Document Detail


Treatment of clinical insulin resistance in children: a systematic review.
MedLine Citation:
PMID:  20003069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The objective of this study was to evaluate the effectiveness of interventions aimed at improving clinical insulin resistance and/or pre-diabetes in children. This study is a systematic review and meta-analysis. Five electronic databases were searched for randomized controlled trials of at least 2-months' duration. The outcomes were fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI) and adverse outcomes. Four randomized controlled trials were identified. All compared the effect of 6 months of metformin plus or minus lifestyle intervention with placebo plus or minus lifestyle intervention. After pooling results from three trials, the mean difference after 6 months favoured the intervention with a statistically significant mean decrease in fasting insulin, HOMA-IR and BMI of 9.6 µU mL(-1) (95% confidence interval [CI]: 6.3, 13.0 µU mL(-1) ; I(2) = 76%), 2.7 (95% CI: 1.7, 3.6; I(2) = 74%) and 1.7 kg m(-2) (95% CI: 1.1, 2.3 kg m(-2) ; I(2) = 75) respectively. Mild gastrointestinal symptoms were reported in 19% (2-29%; median and range) of participants taking metformin. Metformin improves markers of insulin sensitivity and reduces BMI in children and adolescents with clinical insulin resistance or pre-diabetes. Stronger evidence from high-quality studies of longer duration and larger sample size are required before clinical conclusions about the optimal treatment protocol in this population can be drawn.
Authors:
S M Quinn; L A Baur; S P Garnett; C T Cowell
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Obesity reviews : an official journal of the International Association for the Study of Obesity     Volume:  11     ISSN:  1467-789X     ISO Abbreviation:  Obes Rev     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-21     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897395     Medline TA:  Obes Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  722-30     Citation Subset:  IM    
Copyright Information:
© 2009 The Authors. obesity reviews © 2009 International Association for the Study of Obesity.
Affiliation:
Graduate Medical Program, University of Sydney, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Body Mass Index
Child
Child Nutritional Physiological Phenomena / physiology*
Exercise / physiology*
Female
Humans
Hypoglycemic Agents / therapeutic use*
Insulin / blood
Insulin Resistance*
Life Style
Male
Metformin / therapeutic use*
Prediabetic State / blood,  drug therapy*
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Hypoglycemic Agents; 11061-68-0/Insulin; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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