adjusted in the insulin group (10% increments or decrements to keep
blood sugar in the target range. In the insulin + metformin group the
dealing with chronic disease like diabetes, management strategies
metformin dosage was increased and insulin dosage was reduced to
should ideally aim at preventing the long term complications or
atleast. Intervening early to prevent their progression. Several trials
keep blood sugar in the target range (4-8mmol/l). Phone contact was
made weekly with the study subjects for review of side effects and to
have shown that a strict glycemic control reduced clinically
facilitate insulin dose adjustment. At each visit every 2 weeks height,
important progression of complications. us the relationship
between good glycemic control and the prevention of diabetic
weight, body mass index, blood pressure, were performed to monitor
complications in patients with type 1 diabetes mellitus. Is well
side effects. Estimation of creatinine and liver enzymes were made
monthly.
established in the light of the above study the field of interest has
been diverted to methods of attaining strict glycemic control in tpe 1
diabetes mellitus. It is in this contest that the effect of metformin as
Estimation
Glycosylated haemoglobin was done at the start of intervention and
an adjunct therapy in uncontrolled type 1 diabetes mellitus gains
at the end of the study.
importance. ere have been some studies in the west on the effect of
metformin in uncontrolled type 1 diabetes mellitus. e present
study is an effort to evaluate the effect of metformin in type 1 diabetes
Statistical Analysis
A total of 52 patients were selected for the present study.
mellitus in the Indian setup.
Comparisons between the insulin only group and insulin +
metformin group for the variables like age group, duration of
MATERIALS AND METHODS
diabetes, body mass index, glycosylated haemoglobin, insulin
Selection of patients :
dosage, fasting plasma glucose using Student's t test. Associations
e present study included 52 patients chosen from inpatient and
between the variables were found out by employing Chi square
out patient department from Medical College, Trivandrum in the
statistics. Statistical analysis performed using SPSS 10 software for
year 2001 November to 2003 November. ose paitents who were
windows.
detected to have diabetes mellitus before 15 years of age and those
with c peptide level <0.17 picomol/l were chosen for the study. All the
RESULTS
patient had a suboptimal metabolic control as evidenced by
Table - 1
glycosylated haemoglobin >8% and insulin dosage > IU/kg/day for
Baseline demographic an clinical characteristics of the study
prior 1 month. e exclusion crieraia for the study included serum
group
creatinine >2mg%, proliferative retinopathy, hepatic dysfunction, > 3
episodes of diabetic ketoacidosis / year, cardiac dysfunction or
Insulin only
Insulin + Metformin
another serious coexisting medical illness.
Number of patients
28
24
Protocol
Age (mean in yrs)
20.3 + 1.4
19.4 + 1.8
e protocol was approved by research ethical committee of Medical
College Hospital, Trivandrum. Written informed consent was
Sex Male
16
9
obtained from all participants or from the parents in case the
Female
12
15
patients were minor.
Duration of diabetics
11.9 + 2.2
10.9 + 3.2
Subjects underwent a 1 month run in period to screen for
Weight (kg)
44
42.5
complications, to update patient education, optimize insulin
2
BMI (kg/m )
22 + 1.2
19 + 1.8
therapy (all patients were started on human insulin), and to assess
HbA 1c (%)
9.41 + 1.52
10.64 + 1.70
the subjects ability to comply with the protocol. At the end of the run
in period subjects were randomized either to the metformin + insulin
I n s u l i n d o s a g e (u n i t s
1.6 + 0.8
1.2 + 0.28
group or to insulin only group. e subjects were assessed every 2
/kg/day)
weeks during the 3 months active phase. Medication ie metformin
Initial FPG (mg/%)
220 + 2
240 + 2.5
was given with meals to minimize gastro intestinal tract side effects.
Starting dose was 500mg/day (at breakfast) and was increased by 500
mg/day every 2 weeks to a maximum of 1000mg/day for those
IJSR - INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
107
ADVERTISEMENT
0 votes
Related Articles
Related forms
Request For Designation As An Exempt Organization Pursuant To Subdivision Form - State Of California Department Of Corporations
Legal
The Effect Of Alternative Partial Benefits Formulas On Beneficiary Part-time Work Behavior - U.s. Department Of Labor - 1979
Legal
