SynthesisEndocrinology, diabetes & metabolism2025
An Updated Systematic Review and Meta-Analysis on the Efficacy and Safety of Metformin as Add-on Therapy to Insulin in Patients With Type 1 Diabetes.
Synthesis in Endocrinology, diabetes & metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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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.
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Who cites it
3 citing papers in PubMed.
- Tirzepatide Is Associated With Improved Metabolic Outcomes in People With Type 1 Diabetes and Overweight or Obesity: A Retrospective Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Antidiabetic and antioxidant effects of Armillaria gallica and Armillaria cepistipes extracts and their silver nanoparticles against streptozotocin induced diabetes in mice.Scientific reports · 2026Article
- Old Drug, New Science: Metformin and the Future of Pharmaceutics.Pharmaceutics · 2026Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study aims to perform an updated meta-analysis evaluating the efficacy and safety of metformin adjunct therapy in type 1 diabetes mellitus (T1DM) patients.
methodCochrane, PubMed and Embase were searched for randomised controlled trials (RCTs) that reported the efficacy and safety of metformin in T1DM patients. Statistical analyses were performed using STATA software.
resultsTwenty-nine placebo-controlled RCTs enrolling 2051 T1DM patients were included. Adolescents experienced a notable reduction in total insulin daily dose (TIDD) (mean difference [MD] = -0.61 [95% confidence interval (CI): -1.02, -0.20] units/kg per day) and levels of haemoglobin A1c (HbA1c) (MD = -0.45 [95% CI: -0.79, -0.11]), total cholesterol (TC) (MD = -0.78 [95% CI: -1.54, -0.02]), and low-density lipoprotein (LDL) (MD = -0.69 [95% CI: -1.36, -0.02]) at 3 months of follow-up with metformin. In adults, metformin significantly reduced Body Mass Index (BMI) (MD = -0.71 [95% CI: -1.23, -0.19]), TIDD (MD = -0.44 [95% CI: -0.73, -0.16]), and levels of HbA1c (MD = -0.70 [95% CI: -1.10, -0.30]) and TC (MD = -0.60 [95% CI: -1.09, -0.10]) at 6 months. The risk of gastrointestinal adverse events (GIAEs) was significantly higher in both adolescents (Relative Risk [RR] = 1.74 [95% CI: 1.38, 2.21]) and adults (RR = 3.24 [95% CI: 1.49, 7.02]). All of the above had p-values less than 0.05. The metformin group showed no differences in BMI Z-score, high-density lipoprotein (HDL) level, or diabetic ketoacidosis (DKA) risk. No statistical difference was identified for any of the outcomes at other follow-up endpoints.
conclusionsMetformin may reduce TIDD and levels of HbA1c, TC, triglycerides (TG), and LDL in T1DM adolescents. BMI, TIDD, and levels of HbA1c and TC may decrease in adults. Moreover, it may raise the risk of GIAEs in both age groups.
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