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Diabetes medicine shown to have beneficial effect on blood vessels

Remarkable results of international REMOVAL study

Administering metformin to patients with type I diabetes does not have a positive effect on blood sugar levels, but it does appear to have a positive effect on the blood vessels. This is an important discovery because cardiovascular disease is a much-feared complication of diabetes. This conclusion follows from the REMOVAL study, a large-scale international study to which doctors from Maastricht UMC+ also contributed.

Type 1 diabetes is a chronic and highly burdensome disease that often develops during childhood. Approximately 100,000 people in the Netherlands suffer from type I diabetes. Metformin is very frequently prescribed for patients with type II diabetes (‘age-related diabetes’) because of the positive effect it has on blood sugar levels, body weight, and the risk of cardiovascular disease. For this same reason, the substance is also sometimes prescribed - together with insulin - for patients with type I diabetes, although it has never been scientifically proven that it has the same positive effect on this form of the disease. The REMOVAL study showed that blood sugar levels in patients with type I diabetes remained unchanged after taking metformin for three years.

Ultrasound of the neck

There were, however, indications that the degree of atherosclerosis (hardening of the arteries), measured using ultrasound of the neck, was lower in patients using metformin. Moreover, patients lost weight and their levels of LDL cholesterol (‘bad’ cholesterol) were lower. Although these effects were minor, they could all be linked to the use of metformin. Atherosclerosis is a well-known complication in patients with diabetes and one that can lead to cardiovascular disease. Further research is necessary to show whether or not metformin would be useful in reducing the risk of cardiovascular disease in patients with type I diabetes.

REMOVAL

The REMOVAL study is a large-scale international study in which is 23 renowned medical centres in the United Kingdom, Denmark, Australia, Canada and the Netherlands have taken part. Five hundred people participated in the study, making REMOVAL the largest ever study carried out on cardiovascular disease in patients with type I diabetes. The results of the study were recently presented at the symposium of the American Diabetes Association in San Diego (California) and have been published in The Lancet Diabetes & Endocrinology.

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