Metformin In Pcos In Type 1 Diabetes
there are no studies regarding medical treatment of ovarian function in PCOS patients with type 1 diabetes mellitus; however, metformin is reported to be helpful for reducing daily insulin doses and body weight, leading to improved insulin resistance and hyperinsulinemia (1,2,3): in a twelve month study comparing addition of metformin to placebo for type 1 diabetics (3): total daily insulin dose was reduced in the metformin group > -5.7 U/day (-8.6; -2.9), p<0.001; body weight was reduced in the metformin group -1.74 kg (-3.32; -0.17), p = 0.030 Reference: Miyoshi A et al. Ovarian morphology and prevalence of polycystic ovary syndrome in Japanese women with type 1 diabetes mellitus. J Diabetes Investig. 2013 May 6;4(3):326-9. Vella S, Buetow L, Royle P, et al Metformin in type 1 diabetes reduces insulin requirements without significantly improving glycaemic control. Reply to Schatz H [letter]. Diabetologia 2011; 54: 203-204 Continue reading >>
A Case Of Lean Polycystic Ovary Syndrome With Early Stage Of Type 1 Diabetes Successfully Treated With Metformin.
Generate a file for use with external citation management software. Endocr J. 2016;63(2):193-8. doi: 10.1507/endocrj.EJ15-0548. Epub 2016 Jan 13. A case of lean polycystic ovary syndrome with early stage of type 1 diabetes successfully treated with metformin. Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Toho University School of Medicine, Tokyo 143-8541, Japan. Polycystic ovary syndrome (PCOS) is common in obese women with insulin resistant type 2 diabetes for which metformin treatment is getting established in addition to clomiphene. However, lean PCOS patients are sometimes accompanied with type 1 diabetes. It remains unclear whether these patients are insulin resistant and whether metformin is effective for them. A 32-year-old woman, who suffered from acne, hirsutism, and menstrual disorders since age 29, was diagnosed as PCOS by serum high LH levels and polycystic ovary on echography. Interestingly, her body mass index (BMI) had consistently been 21.0 kg/m2 since age 20. She was first treated with clomiphene for one year for infertility but it did not improve her menstrual cycle nor did she get pregnant during that period. She was then assessed with diabetes mellitus and subsequently diagnosed as type 1 diabetes with mild hyperglycemia (HbA1c 6.0%). Since her insulin secretion was still well preserved, to assess insulin sensitivity, hyperinsulinemic-euglycemic clamp test was performed and showed her to be insulin resistant. Low dose insulin and low dose metformin treatment was started without clomiphene. After her ovulation and menstrual cycle were ameliorated only one month later, her treatment was supplemented with clomiphene for the next three months enabling her to at last become pregnant. This report highlights the effi Continue reading >>
Is Metformin Effective For Type 1 Diabetes?
Is Metformin Effective for Type 1 Diabetes? At what point, if any, should one consider the addition of metformin to the regimen of an adherent patient with type 1 diabetes who is not well controlled on insulin? Associate Professor, Department of Pharmacy Practice, Presbyterian College School of Pharmacy; Clinical Pharmacy Specialist, Good Shepherd Free Medical Clinic, Clinton, South Carolina The addition of off-label metformin to insulin therapy to improve insulin sensitivity, promote weight control, and reduce insulin dose requirements in patients with type 1 diabetes has been assessed in systematic reviews.[ 1 , 2 ] One review sought to assess the effects of metformin when added to insulin therapy for type 1 diabetes in adolescents.[ 1 ] The Cochrane Library, MEDLINE, and EMBASE were searched, along with databases of ongoing clinical trials, for randomized controlled trials of at least 3 months' duration. Trials that were included compared metformin added to insulin vs insulin therapy alone. Two trials met inclusion criteria, representing 60 patients in total. Although a lack of heterogeneity made meta-analysis impossible, the authors did note that both studies found a reduction in glycosylated hemoglobin A1c values when metformin was added to insulin. One of the studies also showed a 10% decrease in insulin dosage among those taking metformin. Hypoglycemia and gastrointestinal disturbances were among the most commonly occurring adverse effects of combination therapy. Another systematic review evaluated the addition of metformin to insulin in type 1 diabetes.[ 2 ] This review identified 9 studies, including both adolescents and adults, that involved randomization with informed consent. The studies compared metformin vs placebo or another comparator in parallel or cro Continue reading >>
Five Things To Know About Diabetes And Pcos
September is Polycystic Ovary Syndrome (PCOS) Awareness Month, an opportunity to raise awareness of a health problem that you may not be familiar with. For example: Did you know that PCOS is the most common cause of female infertility? Or that about 5 million women in the United States are affected by it? Wait, what!? Let’s start from the beginning… A woman’s ovaries have follicles (tiny, fluid-filled sacs that hold the eggs). When an egg is mature, the follicle releases the egg so it can travel to the uterus for fertilization. In women with PCOS, immature follicles group together to form large cysts or lumps. The eggs mature within the bunched follicles, but the follicles don’t break open to release them. Because of this, women with PCOS often don’t have menstrual periods or only have them on occasion. And because the eggs are not released, most women with PCOS have trouble getting pregnant. We’re sure you still have plenty of questions about PCOS—and what it means for women with diabetes. Keep reading! ____________________________ 1) What are the causes and symptoms of PCOS? Unfortunately, we don’t yet know the cause of PCOS, but based on studies of twins, scientists believe there’s a good chance genetics could play a role. But not everyone with PCOS genes develops the condition, so researchers are looking for lifestyle factors that affect a woman’s risk for PCOS. Though the cause is fuzzy, researchers know one thing for sure: There’s a link between PCOS and diabetes. How so? Women with type 1 diabetes are at increased risk for PCOS, which suggests that insulin may play a part. Ovaries see more insulin from people with type 1 diabetes than they would from those without diabetes. This extra insulin has a direct effect on ovaries by enhancing the p Continue reading >>
Type And Metformin | Diabetic Connect
im guessing the reason your doc told you 70 units is too high, is because that is at the high end of the average that most diabetics take. im in nursing school, and during our "diabetes" part of one of my classes, we were discussing that the average amount of insulin taken by most diabetics according to most textbooks is actually only 30- 50 units/ day. so, based on some literature, 70 units would still be pretty high. have you always taken that much, or have you just started to creep up? it may also be because you are tall and thin that the doc says 70 units is too high for you, because i am almost 5'11" and currently 153 even when i did weigh a little more, i still wasnt technically "overweight" and my doctor said "because you arent obese, there is no reason for you to take the amount of insulin that you do" sooo i guess that does have a lot to do with it. i would suggest goin on metformin if you dont want to take too much insulin. it has really been a blessing for me. they say that taking too much insulin is not good for you, and very hard on your body- so, i would definitely talk to your doc about it, and see what he thinks ;) yes renee- thats what it sounds like to me too see what your doc thinks, and keep me posted if you go on metformin! i hope that if you do it helps with the insulin intake as much as it has helped me! :) yep, thats kinda what happened to me too. i was always very thin- then all the sudden, my insulin intake started going up- and slowly at first i noticed i was gaining weight then all the sudden, as my intake went higher and higher, i realized i had gained about 40 pounds in such a short time!! i was totally freaked out, because though im still young and i knew i wasnt gonna remain stick thin forever, the rate i was gaining freaked me out even Continue reading >>
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Type 1 Diabetes And Polycystic Ovary Syndrome: Systematic Review And Meta-analysis
BACKGROUND A few small studies have reported increased prevalences of polycystic ovary syndrome (PCOS) and symptoms of androgen excess in women with type 1 diabetes. PURPOSE We performed a systematic review and meta-analysis of studies evaluating androgen excess symptoms and PCOS in women with type 1 diabetes. STUDY SELECTION We selected studies addressing androgen excess signs, symptoms, and disorders in girls, adolescents, and adult women with type 1 diabetes. DATA EXTRACTION The main outcome measures were prevalences of PCOS, hyperandrogenemia, hirsutism, menstrual dysfunction, and polycystic ovarian morphology (PCOM). DATA SYNTHESIS Nine primary studies involving 475 adolescent or adult women with type 1 diabetes were included. The prevalences of PCOS and associated traits in women with type 1 diabetes were 24% (95% CI 15–34) for PCOS, 25% (95% CI 17–33) for hyperandrogenemia, 25% (95% CI 16–36) for hirsutism, 24% (95% CI 17–32) for menstrual dysfunction, and 33% (95% CI 24–44) for PCOM. These figures are considerably higher than those reported earlier in the general population without diabetes. LIMITATIONS The data collected in the original studies were heterogeneous in age, race, ethnicity, and criteria used for the diagnosis of PCOS; yet, we used a quality-effects model in the meta-analyses to overcome this limitation. CONCLUSIONS PCOS and its related traits are frequent findings in women with type 1 diabetes. PCOS may contribute to the subfertility of these women by a mechanism that does not directly depend on glycemic/metabolic control among other negative consequences for their health. Hence, screening for PCOS and androgen excess should be included in current guidelines for the management of type 1 diabetes in women. Introduction Polycystic ovary sy Continue reading >>
Type 1 And Metformin?
My Eno today told me to take Metformin to help ovulate and protect against resistance needs that spike during my luteal stage. I have been trying for 3 years to conceive, does this sound familiar to anyone? He thinks I might have PCOS. I dont have first-hand experience with this, but Metformin is commonly prescribed to women with PCOS, whether they are trying to get pregnant or not. It can help with fertility, but also can reduce insulin resistance (which goes hand in hand with PCOS, unfortunately). PCOS in non-diabetic women very commonly progresses to Type 2. The ADA does have an article about PCOS in diabetics on their website. And irrespective of all other considerations, metformin has a rather nice side effect. It lowers the risk of certain cancers, especially in women. Metformin has also been tied to slight uptick in stem cells which could regenerate blood vessels, which could reduce complications as well. In my opinion, more type 1s should be taking this drug. Its downsides are relatively mild and its upsides seem to be quite substantial. Metformin is anti-androgenic, which is why its the go-to for women with PCOS, especially those trying to conceive. I have PCOS and got pregnant in June 2016, without any medication. Shortly after finding out I was pregnant I found out I had diabetes and started on insulin therapy. I miscarried in August and in September I found out I was Type 1 and started on Metformin. I just found out last week that I am pregnant again, 5w4d, and I am convinced Metformin helped. I did not always ovulate on it alone, some cycles had to be started with Provera, but it helped my resistance tremendously! It also prevents women with PCOS, who typically have a higher chance of miscarriage, from miscarrying. I am long time T1D and recently started t Continue reading >>
Polycystic Ovarian Syndrome & Prediabetes: My Story
One Drop: Diabetes Management Made Simple Polycystic Ovarian Syndrome & Prediabetes: My Story Sixteen years ago, I was a 20-year-old, living on brown sugar Pop-Tarts (68 carbs) and cranberry juice (28 carbs). I gained 30 lbs in my first three years of college, weighing 165 lbs on a 58 frame. With every shower and brush, my hair fell out. I had increasing amounts of facial acne, much worse than when I was 16. Most notably, I was ALWAYS hungry. I ate baby-sized bean burritos (84+ carbs) chased with a Cold Stone creations (46+ carbs) and could always eat more. My PCP ran some tests, and sent me to an endocrinologist who ran more tests. Multiple tests and appointments later I had a diagnosis of Polycystic Ovarian Syndrome or PCOS. The endo gave me five minutes of medical babble, two prescriptions, including Metformin, a xeroxed handout on What you need to know about PCOS, and sent me on my way. The following months transformed me. I learned anything and everything I could about PCOS. I learned PCOS affects 5-10% of women, is the leading cause of infertility and a whole host of physical symptoms (hair loss, acne). I also learned insulin resistance is a key contributor to developing PCOS. Up to 70% of women with PCOS have insulin resistance, resulting in pre-diabetes and a high-risk of developing type 2 diabetes. When I was diagnosed, there was limited evidence on how to treat and manage PCOS. Some women were eating less carbs, exercising, and losing weight to minimize symptoms. I drank the Koolaid (low carb, that is), eating 30-40 carbs per day. I ate cauliflower mashed potatoes at Thanksgiving, deconstructed every burger, wrap, and pizza slice to make it low carb, and lost 45 lbs in the first six months of being diagnosed. My hair stopped falling out. The acne cleared. And Continue reading >>
Hyperandrogenism And Polycystic Ovary Syndrome In Women With Type 1 Diabetes Mellitus
Hyperandrogenism and Polycystic Ovary Syndrome in Women with Type 1 Diabetes Mellitus Institute of Maternal and Child Research (E.C.), School of Medicine, University of Chile, Santiago, 836-0160 Chile Search for other works by this author on: Department of Endocrinology (H.F.E.-M.), Hospital Ramon y Cajal and Universidad de Alcala, Madrid, E-28034 Spain Address all correspondence and requests for reprints to: Hector F. Escobar-Morreale, M.D., Ph.D., Department of Endocrinology, Hospital Ramon y Cajal and Universidad de Alcala, Carretera de Colmenar Km 9100, Madrid, E-28034 Spain. Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 4, 1 April 2007, Pages 12091216, Ethel Codner, Hector F. Escobar-Morreale; Hyperandrogenism and Polycystic Ovary Syndrome in Women with Type 1 Diabetes Mellitus, The Journal of Clinical Endocrinology & Metabolism, Volume 92, Issue 4, 1 April 2007, Pages 12091216, Context: At present, women with type 1 diabetes (DM1) are being treated with supraphysiological doses of exogenous insulin with the aim of providing a strict metabolic control, thereby avoiding the long-term complications of this disease. We hypothesized that PCOS would be especially prevalent in DM1, as might happen in any condition in which the ovary and the adrenals are exposed to excessive insulin concentrations. As will be seen in the present review, androgen excess and PCOS are very frequent complaints in women with DM1, yet nowadays hyperandrogenism is seldom diagnosed in these patients. Evidence Acquisition: We conducted a systematic review of all the published studies addressing hyperandrogenic symptoms in women with DM1, identified through the Entrez-PubMed search engine, followed by a comprehensive review of the pa Continue reading >>
Any Other Type I's Taking Metformin?
I developed Type I at age 22 while recovering from Hepatitis A in 1986. Sometime in the mid 1990's a doctor prescribed Metformin for me along with my insulin regimen. He told me it would reduce the amount of insulin I was injecting, which was a normal amount for a Type I of athletic build. I have been taking 2000mg/day of Metformin since that time, and recently a new endocrinologist refused to renew my prescription for Metformin, because he insisted it wasn't right for a Type I. I had visited him because I wanted to change from Lantus to Levemir, due to reduced binding to IGF-1 receptor sites in the body, versus Lantus or normal human insulin. I have been studying organism aging, and have found that metformin is basically a wonder drug, with possible properties like cancer prevention and slower rate of aging. It is known that virtually all organisms will live longer if their caloric intake is restricted. When we look at the metabolisms of these calorically restricted animals, their blood has properties like reduced fasting insulin levels, which are similar to the effects caused by metformin. Metformin can be called a Caloric-Restriction mimetic. In fact, simply adding Metformin to the food of nematodes, a classic study animal, like fruitflies, causes them to live longer. Studies with mice are underway. Recently, Metformin has been shown to be effective in lung cancer prevention, some studies show the safest use of metformin is in conjunction with endogenous insulin injections, as I use it. Metformin has been in use globally for decades with a strong safety record. Metformin causes your body to be less insulin resistant, and insulin resistance rises with age. Studies of centenarians consistently show that they have lower insulin levels than the normal population. I thin Continue reading >>
Too Old For Acne? Difficult-to-diagnose Pcos May Be The Cause
Polycystic Ovarian Syndrome, or PCOS, is a health condition resulting from a hormonal imbalance that affects approximately one in every 10 to 15 women in the United States. More than half of women with PCOS will have diabetes or prediabetes by age 40. Learn more about the link and how to treat these often-related conditions. Though the exact cause of PCOS is unknown, many scientists believe that a combination of environmental and genetic factors are involved. Your risk may be higher if you are overweight or if your mother, aunt, or sister has PCOS. As Andrea Dunaif, MD, Chief of the Division of Endocrinology, Diabetes, and Bone Disease at the Icahn School of Medicine at Mount Sinai points out, “The name can be confusing and misleading, because not all women with PCOS have cysts on their ovaries.” In fact, many experts and patient advocates are joining an international effort to change the name to something that is more reflective of what PCOS actually is – a metabolic issue. The hope is that having a more accurate name will help further research and improve treatment. Signs and Symptoms Most women are diagnosed in their twenties and thirties, but PCOS often starts in adolescents and can affect girls before they begin menstruating. The hormonal imbalance can interrupt the development and release of eggs from the ovaries. It often goes undiagnosed because many of the symptoms can be attributed to other causes. Common symptoms of PCOS include: Irregular or missed periods Weight gain Fatigue Unwanted hair growth on the face, arms, chest, back, abdomen, and extremities Thinning hair on the head Infertility Acne Mood changes, depression, and anxiety Pelvic pain Headaches Sleep problems such as insomnia, sleep apnea, or poor sleep These symptoms are caused by hormonal im Continue reading >>
Metformin For Type 1 Diabetes - Really? Why?
You've heard it before: someone with type 2 diabetes goes on insulin. That's no surprise. But how often have you heard the reverse — someone with type 1 going on Metformin? Since the launch of Symlin in 2005, it's not uncommon for people to treat their type 1 diabetes with a supplemental injectable medication. But hang around long enough, and you too might get to know someone with type 1 who takes insulin and oral meds, those formerly known as "type 2 only" drugs. Really? Type 1's taking oral meds alongside insulin? To clarify this, I just had to query some experts. Just like in type 2 diabetes, people with type 1 diabetes can sometimes suffer from insulin resistance (when the insulin that's present can't perform it's work properly), and Metformin can lower your insulin requirements by helping the body make better use of the stuff — in this case coming from an injection or insulin pump. Gary Scheiner, CDE, author, and head of Integrated Diabetes Services in Wynnewood, PA, explained it this way: "Some of the more creative and aggressive endos are prescribing Metformin for type 1's, particularly if they are overweight or requiring very large basal insulin doses. In addition to having some mild appetite-suppression effects, it will enhance insulin sensitivity by hepatic cells (in the liver) and limit the amount of glucose secreted by the liver. Personally, I think it can be helpful during adolescence as well. As long as the patient has good liver and kidney function, the side effects and risks are negligible." I also learned this: a couple of other uses of Metformin for women to consider are PCOS (ovary disease) and pregnancy. Kelley Champ Crumpler, RN, who is a diabetes nurse educator and a type 1 diabetic married to an endocrinologist with type 1 diabetes (how's that Continue reading >>
Using Metformin To Treat Type 1
Metformin might look like this, but it doesnt I have completely befuddled my GP. I am taking Metformin and insulin to control my Type 1 diabetes. I might as well have said Im going to start walking on my hands in order to protect my feet from damage. His first thought was that I have suddenly morphed into a Type 2 diabetic, having spent almost 30 years as a Type 1. Interesting, but wrong. Heres the real story. Category: Kit & equipment Living with diabetes Tags: drugs , insulin resistance , metformin Diagnosed with Type One in 1983 at the age of four, Alison's been at this for a while now. She uses Humalog in a combined insulin pump and continuous glucose monitoring system and any blood glucose meter as long as it takes five seconds or less. 10 thoughts on Using Metformin to treat Type 1 Im on Metformin and Insulin Initially they thought I was a T2 diabetic, so put me on metformin. When they worked out I was T1, they never took me off it.. Not noticed any additional flatulance or toilet trips either.. From what Ive read, I think the stomach issues are hit and miss thankfully you seemed to have missed them! If Id have left it a few months, they might have subsided, but that wouldnt have sorted my issue of having to take the tablets, and therefore eat, at regimented times otherwise the impacts on my BG were (for me) unacceptable. Hey Alison, thanks for the post. The more I hear about this the more I wonder if it would be an option for me. Although I dont have PCOS, I do have a big ol waistline and can go through a lot of insulin resistence and seem to (according to the info above) use around 1.6 units of insulin per kg. Might be worth a chat with the doc! Ive actually heard this one before. as I did have a Doctor suggest the idea to me never went any further however. Due Continue reading >>
Type 1 And Metformin
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I am just wondering what your views are on metformin for type 1 diabetics, my consultant wants to put me on it so I can lower my insulin and loose weight ? x I'm Type 1 and on Metformin - I think it's a great idea. It's a generally well tolerated drug albeit with a reputation for causing gas, but I've never had any problems with it. It will mean that you can reduce the amount of insulin you are on slightly and will have a beneficial effect on the dawn phenomenon as it inhibits your liver dumping glycogen. If you take it and reduce your carbs then you will certainly lose weight. I am very interested in taking this drug. I don't see a hospital consultant I only see the Diabetic Nurse at my GP's, would she be able to prescribe this? I am seeing her shortly to have my HBA1c checked again as the last one was rather high, 7.9, due to me waking up very high. Ialso need to lose a LOT of weight Don't really have any views to be honest, if your consultant thinks it well help with your weight and insulin usage then I would be tempted to take it. I am not sure if the diabetic nurse can prescribe this, it may be worth having a word with her good luck xx It has helped my pcos more than anything and I went on it before insulin as needle phobic not done any harm didn't lower my levels but has helped weight loss. Questions for you all, when exactly are you supposed to take the Metformin? My doctor has suggested me taking it but I haven't found a benefit from it when I've tried it in the past. I am hoping it will help increase weight loss. I also have pcos which is actually in control. Also when should you take it if you wanted to reduce the the dawn affect. Thanks all Continue reading >>
Pcos And Hyperandrogenism In Type 1 Diabetes
PCOS and hyperandrogenism in type 1 diabetes Download as PDF (Size:60KB) PP. 76-80 DOI: 10.4236/ojog.2012.21015 5,362 Downloads 10,041 Views Citations Women with both type 1 diabetes and polycystic ovarian syndrome (PCOS) represent a unique population, with long term implications on fertility and diabetic complications, which need to be addressed. The studies reviewed herein address the increased incidence of PCOS in women with type 1 diabetes. The leading theories suggest that the underlying pathophysiology is related to intensive insulin therapy and resulting ovarian hyperandrogenism. We have searched the literature to determine what studies have been done to address the role of insulin resistance and insulin sensitizers for reduction of hyperandrogenism in these patients. According to the available evidence, we conclude that metformin may have a role in reducing the androgenic picture in type 1 patients with PCOS and insulin resistance. Type 1 Diabetes Mellitus; Hyperandrogenism; PCOS; Metformin Tibuni-Sanders, S. and Nader, S. (2012) PCOS and hyperandrogenism in type 1 diabetes. Open Journal of Obstetrics and Gynecology, 2, 76-80. doi: 10.4236/ojog.2012.21015 . Escobar-Morreale, H.F., Roldan, B., Barrio, R., Alonso, M., Sancho, J., De la Calle, H. and Garcia-Robles, R. (2000) High prevalence of polycystic ovary syndrome and hirsutism in women with type 1 diabetes mellitus. Journal of Experimental and Clinical Medicine, 85, 4182-4187. Codner, E., Soto, N., Lopez, P., Trejo, L., Avila, A., Eyzaguirre, F.C., Iniguez, G. and Cassorla, F. (2006) Diagnostic criteria for polycystic ovary syndrome and ovarian morphology in women with type 1 diabetes mellitus. Journal of Clinical Endocrinology & Metabolism, 91, 2250-2256. Amin, R., Schultz, C., Ong, K., Frystyk, J., Dalton, Continue reading >>