BSPED2015 ORAL COMMUNICATIONS Oral Communications 8 (5 abstracts)
1Royal Manchester Childrens 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 (6.117.2) years. Mean BMI 35.2 (24.248.5 kg/m2) and BMI SDS 3.4 (2.24.7). 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 612 months (−0.1 SDS, P<0.05) and 1824 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 1218 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.