Oleh admin kalbemed pada August 06, 2018 06:00

Adakah Manfaat Metformin pada Anak DM Tipe I?

Seperti telah diketahui bahwa metformin menjadi terapi lini utama dalam pengobatan DM tipe 2. Manfaat metformin pun banyak, selain terjadi penurunan HbA1c yang baik, metformin juga dapat menurunkan berat badan, diberikan sebagai bagian terapi PCOS, dan metformin dipasarkan dengan harga yang terjangkau. Bagaimana pemberian metformin bagi pasien DM tipe 1?

Dari suatu studi didapatkan bahwa pemberian metformin pada anak DM tipe 1 yang obesitas atau overweight akan dapat menurunkan dosis insulin yang sedang diterimanya. Kita tahu bahwa pasien DM tipe 1 mau tidak mau harus diberikan injeksi insulin sebagai terapi utamanya.

Walaupun dapat menurunkan dosis insulin yang sedang diterima pasien itu, pemberian metformin tidak lantas memberikan kontrol glikemik yang lebih baik dibandingkan sebelumnya, berdasarkan studi yang dilakukan selama 6 bulan, dan dipublikasikan pada Journal of the American Medical Association. Studi ini merupakan studi dengan skala terbesar yang pernah dilakukan untuk menilai efikasi terapi tambahan metformin pada pasien anak DM tipe 1 yang menderita overweight atau obesitas.

Dalam studi yang memiliki desain acak, tersamar ganda dengan kontrol plasebo dilakukan pada 26 senter di US T1D Exchange Clinical Network dari Oktober 2013 sampai Februari 2014, melibatkan 140 remaja DM tipe 1. Subjek diberikan metformin secara acak dengan titrasi sampai 2000 mg/hari atau plasebo, sebagai tambahan terhadap terapi insulin basal-bolus selama 26 minggu. Pada akhir studi pada minggu 26, proporsi lebih besar pada metformin yang mengalami penurunan dosis insulin harian total pada perjalanan studi ini .

Dari hasil yang tersaji, menunjukkan bahwa terjadi perbaikan pada sensitivitas insulin, yang dipertimbangkan menjadi suatu manfaat tambahan dari metformin. Namun perlu dibuktikan dengan menggunakan clamp untuk mengetahui seberapa membaiknya resistensi insulin setelah pemberian metformin.[PMP]


Image: Ilustrasi
Referensi: Hackethal V. Metformin doesn’t improve HbA1c in kids with type 1 diabetes [Internet]. 2015 [cited 2017 Agust 4]. Available from : http://www.medscape.com/viewarticle/855442

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