Next Article in Journal
Comparative Safety and Efficacy Profile of a Novel Oil in Water Vaccine Adjuvant Comprising Vitamins A and E and a Catechin in Protective Anti-Influenza Immunity
Previous Article in Journal
Effects of Polyphenols on Oxidative Stress-Mediated Injury in Cardiomyocytes
Article Menu
Issue 5 (May) cover image

Export Article

Open AccessArticle
Nutrients 2017, 9(5), 524; doi:10.3390/nu9050524

Retrospective Evaluation of Metformin and/or Metformin Plus a New Polysaccharide Complex in Treating Severe Hyperinsulinism and Insulin Resistance in Obese Children and Adolescents with Metabolic Syndrome

1
Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence 50139, Italy
2
Department of Paediatrics, University of Siena, Siena 53100, Italy; gmunicchi@technet
3
Paediatric Diabetology Unit, Anna Meyer Children's University Hospital, University of Florence, Florence 50139, Italy
4
Department of Paediatrics, University of L’Aquila, L’Aquila 67100, Italy
*
Author to whom correspondence should be addressed.
Received: 18 March 2017 / Revised: 1 May 2017 / Accepted: 12 May 2017 / Published: 20 May 2017
View Full-Text   |   Download PDF [291 KB, uploaded 20 May 2017]

Abstract

Background: Pharmacological treatment of obesity and glucose-insulin metabolism disorders in children may be more difficult than in adults. Thus, we evaluate the effects of metformin in comparison with metformin plus a polysaccharide complex (Policaptil Gel Retard®, PGR) on body weight and metabolic parameters in obese children and adolescents with metabolic syndrome (MetS). Patients and methods: We retrospectively collected 129 children and adolescents (67 girls, 62 boys; median age 12.6 years) treated for a minimum of two years with metformin and low glycemic index (LGI) diet. Of these, 71 patients were treated with metformin plus PGR after at least 12 months of metformin alone. To minimize the confounding effect of the LGI on auxological and metabolic parameters, the patients were compared with age-, sex-, and BMI-matched control group with obesity and MetS (51 subjects; 24 males, 27 females) treated only with a LGI diet. Assessments included lipids, glucose and insulin (fasting and after oral glucose tolerance test) concentrations. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Matsuda, insulinogenic and disposition indices were calculated. Results: Metformin treatment led to a significant reduction in BMI SDS (p < 0.0001), with a significant difference in ΔBMI SDS between patients and controls (p < 0.0001). Moreover, metformin treated patients showed a reduction in HOMA-IR (p < 0.0001), HbA1c levels (p < 0.0001) and a significant increase in Matsuda index (p < 0.0001) in respect to the reduction discovered in controls (p < 0.05). Moreover, in contrast to the group treated with metformin alone and controls, patients treated with metformin plus PGR showed a further reduction in BMI SDS (p < 0.0001), HOMA-IR (p < 0.0001), HbA1c (p < 0.0001), total, HDL and LDL cholesterol (p < 0.0001), as well as an increase in Matsuda (p < 0.0001), disposition (p < 0.005) and insulinogenic (respectively, p < 0.05 and p < 0.0001) indices. Conclusions: Metformin appears to show short-term efficacy in reducing BMI, adiposity and glucose and insulin parameters in obese children and adolescents with MetS. However, PGR added to metformin may be useful to potentiate weight loss and to improve glucose-insulin metabolism and adiposity parameters in these patients. View Full-Text
Keywords: children; adolescents; metformin; Policaptil Gel Retard®; obesity; type 2 diabetes mellitus; haemoglobin A1c; treatment; hyperinsulinism; insulin resistance; metabolic syndrome; insulin; cholesterol; triglycerides children; adolescents; metformin; Policaptil Gel Retard®; obesity; type 2 diabetes mellitus; haemoglobin A1c; treatment; hyperinsulinism; insulin resistance; metabolic syndrome; insulin; cholesterol; triglycerides
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

Scifeed alert for new publications

Never miss any articles matching your research from any publisher
  • Get alerts for new papers matching your research
  • Find out the new papers from selected authors
  • Updated daily for 49'000+ journals and 6000+ publishers
  • Define your Scifeed now

SciFeed Share & Cite This Article

MDPI and ACS Style

Stagi, S.; Ricci, F.; Bianconi, M.; Sammarco, M.A.; Municchi, G.; Toni, S.; Lenzi, L.; Verrotti, A.; de Martino, M. Retrospective Evaluation of Metformin and/or Metformin Plus a New Polysaccharide Complex in Treating Severe Hyperinsulinism and Insulin Resistance in Obese Children and Adolescents with Metabolic Syndrome. Nutrients 2017, 9, 524.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
Nutrients EISSN 2072-6643 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top