Effect of Adjunct Metformin Treatment in Patients with Type-1 Diabetes and Persistent Inadequate Glycaemic Control. A Randomized Study

Despite intensive insulin treatment, many patients with type-1 diabetes (T1DM) have longstanding inadequate glycaemic control. Metformin is an oral hypoglycaemic agent that improves insulin action in patients with type-2 diabetes. We investigated the effect of a one-year treatment with metformin versus placebo in patients with T1DM and persistent poor glycaemic control.One hundred patients with T1DM, preserved hypoglycaemic awareness and HaemoglobinA(1c) (HbA(1c)) > or = 8.5% during the year before enrolment entered a one-month run-in on placebo treatment. Thereafter, patients were randomized (baseline) to treatment with either metformin (1 g twice daily) or placebo for 12 months (double-masked). Patients continued ongoing insulin therapy and their usual outpatient clinical care. The primary outcome measure was change in HbA(1c) after one year of treatment. At enrolment, mean (standard deviation) HbA(1c) was 9.48% (0.99) for the metformin group (n = 49) and 9.60% (0.86) for the placebo group (n = 51). Mean (95% confidence interval) baseline-adjusted differences after 12 months with metformin (n = 48) versus placebo (n = 50) were: HbA(1c), 0.13% (-0.19; 0.44), p = 0.422; Total daily insulin dose, -5.7 U/day (-8.6; -2.9), p<0.001; body weight, -1.74 kg (-3.32; -0.17), p = 0.030. Minor and overall major hypoglycaemia was not significantly different between treatments. Treatments were well tolerated.In patients with poorly controlled T1DM, adjunct metformin therapy did not provide any improvement of glycaemic control after one year. Nevertheless, adjunct metformin treatment was associated with sustained reductions of insulin dose and body weight. Further investigations into the potential cardiovascular-protective effects of metformin therapy in patients with T1DM are warranted.ClinicalTrials.gov NCT00118937

Increasing trend of childhood type 1 diabetes in Franche-Comté (France): analysis of age and period effects from 1980 to 1998.

International audienceAIMS/HYPOTHESIS: A study was conducted by the Franche-Comté Regional Association of Private Practitioners (Union Régionale des Médecins Libéraux de Franche-Comté) to assess trends in childhood-onset Type 1 diabetes in this administrative region of France, between 1980 and 1998. METHODS: Cases of childhood-onset Type 1 diabetes (aged 0-14 years) were retrospectively recorded with the help of general practitioners, private specialists and hospitals in the Franche-Comté and surrounding administrative regions. Incidence rates and trends during the period were analysed using Poisson regression. RESULTS: During the 19-year study period, 308 cases of childhood-onset Type 1 diabetes were identified. The level of case ascertainment was estimated to be 80.6% (95% CI: 74.7, 87.4). The male-to-female sex ratio was 1.03. The World standardised incidence rate was 6.90/100,000. The incidence rate was 6.03 (95% CI: 4.76, 7.53) for children aged 0 to 4 years, 6.45 (95% CI: 5.23, 7.88) for children aged 5-9 years and 8.56 (95% CI: 7.18, 10.13) for those aged 10-14 years. The annual increase rate was 4.9%, continuous and regular, without any deviation. This trend did not differ according to gender or age group. CONCLUSION/INTERPRETATION: These results confirm that the incidence and the increase rate in childhood Type 1 diabetes in France are average compared to in other European countries over an extended period of time. Furthermore, the regular and linear increase in incidence supports the hypothesis of causal environmental factors diffusing over time. The complementary data provided also illustrate the role that private practitioners may play by their implication in epidemiology and public health

Retentissements d'une déshydratation cellulaire isolée, causée par hyperglycémie prolongée chez le chien anesthésié

SCOPUS: ar.jSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Methods to Quantify In Vivo Phagocytic Uptake and Opsonization of Live or Killed Microbes in Drosophila melanogaster

International audienc