26th Aug 2017
Metformin is quite frequently used off-label in type 1 diabetes to limit insulin dose requirement.
Guidelines recommend that it can improve glucose control in those who are overweight and obese but evidence in support of this is limited. Recently-published findings from the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial suggest that metformin therapy in type 1 diabetes can reduce atherosclerosis progression, weight and LDL-cholesterol levels. This provides a new perspective on metformin therapy in type 1 diabetes and suggests a potential role for reducing the long-term risk of cardiovascular disease.
The recent larger trials provide a new perspective on the use of metformin in type 1 diabetes. Although there is evidence that
metformin can limit insulin dose requirement, there is little evidence to support the recommendation by current guidelines
that it can help to improve glucose control in individuals with type 1 diabetes who are overweight or obese.