Newcastle, UK—While metformin is the most common medication prescribed to patients with type 2 diabetes, it usually isn’t recommended for patients with type 1 diabetes.
A new clinical trial published recently in the journal, Cardiovascular Diabetology, potentially could change that.
Newcastle University researchers report that metformin, an inexpensive treatment that is often used for type 2 diabetes to lower blood sugar levels by reducing glucose production in the liver, can promote the ability to repair damaged blood vessels by increasing vascular stem cells in type 1 diabetes patients.
Background information in the article notes that cardiovascular disease (CVD) accounts for more than half of all deaths in patients with diabetes.
“As the outcomes of heart disease are worse in diabetic vs. non-diabetic patients, there is a need to identify additional treatment options,” explained lead investigator Jolanta Weaver, MD, Senior Lecturer in Diabetes Medicine at Newcastle University and Honorary Consultant Diabetologist at Queen Elizabeth Hospital, Gateshead.
For the open label and parallel standard treatment study, 23 type 1 diabetes patients without overt CVD were treated with metformin for eight weeks, matched with nine type 1 diabetes patients on standard treatment (SG) and 23 age- and sex-matched healthy volunteers (HC). Insulin dose was adjusted to keep unchanged glycemic control.
Results indicate that metformin improved circulating endothelial progenitor cells (cEPCs), pro-angiogenic cells (PACs), colony forming units (CFU-Hill’s colonies) number, circulating endothelial cells (cECs) and PACs adhesion (p < 0.05-all variables) to levels seen in healthy volunteers without a change in HbA1c and glucose variability.
“Metformin has potential cardio-protective effect through improving cEPCs, CFU-Hill’s colonies, cECs, PACs count and function independently of hypoglycemic effect,” study authors conclude. “This finding needs to be confirmed by long term cardiovascular outcome studies in type 1 diabetes.”
"Our research is an exciting step forward as it may have positive clinical implications for patients with increased risk of cardiovascular disease by improving their treatment options,” Weaver added in a University of Newcastle press release. “For the first time, this study has shown metformin has additional benefit beyond improving diabetes control when given to patients with relatively well controlled Type 1 diabetes.”
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