metformin

Common type 2 diabetes drug could combat heart disease in people with type 1 diabetes

by Barbara Hewitt on October 23, 2018

A drug commonly used to treat type 2 diabetes could be beneficial for those with type 1 diabetes as it has been found to help prevent heart disease in people with the long term health condition.

Metformin, an inexpensive drug for the treatment of type 2 diabetes, could hold the clues to better treatment of heart diseases among people with type 1 diabetes, yet it is not regularly given to type 1 diabetics.

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A clinical trial carried out by scientists at Newcastle University in the UK has found that metformin can help the body repair damaged blood vessels in addition to improving glucose levels.

‘This is an exciting development as understanding this underlying mechanism opens up the possibility of new forms of treatment which will lower the chances of patients with type 1 diabetes developing heart disease,’ said Dr Jolanta Weaver, a senior lecturer in diabetes medicine at the university and an honorary consultant diabetologist at the Queen Elizabeth Hospital in Gateshead who led the trial.

‘As the outcomes of heart disease are worse in diabetic patients compared to people who don’t have diabetes, there is a need to identify additional treatment options,’ she pointed out.

A previous study by the team showed that the vascular stem cells were improved by metformin so this was the first example how metformin improved heart disease as well as lowering glucose levels.

‘Now we know that the drug metformin was able to do this by lowering the presence of microRNAs,’ added Weaver.

The study, known as MERIT, was the first to test metformin for the cardio-protective effects in type 1 diabetes patients. The trial involved 23 people in a treatment group aged between 19 and 65 with type 1 diabetes who were free of cardiovascular disease. They were treated with metformin for eight weeks.

Patients in the treatment group were matched with a standard group of nine type 1 diabetic patients taking standard insulin. Additionally, there were 23 participants in the healthy control group without diabetes.

At the start of the study, the anti-angiogenic microRNAs, miR-222, miR-195, and miR-21a were detected to be higher in type 1 diabetic patients compared to the control group. However, metformin treatment successfully reduced the levels of miR-222, miR-195, and miR-21a.

Moreover, as the levels of miR-222 lowered, there was a corresponding decrease in the amount of circulating endothelial cells, which indicates an improvement in vascular repair.

‘These results confirm that as well as improving a patient’s blood sugar control, metformin is working to protect the heart,’ said Weaver. She added that the team will now be working to further the work with the goal of developing new therapies based on regulating the levels of microRNAs.

One of those taking part was Alex Laws, aged 33 from Gateshead, who was diagnosed with type 1 diabetes when she was seven and has good control of her condition. She was enrolled on the clinical trial in the summer of 2013.

‘I previously worked in medical research so I know how important studies like this can be in helping people, like me, with type 1 diabetes. Type 1 diabetes can lead to a number of complications, especially in the long term, so it’s important as much as possible is done to limit serious problems,’ she said.

‘Heart disease is a concern for people with type 1 diabetes so understanding how treatments can help and improve the condition for patients is a good thing,’ she added.

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