Long-term follow-up of non-diabetic obese children and adolescents treated with metformin

Aim: Childhood obesity is an important public health problem with increasing prevalence.Type 2 diabetes mellitus(T2DM) is strongly associated with obesity and metabolic syndrome. Adressing obesity and insulin resistance by drug treatment represents a rational strategy for the prevention of T2DM. The aim of our study was to evaluate the one year metformin treatment’slong-term effectiveness in children and adolescent. Material and Methods: Patients who were diagnosed with obesity (VK？>+2 SDS)and found to have insulin resistance (total insulin at OGTT >300 mIU/ml and homa-IR >3.4)and other obesity co-morbidities, agedbetween 10-18 years, treated with metformin in addition to lifestyle change for a year and with regular follow-up for a minimum of 2 years after metformin treatmentin our clinicwere included inthe study. Results: A total of 12 cases including 8 girls with a mean age of 13.2±2.1 years and mean follow-up duration of 3.9±1 years were included in the study. While the body mass index (BMI) of the cases at presentation was 31.2±5.6 kg/m2 and BMI-SDS was 2.7±0.7, the BMI-SDS value after one year of metformin treatment was found to have regressed to 1.9±1 (p:0.04), and the BMI-SDS value two years after the interruption of metformin treatment had increased to 2.1±1.04 but was not as high as the period before metformin treatment (p:0.033). Conclusion: One-year metformin treatment improved the BMI SDS and homa-IR values of the obese children and this improvement decreased but continued in the second year after the discontinuation of the treatment