| Treatment of clinical insulin resistance in children: a systematic review. | |
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MedLine Citation:
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PMID: 20003069 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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S M Quinn; L A Baur; S P Garnett; C T Cowell |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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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:
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Created Date: 2010-09-21 Completed Date: 2010-11-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100897395 Medline TA: Obes Rev Country: England |
Other Details:
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Languages: eng Pagination: 722-30 Citation Subset: IM |
Copyright Information:
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© 2009 The Authors. obesity reviews © 2009 International Association for the Study of Obesity. |
Affiliation:
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Graduate Medical Program, University of Sydney, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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