Insulin Sensitizers for Type 1 and Type 2 Diabetes

A number of fascinating reports discussed treatment with metformin. Jones and colleagues studied 82 children with type 2 diabetes aged 10 to 16 years who had an average HbA1c of 8.6%, fasting glucose of 182 mg/dL, and weighing 92 kg. Results of this study showed that metformin at a dose of 500-1000 mg twice daily lowered fasting glucose levels by 43 mg/dL in 40 patients. Patients in the control group (n = 30) experienced an average 21 mg/dL increase in blood glucose levels. Metformin treatment did not produce a change in body weight, suggesting that it should be used in the treatment of pediatric type 2 diabetes. In another fascinating study of pediatric diabetes, Walravens and colleagues studied 80 teenagers with poorly controlled type 1 diabetes, with mean HbA1c of 9.6%, despite treatment with > 1 unit insulin/kg body weight. Metformin 500 mg twice daily was given to half of these patients. Assessment at 3 months showed that compared with placebo, metformin decreased HbA1c (9.4%vs 8.7%), decreased mean blood glucose (224 vs 190 mg/dL), and decreased body weight (70 vs 64 kg).