Małgorzata Bekier, Aleksandra Uruska, Danuta Szkutnik-Fiedler
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Insulin resistance and iatrogenic hyperinsulinemia in type 1 diabetes - norm or complication? Role of metformin in type 1 diabetes mellitus
There is a rising trend of overweight and obesity among individuals with type 1 diabetes. This is often associated with decreased insulin sensitivity, increased insulin dose requirements and poor glycemic control. Insulin resistance is a state of diminished effect of insulin on target tissues, despite normal or elevated serum insulin levels. Metformin as an adjunct to insulin in treating overweight or also not specific image of insulin resistance (without overweight or hormonal disorders) adults with type 1 diabetes is increasingly used. The main goal of this off-label type 1 diabetes treatment method is to improve insulin signaling leading to a subsequent increase in glucose uptake by skeletal myocytes, inhibition of hepatic gluconeogenesis and, as a result, a reduction in the need for a daily dose of insulin. The use of metformin as an addition to insulin may increase the chance of achieving target glucose control and reduce the anabolic effect of this hormone. Metformin can improve insulin sensitivity, glycemia and modulate cardiovascular disease risk factors or nonalcoholic fatty liver disease. In the vast majority of clinical trials conducted with metformin in type 1 diabetes, the effect of the drug on daily insulin doses, improvement in lipid parameters, and decline in body fat was assessed without correlating pre-specified outcomes with drug plasma concentrations.
期刊介绍:
The international journal of the Polish Pharmaceutical Society is published in 6 issues a year. The journal offers Open Access publication of original research papers, short communications and reviews written in English, in all areas of pharmaceutical sciences. The following areas of pharmaceutical sciences are covered: Analysis, Biopharmacy, Drug Biochemistry, Drug Synthesis, Natural Drugs, Pharmaceutical Technology, Pharmacology and General.
A bimonthly appearing in English since 1994, which continues “Acta Poloniae Pharmaceutica”, whose first issue appeared in December 1937. The war halted the activity of the journal’s creators. Issuance of “Acta Poloniae Pharmaceutica” was resumed in 1947. From 1947 the journal appeared irregularly, initially as a quarterly, then a bimonthly. In the years 1963 – 1973 alongside the Polish version appeared the English edition of the journal. Starting from 1974 only works in English are published in the journal. Since 1995 the journal has been appearing very regularly in two-month intervals (six books a year). The journal publishes original works from all fields of pharmacy, summaries of postdoctoral dissertations and laboratory notes.