A new study reveals the ability of the drug metformin – used to treat patients with type 2 diabetes – to reduce the amount of insulin that patients with type 1 diabetes need to maintain blood sugar levels within the ideal range.
The study was conducted by researchers from the Garvan Institute for Medical Research in Australia, and its results were published in the journal Nature Communications on November 24, and the Eurek Alert website wrote about it.
Type 1 diabetes is considered an autoimmune disease, in which the immune system mistakenly attacks the pancreatic cells that produce insulin. As a result, people with type 1 diabetes need to take insulin for the rest of their lives to regulate blood sugar levels.
Long-term use of insulin in some people with type 1 diabetes leads to insulin resistance, where the body’s cells do not respond to the drug effectively, and this means that patients will need constantly increasing amounts of insulin to keep blood sugar levels under control.
“Insulin resistance makes regulating blood sugar levels a major challenge, and represents an underappreciated risk factor for heart disease, which is one of the biggest causes of health complications and deaths in patients with type 1 diabetes,” says Dr. Jennifer Snaith, an endocrinologist at St. Vincent’s Hospital in Sydney and a co-researcher in the study.
Unknown mechanism
The study team found that the use of metformin did not lead to improvements in insulin resistance or changes in blood sugar levels, and this indicates that it does not treat insulin resistance in patients with type 1 diabetes as it does in type 2 diabetes, but it may reduce the amount of insulin that patients need to maintain stable blood sugar levels.
The results showed that people who took metformin used approximately 12% less insulin than those who took a placebo.
“Metformin has been available in various forms for about 100 years, but its mechanism of action is still unknown,” explains a faculty member at the Garvan Institute of Medical Research, head of the Department of Diabetes and Endocrinology at St. Vincent’s Hospital in Sydney, and study co-researcher, Professor Jerry Greenfield.
He added: “We expected that the observed decrease in insulin dose caused by metformin in our study was due to an increase in the body’s sensitivity to insulin, that is, a decrease in its resistance, but we have proven that this is not true. Our priority now is to find out how metformin achieves this effect.”
Greenfield considered, “There is increasing evidence indicating that metformin may affect the intestines, and for this reason we are now studying how metformin changes the intestinal bacteria in patients with type 1 diabetes,” noting that this matter has not been studied before in type 1 diabetes.
Greenfield hopes that the research will provide evidence of how metformin works, so that it can be used more widely in the management of type 1 diabetes.