The improvement of metabolic control after using metformin in patients with type 1 diabetes mellitus and excessive visceral fat tissue treated with intensive insulin therapy—pilot study

Abstract

The use of exogenous insulin and incorrect nutritional habits are conducive to obesity and excess weight. This leads to the development of insulin resistance, even in patients with type 1 diabetes mellitus. The aim of this study was to assess the effects of metformin as adjunctive therapy on anthropometric parameters and metabolic control in patients with type 1 diabetes mellitus. The study included a group 45 patients with elevated adipose tissue content as measured by electrical bioimpedance. Thirty-nine patients (11 males and 28 females) of the group fulfill the study protocol. The mean age was 33.5 ± 11.9 years and duration of diabetes 12.6 ± 7.4 years. Metformin was administered for at least 6 months at a mean dose of 1032 ± 718 mg/day. Application of metformin resulted in a statistically significant reduction in total adipose tissue (4.8 ± 4.0 vs. 2.9 ± 4.4 kg, p = 0.03), waist circumference (96.4 ± 9.5 vs. 89.1 ± 11.1 cm, p = 0.003), and VAI (4.1 ± 2.4 vs. 2.5 ± 1.8, p = 0.006). Reduction in insulin requirement (0.7 ± 0.1 vs. 0.6 ± 0.2 units/kg/day, p = 0.02), fasting glycemia (166.5 ± 52.5 vs. 135.7 ± 48 mg/dl, p = 0.01), and postprandial glycemia (196.9 ± 74.3 vs. 137.1 ± 37.5 mg/dl, p = 0.00002) was also observed. In addition, decrease in triglyceride serum concentration (128.2 ± 52.9 vs. 94.0 ± 32.1 mg/dl, p = 0.002) and non-HDL cholesterol (154.5 ± 41.3 vs. 130.0 ± 39.7 mg/dl, p = 0.01) was achieved. Addition of metformin to insulin therapy of patients with type 1 diabetes mellitus and elevated adipose tissue content is safe and may lead to measurable clinical benefits.