Summary
It has been suggested that biguanides should be used in Type 1 (insulin-dependent) diabetic patients in order to diminish insulin requirements and reduce the chances of insulin reactions. The efficacy of these compounds in such patients has been controversial. We have studied the effect of metformin (850mg) given at 08.00 h in diminishing insulin needs after a 60g carbohydrate mixed meal taken at 12.00 h, using an artificial pancreas and a sequential analysis of the results. The morning test dose of metformin or placebo was preceded by 48 h treatment with metformin (850mg twice daily) or placebo. After the eighth patient a 26% saving of insulin need was demonstrated in the metformin-treated group (p<0.01). Metformin is thus effective in reducing post-prandial insulin needs in Type 1 diabetic patients, although its use in such circumstances requires consideration of several other issues.
Article PDF
Similar content being viewed by others
References
Azerad E (1963) Le traitement du diabète de l'adulte par le N.N. dimethyl biguanide. Union Med Canada 92, 1251–1259
Metformin: current aspects and future developments (1979) Cudworth AG (ed) Proceedings of a Symposium held at the Lido de France, Jersey. Research and Clinical Forums, Tunbridge Wells, Kent, UK, pp 1–152
Ferguson AW, De la Harpe PD, Farquhar JW (1961) Dimethyl biguanide in the treatment of diabetic children. Lancet 2:1367–1369
Lestradet H, Besse J, Billaud L (1960) Etude de l'action d'un biguanide (N. N.-diméthyl guanyl guanidine) sur un groupe de 235 enfants diabétiques. Presse Med 68:391–393
Schatz H, Winkler G, Jonatha EM, Pfeiffer EF (1975) Studies on juvenile-type diabetes in children. Diab Metab 1:211–220
Leng-Levy J, Leng B, Aubertin J, Lacut JY, Le Gall F, Boget JC, Lenoir MP (1972) L'association biguanides-insuline dans le traitement de certains diabétiques. Bordeaux Med. 19:2659–2664
Oberdisse K, Jahnke K, Daweke H, Liebermeister H (1971) Pathophysiological aspects and clinical experience with biguanides in the treatment of diabetes and obesity in diabetes. In: Rodriguez RR, Vallence Owen J (eds) Proceedings of the VIIth Congress of the International Diabetes Federation, Buenos-Aires, 1970. Excerpta Medica, Amsterdam, pp 726–735
Bloom A, Kolbe RJ (1970) Phenformin in insulin-dependent diabetics. Br Med J 1:660–662
Krall LP (1968) Ten years experience with biguanides in the treatment of diabetes mellitus. In: Oberdisse K, Daweke H, Michael G (eds) International Biguanide Symposium, Düsseldorf. Georg Thieme Verlag, Stuttgart, pp 161–166
Keen H, Jarrett RJ (1968) The use of biguanides in diabetes mellitus. Postgrad Med J 44:466–471
Pirart J (1971) Failure of the biguanides to improve the control of unstable diabetes treated with insulin. Diabetologia 7:283–286
Lambert AE, Buysschaert M, Marchand E, Pierard M, Wojcik S, Lambotte L (1978) Determination of insulin requirements in brittle diabetic patients by the artificial pancreas. Diabetes 27:825–833
Mirouze J, Selam JL, Pham TC, Cavadore D (1977) Evaluation of exogenous insulin homeostasis by the artificial pancreas in insulindependent diabetes. Diabetologia 13:273–278
Poynard T, Slama G, Delage A, Tchobroutsky G (1980) Pectin efficacy in insulin treated diabetics assessed by the artificial pancreas. Lancet 1:158
Christiansen JS, Bonnevie-Nielsen V, Svendsen PA, Rubin P, Rønn B, Nerup J (1980) Effect of guar gum on 24-hour insulin requirements of insulin-dependent diabetic subjects as assessed by an artificial pancreas. Diabetes Care 3:659–662
Slama G, Klein JC, Delage A, Ardila E, Lemaignen H, Papoz L, Tchobroutsky G (1981) Correlation between the nature and amount of carbohydrate in meal intake and insulin delivery by the artificial pancreas in 24 insulin-dependent diabetics. Diabetes 30: 101–105
Armitage P (1960) Sequential medical trials. Blackwell Scientific Publications, Oxford
Stout RW (1979) Diabetes and atherosclerosis. The role of insulin. Diabetologia 16:141–150
Gale EAM, Tattersall RB (1976) Can phenformin-induced lactic acidosis be prevented? Br Med J 2:972–975
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gin, H., Slama, G., Weissbrodt, P. et al. Metformin reduces post-prandial insulin needs in type I (insulin-dependent) diabetic patients: Assessment by the artificial pancreas. Diabetologia 23, 34–36 (1982). https://doi.org/10.1007/BF00257727
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00257727