UMMS Affiliation

Division of Pediatric Endocrinology, Department of Pediatrics; Department of Quantitative Health Sciences

Document Type

Data

File Format & Size

.xlsx (54 KB)

Identifier

Clinical trial identification number: ClinicalTrial.gov NCT01334125

Funders

This study was supported by an investigator-initiated research grant to Benjamin U. Nwosu from Novo Nordisk, Inc. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Keywords

type 1 diabetes mellitus, biguanides, metformin, insulin resistance, cardiovascular risk

Description

This dataset is the primary data source for a manuscript submitted for publication.

Manuscript abstract:

Context: The cardiovascular effect of adjunctive metformin therapy in overweight/obese youth with type 1 diabetes (T1D) is unknown.

Objective: To compare the effect of prolonged, adjunctive metformin vs. placebo therapy on markers of cardiovascular risk in overweight/obese youth with T1D based on differences in total cholesterol (TC)/ high-density lipoprotein (HDL) ratio, triglycerides (TG)/HDL ratio, Atherogenic Index of Plasma (AIP) log [TG/HDL] ratio, adiponectin/leptin ratio, and 25-hydroxyvitamin D [25(OH)D] concentration.

Hypothesis: Adjunctive metformin therapy will improve markers of cardiovascular health in overweight/obese youth with T1D.

Setting: University outpatient facility.

Design and Participants: A 9-mo randomized, double-blind, placebo-controlled trial of metformin (1000 mg daily) and placebo in 28 subjects (13m/15f) of ages 10-20years (y), with HbA1c >8%, BMI >85%, and T1D > 12 months. The metformin group consisted of 15 subjects (8 m/7f), of age 15.0±2.5 y; while the control group consisted of 13 subjects (5m/8f), of age 14.5±3.1y. Participants employed a self-directed treat-to-target insulin regimen based on a titration algorithm of (-2)-0-(+2) units to adjust long-acting insulin dose every 3rd day from -3 mo through +9 mo to maintain fasting plasma glucose between 90-120 mg/dL.

Results: After adjusting for age, gender, BMI, and baseline values, the metformin group had a clinically significant reduction in TC/HDL of 0.5 unit: 3.5[3.0-4.1] vs. 4.0 [3.3-4.4] (p=0.578); and TG/HDL of 1.0 unit, 2.6 [1.1-4.3] vs. 3.6 [2.0-5.2] (p=0.476); and AIP of 0.44 unit: -0.23 ± 0.9 vs. 0.21 ± 0.8 (p=0.251). Conversely, the metformin group had a clinically significant elevation in adiponectin/leptin ratio of 0.8 unit: 2.0[0.84-3.2] vs. 1.2[0.11-2.3], (p=0.057); and a mean serum 25(OH)D in the vitamin D sufficiency range, 31.3 ng/mL [22.3-40.4] compared to the placebo group's lower mean 25(OH)D of 25.8 ng/mL [14.1-35.9], (p=0.337).

Conclusions: Prolonged adjunctive metformin therapy may be cardio-protective in overweight/obese youth with T1D.

Methodology

Methodology is documented in manuscript.

Publisher

eScholarship@UMMS

Language

eng

Code Lists

The code list for this dataset is available under "Additional Files."

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Nwosu T1DM Dataset Code List Oct2015.pdf (19 kB)
Nwosu T1DM Dataset Code List

.xlsx (54 KB)

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