Metformin in type 1 diabetes diabetescarenet _ diabetescare. net

When I first started working with teens and adolescents with type 1 diabetes sixteen years ago, “insulin resistance” and “overweight” were not common terms used for this population. Type 1 diabetes symptoms adults Fast forward to today and it is becoming a more prevalent occurrence. Type 1 diabetes life expectancy While metformin is an off-label use for patients with type 1 diabetes, several studies have identified a positive effect on weight loss, insulin sensitivity, and reduction in insulin doses.

Type 1 diabetes nhs A systematic review was published in 2010 and concluded that metformin was associated with reductions in insulin dose requirements by as much as 5-10 units per day and A1C by 0.6-0.9 percent. Type 1 diabetes insulin resistance (1) A Cochrane Library review published in 2009 also concluded similar findings. Type 1 diabetes pregnancy symptoms (2) In our clinic at the University of Chicago Kovler Diabetes Center, it has become a common practice to use metformin with type 1 adolescent females to aid in reducing weight and insulin requirements. Difference between type1 and type 2 diabetes mellitus The studies to date used 1000-2550mg/day, with benefits to weight and glucose control while using 2000 mg/day. Type 1 diabetes complications timeline To illustrate the benefits of adding metformin to an adolescent with type 1 diabetes, I will present the case of a 14-year old female with type 1 diabetes at our clinic. She was diagnosed with type 1 diabetes at age 9; her A1Cs for the past five years have ranged between 9-11 percent; total insulin dose: 40units; consuming <120 grams carbohydrate per day; height: 5’2”; weight: 147 lbs. Type 1 diabetes insulin dosing She has also been on the Omnipod insulin pump for three years. Starting in August 2012, metformin was initiated. Type 1 diabetes symptoms child In order to reduce the risk of gastrointestinal distress, she was initiated on 500 mg at dinner. Type 1 diabetes prognosis As long as she was tolerating the dinner dose, she added another 500 mg tablet with breakfast one week later. Gestational diabetes numbers chart The next week, if tolerated both doses, she added a second tablet at dinner to increase the dose to 1000 mg. Type 1 diabetes mellitus definition Finally, one week after that, if still tolerating, she added the final 500 mg to breakfast for a total dose of metformin of 1000 mg BID (2000 mg/day). Type 1 diabetes mellitus symptoms In the event she did not tolerate the doses on the schedule above, we would have kept her on the dose that resulted in the least amount of gastrointestinal distress. Definition of type 1 diabetes Also, we would suggest altering how she took the dose: if GI distress was occurring when she took the dose pre-meal, we would suggest that she “sandwich” the dose with her meal: eat a little bit, then take the dose and continue eating. Late onset type 1 diabetes symptoms This technique has reduced GI distress in many of our patients. She did admit that on some occasions– which occurs 20 to 30 percent of the time for similar patients on this regimen, especially on weekends–she forgot to take her morning metformin dose, but this did not have a negative effect on her insulin dose during the day. Reversing type 1 diabetes naturally All her basal rates were decreased by 0.1-0.15 units and her carbohydrate ratios were adjusted from 1:4 to 1:7; her correction factor was also adjusted from 1:30>120 to 1:45>120. Signs of type 1 diabetes in child Her overall weight loss since August 2012 was 9 lbs.; insulin dose change was 14.2 unit reduction and A1C reduction was 2.1percent. Type 1 diabetes in babies While metformin may not be an appropriate choice for all adolescents with type 1 diabetes who are insulin resistant, it can be a cost-effective addition to a motivated teenager. (2) Abdelghaffar S, Attia AM. Type 1 diabetes statistics Cochrane Database of Systematic Reviews. Juvenile onset diabetes 2009; (1): CD006691. Difference between type1 and type 2 diabetes symptoms Metformin added to insulin therapy for type 1 diabetes mellitus in adolescents.