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Metformin improves endothelial function in type 1 diabetic subjects: a pilot, placebo-controlled randomized study.
D Pitocco1, F Zaccardi, P Tarzia
1Diabetes Care Unit, Department of Internal Medicine, Catholic University School of Medicine, Rome, Italy.
Diabetes, Obesity & Metabolism
|November 22, 2012
Summary
Metformin improved endothelial function (FMD) and increased oxidative stress markers in type 1 diabetes patients. This pilot study suggests potential benefits beyond glycaemic control, warranting further investigation.
Area of Science:
- Cardiovascular Research
- Metabolic Disorders
- Diabetes Mellitus
Background:
- Type 1 diabetes mellitus (T1DM) is associated with endothelial dysfunction.
- Metformin is widely used for type 2 diabetes but its role in T1DM is less understood.
- Endothelial function is a key determinant of cardiovascular risk in diabetes.
Purpose of the Study:
- To evaluate the effect of metformin on endothelial function in patients with type 1 diabetes.
- To assess changes in glycaemic control, body weight, and oxidative stress markers.
- To explore the relationship between metformin's effects and clinical parameters.
Main Methods:
- A 6-month, placebo-controlled, double-blind trial involving 42 T1DM patients.
- Randomized assignment to metformin or placebo treatment.
- Assessment of flow-mediated dilation (FMD), nitrate-mediated dilation (NMD), glycaemic variability (GV), and urinary 8-iso-prostaglandin F2α (PGF2α).
Main Results:
- Metformin significantly improved FMD (p=0.013) and increased PGF2α (p=0.004) compared to placebo.
- Metformin also led to a significant reduction in body weight (p=0.012).
- No significant changes were observed in NMD, HbA1c, GV, or insulin dose.
Conclusions:
- Metformin improved endothelial function and increased a marker of oxidative stress in T1DM patients.
- These improvements occurred independently of changes in glycaemic control or body weight.
- Further randomized trials are necessary to confirm the benefits and risks of metformin as an adjunct therapy in T1DM.
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