Effect of adjunct metformin treatment on levels of plasma lipids in patients with type 1 diabetes

S.S. Lund; L. Tarnow; A.S. Astrup; P. Hovind; P.K. Jacobsen; A.C. Alibegovic; I. Parving; L. Pietraszek; M. Frandsen; P. Rossing; Hans-Henrik Parving; Allan Vaag

doi:10.1111/j.1463-1326.2009.01079.x

Effect of adjunct metformin treatment on levels of plasma lipids in patients with type 1 diabetes

S.S. Lund, L. Tarnow, A.S. Astrup, P. Hovind, P.K. Jacobsen, A.C. Alibegovic, I. Parving, L. Pietraszek, M. Frandsen, P. Rossing, Hans-Henrik Parving, Allan Vaag

34 Citations (Scopus)

Abstract

BACKGROUND: In addition to its glucose-lowering effect, metformin treatment has been suggested to improve lipidaemia in patients with type 2 diabetes. In contrast, in patients with type 1 diabetes (T1DM), information about the effect of metformin treatment on lipidaemia is limited. In this study, we report the effect of a 1-year treatment with metformin vs. placebo on plasma lipids in T1DM patients and persistent poor glycaemic control. METHODS: One hundred T1DM patients with haemoglobinA(1c) (HbA(1c)) > or =8.5% during the year before enrolment entered a 1-month run-in period on placebo treatment. Thereafter, patients were randomized (baseline) to treatment with either metformin (1000 mg twice daily) or placebo for 12 months (double masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. Outcomes were assessed at baseline and after 1 year. RESULTS: After 1 year, in those patients who did not start or stop statin therapy during the trial, metformin treatment significantly reduced total and LDL cholesterol by approximately 0.3 mmol/l compared with placebo (p = 0.021 and p = 0.018 respectively). Adjustment for statin use or known cardiovascular disease did not change conclusions. In statin users (metformin: n = 22, placebo: n = 13), metformin significantly lowered levels of LDL and non-HDL cholesterol by approximately 0.5 mmol/l compared with placebo (adjusted for changes in statin dose or agent: p = 0.048 and p = 0.033 respectively). HbA(1c) (previously reported) was not significant different between treatments. CONCLUSION: In patients with poorly controlled T1DM, at similar glycaemic levels, adjunct metformin therapy during 1 year significantly lowered levels of proatherogenic cholesterolaemia independent of statin therapy.

Original language	English
Journal	Diabetes, Obesity and Metabolism
Volume	11
Issue number	10
Pages (from-to)	966-77
Number of pages	11
ISSN	1462-8902
DOIs	https://doi.org/10.1111/j.1463-1326.2009.01079.x
Publication status	Published - 2009

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10.1111/j.1463-1326.2009.01079.x

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Lund, S. S., Tarnow, L., Astrup, A. S., Hovind, P., Jacobsen, P. K., Alibegovic, A. C., Parving, I., Pietraszek, L., Frandsen, M., Rossing, P., Parving, H-H., & Vaag, A. (2009). Effect of adjunct metformin treatment on levels of plasma lipids in patients with type 1 diabetes. Diabetes, Obesity and Metabolism, 11(10), 966-77. https://doi.org/10.1111/j.1463-1326.2009.01079.x

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title = "Effect of adjunct metformin treatment on levels of plasma lipids in patients with type 1 diabetes",

abstract = "BACKGROUND: In addition to its glucose-lowering effect, metformin treatment has been suggested to improve lipidaemia in patients with type 2 diabetes. In contrast, in patients with type 1 diabetes (T1DM), information about the effect of metformin treatment on lipidaemia is limited. In this study, we report the effect of a 1-year treatment with metformin vs. placebo on plasma lipids in T1DM patients and persistent poor glycaemic control. METHODS: One hundred T1DM patients with haemoglobinA(1c) (HbA(1c)) > or =8.5% during the year before enrolment entered a 1-month run-in period on placebo treatment. Thereafter, patients were randomized (baseline) to treatment with either metformin (1000 mg twice daily) or placebo for 12 months (double masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. Outcomes were assessed at baseline and after 1 year. RESULTS: After 1 year, in those patients who did not start or stop statin therapy during the trial, metformin treatment significantly reduced total and LDL cholesterol by approximately 0.3 mmol/l compared with placebo (p = 0.021 and p = 0.018 respectively). Adjustment for statin use or known cardiovascular disease did not change conclusions. In statin users (metformin: n = 22, placebo: n = 13), metformin significantly lowered levels of LDL and non-HDL cholesterol by approximately 0.5 mmol/l compared with placebo (adjusted for changes in statin dose or agent: p = 0.048 and p = 0.033 respectively). HbA(1c) (previously reported) was not significant different between treatments. CONCLUSION: In patients with poorly controlled T1DM, at similar glycaemic levels, adjunct metformin therapy during 1 year significantly lowered levels of proatherogenic cholesterolaemia independent of statin therapy.",

author = "S.S. Lund and L. Tarnow and A.S. Astrup and P. Hovind and P.K. Jacobsen and A.C. Alibegovic and I. Parving and L. Pietraszek and M. Frandsen and P. Rossing and Hans-Henrik Parving and Allan Vaag",

note = "Export Date: 4 November 2009Source: Scopus",

year = "2009",

doi = "10.1111/j.1463-1326.2009.01079.x",

language = "English",

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pages = "966--77",

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T1 - Effect of adjunct metformin treatment on levels of plasma lipids in patients with type 1 diabetes

AU - Lund, S.S.

AU - Tarnow, L.

AU - Astrup, A.S.

AU - Hovind, P.

AU - Jacobsen, P.K.

AU - Alibegovic, A.C.

AU - Parving, I.

AU - Pietraszek, L.

AU - Frandsen, M.

AU - Rossing, P.

AU - Parving, Hans-Henrik

AU - Vaag, Allan

N1 - Export Date: 4 November 2009Source: Scopus

PY - 2009

Y1 - 2009

N2 - BACKGROUND: In addition to its glucose-lowering effect, metformin treatment has been suggested to improve lipidaemia in patients with type 2 diabetes. In contrast, in patients with type 1 diabetes (T1DM), information about the effect of metformin treatment on lipidaemia is limited. In this study, we report the effect of a 1-year treatment with metformin vs. placebo on plasma lipids in T1DM patients and persistent poor glycaemic control. METHODS: One hundred T1DM patients with haemoglobinA(1c) (HbA(1c)) > or =8.5% during the year before enrolment entered a 1-month run-in period on placebo treatment. Thereafter, patients were randomized (baseline) to treatment with either metformin (1000 mg twice daily) or placebo for 12 months (double masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. Outcomes were assessed at baseline and after 1 year. RESULTS: After 1 year, in those patients who did not start or stop statin therapy during the trial, metformin treatment significantly reduced total and LDL cholesterol by approximately 0.3 mmol/l compared with placebo (p = 0.021 and p = 0.018 respectively). Adjustment for statin use or known cardiovascular disease did not change conclusions. In statin users (metformin: n = 22, placebo: n = 13), metformin significantly lowered levels of LDL and non-HDL cholesterol by approximately 0.5 mmol/l compared with placebo (adjusted for changes in statin dose or agent: p = 0.048 and p = 0.033 respectively). HbA(1c) (previously reported) was not significant different between treatments. CONCLUSION: In patients with poorly controlled T1DM, at similar glycaemic levels, adjunct metformin therapy during 1 year significantly lowered levels of proatherogenic cholesterolaemia independent of statin therapy.

AB - BACKGROUND: In addition to its glucose-lowering effect, metformin treatment has been suggested to improve lipidaemia in patients with type 2 diabetes. In contrast, in patients with type 1 diabetes (T1DM), information about the effect of metformin treatment on lipidaemia is limited. In this study, we report the effect of a 1-year treatment with metformin vs. placebo on plasma lipids in T1DM patients and persistent poor glycaemic control. METHODS: One hundred T1DM patients with haemoglobinA(1c) (HbA(1c)) > or =8.5% during the year before enrolment entered a 1-month run-in period on placebo treatment. Thereafter, patients were randomized (baseline) to treatment with either metformin (1000 mg twice daily) or placebo for 12 months (double masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. Outcomes were assessed at baseline and after 1 year. RESULTS: After 1 year, in those patients who did not start or stop statin therapy during the trial, metformin treatment significantly reduced total and LDL cholesterol by approximately 0.3 mmol/l compared with placebo (p = 0.021 and p = 0.018 respectively). Adjustment for statin use or known cardiovascular disease did not change conclusions. In statin users (metformin: n = 22, placebo: n = 13), metformin significantly lowered levels of LDL and non-HDL cholesterol by approximately 0.5 mmol/l compared with placebo (adjusted for changes in statin dose or agent: p = 0.048 and p = 0.033 respectively). HbA(1c) (previously reported) was not significant different between treatments. CONCLUSION: In patients with poorly controlled T1DM, at similar glycaemic levels, adjunct metformin therapy during 1 year significantly lowered levels of proatherogenic cholesterolaemia independent of statin therapy.

U2 - 10.1111/j.1463-1326.2009.01079.x

DO - 10.1111/j.1463-1326.2009.01079.x

M3 - Journal article

C2 - 19558610

SN - 1462-8902

VL - 11

SP - 966

EP - 977

JO - Diabetes, Obesity and Metabolism

JF - Diabetes, Obesity and Metabolism

IS - 10

ER -

Effect of adjunct metformin treatment on levels of plasma lipids in patients with type 1 diabetes

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