Background: Overweight (OW) and obesity in paediatric population has been shown to be associated with an increase in prevalence of insulin resistance and type 2 diabetes (T2D) in youth.
Objective and hypotheses: The aim of this study was to assess the efficiency and safety of metformin use in combination with lifestyle changes or alone for weight management in OW and obese (OB) children and adolescents.
Methods: Study included 145 1017 years old OW (BMI 1.02.0 S.D.) and OB (BMI ≥2.0 S.D.) children and adolescents of age. Study participants were randomised into four groups: group 1 controls (n=33), group 2 lifestyle changes with two-times weekly swimming pool exercise and monthly dietologist consultations (n=26), group 3 metformin treatment (n=21), and group 4 metformin treatment in combination with lifestyle changes (n=32). Anthropometric parameters were evaluated in all study subjects at baseline and after 12 months of intervention.
Results: Mean age of study participants was 13.4±2.0 years; 44.1% were boys; 32.6% were OW, others OB. Reduce in BMI, waist circumference (WC), and WCSDS adjusted by gender and puberty stages was significantly greater in the group 4 compared to the group 1 (Δ −1.07±2.8 kg/m2 vs Δ 0.18±2.1 kg/m2, P=0.029; Δ −4.5±5.7 cm vs Δ −1.8±5.2 cm, P=0.04, and Δ −0.85±0.8 vs Δ −0.38±0.7, P=0.009 respectively). Changes in these parameters in other groups compared to group 1 were not significant. Initially, mild side effects of metformin (nausea and diarrhoea) were observed in 21.6% of subjects from groups 3 to 4, which disappeared within 1 week of metformin administration.
Conclusion: Twelve months metformin treatment with lifestyle modification was effective and safe method reducing BMI and waist circumference in OW/OB children and adolescents, superior to that of lifestyle changes alone.
Funding: Lithuanian Research Council (grant number MIP-039/2013), grant from Research Foundation of Lithuanian University of Health Sciences (2013).
01 - 03 Oct 2015
European Society for Paediatric Endocrinology