Evidence map›Paper›PMID 20057994›Full record

SynthesisDiabetologia2010

The use of metformin in type 1 diabetes: a systematic review of efficacy.

S Vella, L Buetow, P Royle, S Livingstone, H M Colhoun, J R Petrie

Registry-linked trialOpen access · bronzeAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Diabetologia, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01881828 (A Randomized Trial of Metformin as Adjunct Therapy for Overweight Adolescents With Type 1 Diabetes), which is not on this map. Cited by 68 papers.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed
6.7field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01881828 phase3completedstarted 2013, after this paper: background citation

A Randomized Trial of Metformin as Adjunct Therapy for Overweight Adolescents With Type 1 Diabetes

Ran2013Enrolled164Registered outcomes16Posted comparisons0ConditionsType 1 DiabetesArmsMetformin (glucophage), oral placebo
PMID 22540912PMID 15855566PMID 18777487PMID 12502670PMID 23175691PMID 19996308PMID 20393934PMID 18721166PMID 12107742PMID 12702748PMID 12716791PMID 14514347other papers from this trial
Open the trial in the graph
3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 200 citations in OpenAlex.

  1. Trial
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  6. Obesity in Adults with Type 1 Diabetes Mellitus.Journal of obesity & metabolic syndrome · 2026
    Review
  7. Article
  8. Review
  9. Article
  10. Review
  11. Article
  12. Review
  13. Review
  14. Review
  15. Article
  16. Review
  17. Adjunctive Therapies to Optimize Closed-loop Glucose Control.Journal of diabetes science and technology · 2021
    Article
  18. Review
  19. Article
  20. Article

8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

S VellaBiomedical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK.
L Buetow
P Royle
S Livingstone
H M Colhoun
J R Petrie
Ninewells Hospital · GBUniversity of Dundee · GBUniversity of Aberdeen · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisAs adding metformin to insulin therapy has been advocated in type 1 diabetes, we conducted a systematic review of published clinical trials and clinical trial databases to assess the effects on HbA(1c), weight, insulin-dose requirement and adverse effects.

methodsWe constructed evidence tables and fitted a fixed-effects model (inverse variance method) in order to assess heterogeneity between studies and give a crude measure of each overall treatment effect.

resultsOf 197 studies identified, nine involved randomisation with informed consent of patients with type 1 diabetes to metformin (vs placebo or comparator) in either a parallel or crossover design for at least 1 week. We noted marked heterogeneity in study design, drug dose, age of participants and length of follow-up. Metformin was associated with reductions in: (1) insulin-dose requirement (5.7-10.1 U/day in six of seven studies); (2) HbA(1c) (0.6-0.9% in four of seven studies); (3) weight (1.7-6.0 kg in three of six studies); and (4) total cholesterol (0.3-0.41 mmol/l in three of seven studies). Metformin was well tolerated, albeit with a trend towards increased hypoglycaemia. Formal estimates of combined effects from the five trials which reported appropriate data indicated a significant reduction in insulin dose (6.6 U/day, p < 0.001) but no significant reduction in HbA(1c) (absolute reduction 0.11%, p = 0.42). No reported trials included cardiovascular outcomes. CONCLUSIONS/

interpretationMetformin reduces insulin-dose requirement in type 1 diabetes but it is unclear whether this is sustained beyond 1 year and whether there are benefits for cardiovascular and other key clinical outcomes.

Indexed as

Clinical Trials as TopicDiabetes Mellitus, Type 1Drug Therapy, CombinationHumansHypoglycemic AgentsInsulinMetforminTreatment OutcomeHypoglycemic AgentsInsulinMetformin

Identifiers

PMID20057994
OpenAlexW1965620761

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.