The Effect of Metformin in Overweight Patients With Dysregulated Type 1 Diabetes Mellitus

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00145379
Recruitment Status : Completed
First Posted : September 5, 2005
Last Update Posted : May 20, 2013
Information provided by:
Odense University Hospital

Brief Summary:

Patients suffering from diabetes through many years have a risk of developing late diabetic complications including changes in eyes, kidney, vessels and nerves. Late complications can be postponed or avoided when assuring a good diabetes control, i.e. sensible diet, exercise, frequent blood glucose measurements and a good medical treatment.

Blood glucose regulation depends on two different factors i.e. the insulin need of the body and the amount of insulin in the body. The amount of insulin, in blood, is decided by the amount of insulin infused daily, whereas the insulin need depends on the patient's weight, physical activity and diet. Overweight type 2 diabetes patients have a large insulin need and especially this need is decisive for their development of diabetes. If these patients are treated with Metformin, blood glucose decreases and the result is an easier weight loss for the patient. Especially, when these patients take this drug, the development of late diabetic complications, especially arteriosclerosis, can be avoided or postponed.

Whether these favourable effects of Metformin are also present in type 1 diabetic patients remains to be fully clarified, but some studies have indicated that this is the case. This results in a better regulation of diabetes on a smaller insulin dose than the one given to the patients before.

Metformin probably takes effect by increasing the glucose uptake in muscles and by reducing the hepatic glucose production. The drug usually has no side-effects, but some patients do, however, suffer from abdominal pain, small tendency to nausea, loose defaecation and a metallic taste in the mouth. These side-effects are often temporary.

Project description

In total, 50 type 1 diabetic patients are offered to participate in the project. All are from the outpatient clinic at the Department of Endocrinology. The project lasts 7 months divided as follows:

  1. An introductory period of one month introducing an optimisation of the insulin treatment
  2. A 6 month period (in which neither the patients nor the treating doctor know which medication is given) with either T. Metformin treatment twice daily or T. Placebo (lime) twice daily together with the usual insulin treatment four times daily.

Choice of either T. Metformin or T. Placebo will be made by draw, and as stated above, the drug type will be unknown for both the patient and the treating doctor in order to make sure that the investigation is as objective as possible.

Throughout the examination period, the patients are asked to measure blood glucose four times daily, i.e. before main meals and before bed time. These values will be used for regulating the fasting insulin dose with help from the treating doctor, and for adjusting the daily insulin dose. During the first and the last two days of the examination period we will also ask the patients to measure blood glucose at 03h00 for two days. Those diurnal profiles will be included in the evaluation of the blood glucose control during the treatment period. Furthermore, the patients' blood pressures are determined during 24 hours before and after the 6 months' treatment period. This will be carried out automatically by means of a blood pressure cuff around the arm connected to a small apparatus registering the values during 24 hours. The apparatus can be taken home after installation at the outpatient clinic and can be carried around in a belt around the waist until next day where the apparatus will be dismantled.

At the first and the last of 5 outpatient visits, blood tests will be taken (for evaluation of the long-term blood glucose, kidney, liver, insulin and fat in blood) and nocturnal urine must be collected and disposed in order to evaluate protein secretion and thereby kidney function.

Condition or disease Intervention/treatment Phase
Type 1 Diabetes Mellitus Drug: Tablet Metformin 500 mg Drug: Placebo Phase 4

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 42 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double
Primary Purpose: Prevention
Official Title: The Effect of Metformin in Overweight Patients With Dysregulated Type 1 Diabetes Mellitus
Study Start Date : March 2003
Actual Study Completion Date : June 2006

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Diabetes Type 1

Arm Intervention/treatment
Experimental: Metformin Drug: Tablet Metformin 500 mg
Placebo Comparator: Placebo comparator Drug: Placebo

Primary Outcome Measures :
  1. HbA1c after the two intervention periods

Secondary Outcome Measures :
  1. Insulin need, hypoglycaemia frequence, body weight, lipid profile, blood pressure after the two intervention periods

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients with type 1 diabetes mellitus treated with insulin 4 times daily.
  • Age: 18-60 years
  • Fertile women use adequate contraception, e.g. contraceptive pills
  • C-peptide <300 pmol/L
  • BMI >/= 25
  • HbA1c >/=8%

Exclusion Criteria:

  • Pregnant and patients planning to become pregnant during the investigation period
  • Reduced eyesight
  • Known kidney disease, s-creatinin >100
  • Liver disease, Alat > 50
  • Neuropathic patients diagnosed by clinical examination

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00145379

Diabetes Research Center
Odense, Funen, Denmark, 5000
Sponsors and Collaborators
Odense University Hospital
Principal Investigator: Iben Brock Jacobsen, MD Odense University Hospital Identifier: NCT00145379     History of Changes
Other Study ID Numbers: 006
First Posted: September 5, 2005    Key Record Dates
Last Update Posted: May 20, 2013
Last Verified: May 2013

Keywords provided by Odense University Hospital:
type 1 diabetes mellitus
insulin resistance
randomized, controlled study

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 1
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases
Body Weight
Signs and Symptoms
Hypoglycemic Agents
Physiological Effects of Drugs