Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 39 OC8.4 | DOI: 10.1530/endoabs.39.OC8.4

BSPED2015 ORAL COMMUNICATIONS Oral Communications 8 (5 abstracts)

Predictors of insulin resistance and the effect of Metformin treatment in obese paediatric patients

Hannah Gallen 2 , Indraneel Banerjee 1 , Peter E Clayton 1 , Sarah Ehtisham 1 , Raja Padidela 1 , Leena Patel 1 , Louise Salsbury 1 & Mars Skae 1


1Royal Manchester Children’s Hospital, Manchester, UK; 2University of Manchester, Manchester, UK.


Introduction: Paediatric obesity is a growing concern for the health service. There is currently no consensus for routine screening of metabolic profiles and medical treatment in obese paediatric patients.

Aims/methods: We aimed to determine medium-term outcomes of Metformin treatment on BMI, glucose and insulin levels in obese paediatric patients. In a retrospective review, data were collected from obese paediatric patients on Metformin for insulin resistance between October 9 and October 14. Changes in BMI SDS, glucose and insulin were analysed. Paired sample t-tests were used to compare pre- and post- treatment results (treatment washout period of 1 month).

Results: 70 patients were treated with metformin (50=female) (35=British White, 18=Pakistani) at a mean age of 12.7 (6.1–17.2) years. Mean BMI 35.2 (24.2–48.5 kg/m2) and BMI SDS 3.4 (2.2–4.7). All patients with a family history of T2DM had acanthosis nigricans (AN). All patients with acanthosis nigricans (n=43, 49% with no family history of T2DM) had insulin resistance with significantly higher basal insulin levels (P<0.05) than those without. All patients were normoglycaemic at start of treatment. Metformin was associated with reduced BMI z-score at 6–12 months (−0.1 SDS, P<0.05) and 18–24 months (−0.2 SDS, P<0.05). Reduction in fasting and postprandial glucose levels were (−0.1 mmol/l, P=0.17) and (−0.5 mmol/l, P=0.17) respectively. Metformin was associated with a reduction in fasting insulin (−3.0 mU/l, P=0.44), and significantly reduced 2 h insulin (−118.0 mU/l, P<0.05) after treatment for 12–18 months. In prepubertal children <10 years, fasting insulin increased (+9.3 mU/l, P=0.16), but postprandial insulin decreased (−33.8 mU/l, P=0.42).

Conclusions: Metformin treatment is significantly associated with reduction in BMI z-score from 6 months and reduced postprandial insulin levels after treatment. It should be considered as a treatment modality in normoglycaemic obese paediatric patients for weight stabilisation and improvement of insulin resistance, which may have longer term implications on metabolic health.

Volume 39

43rd Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

Browse other volumes

Article tools

My recent searches

No recent searches.