Obesity, Type 2 diabetes and metformin

In March 2014, Archivist reported on a systematic review of the use of metformin in treating morbid obesity: the conclusion was that it was of limited value (doi: 10.1136/archdischild-2014-305957). This has now been added to by a trial from Spain (Pastor-Villaescusa B et al. Pediatrics 2017. doi:10.1542/peds.2016-4285). In a double-blind trial, 140 young people with a BMI > 95^th centile, half of whom were pre-pubertal, were randomised: they received either 500 mg twice daily of metformin or placebo, for 6 months. The outcomes differed depending on pubertal status: in the pre-pubertal group, the BMI z-score was reduced by 0.2 more by the intervention compared with by placebo, a modest but significant effect (p=0.04). There were also improvements in some laboratory markers. No such benefit was seen in the post-pubertal group. The reason for the different outcomes is unclear, but may be due to metabolic factors, or may simply be that they didn’t...

from Archives of Disease in Childhood current issue http://ift.tt/2wh2sL6