Metformin, a commonly prescribed drug for type 2 diabetes could prevent heart disease in patients with type 1 diabetes -and could lead to the development of new treatments, according to scientists in the U.K.
Metformin is commonly used for the treatment of type 2 diabetes to lower blood sugar levels by reducing glucose production in the liver. It is not regularly given to patients with type 1 diabetes.
New research has revealed that metformin can promote a patient’s ability to repair their own damaged blood vessels by decreasing the presence of “microRNAs” which increases the growth of blood vessels – in addition to improving glucose levels.
These microRNAs are messenger molecules which regulate different genes in different cells.
“This is an exciting development as understanding this underlying mechanism opens up the possibility of new forms of treatment which will lower the chances of patients with type 1 diabetes developing heart disease,” says Dr. Jolanta Weaver who led the clinical trial and is the lead author of the research.
“As the outcomes of heart disease are worse in diabetic patients compared to people who don’t have diabetes, there is a need to identify additional treatment options,” she points out.
Previous studies have shown that the vascular stem cells were improved by metformin. This was the first example of how metformin improved heart disease as well as lowering glucose levels.
“Now we know that the drug metformin was able to do this by lowering the presence of microRNAs.”
A previous study revealed the potential of metformin to slow the development or delay heart disease, however, this is the first time that the potential of microRNAs in preventing heart disease has been identified.
What were the Study Details?
The clinical trial, known as MERIT, was the first to test metformin for the cardioprotective effects in type 1 diabetes patients.
In an open-label, case-controlled study, the treatment group consisted of 23 people, between the ages of 19 and 65, diagnosed with type 1 diabetes. All the trial subjects were free of cardiovascular disease. They were treated with metformin for 8 weeks.
Patients in the treatment group were matched with a standard group of nine type 1 diabetic patients taking standard insulin.
In addition, there were 23 participants in the “healthy” control group without diabetes.
At the start of the study, the anti-angiogenic microRNAs were detected to be higher in type 1 diabetic patients compared to the control group.
However, it was found that metformin treatment successfully reduced the levels of microRNAs.
Moreover, as the levels lowered, there was a corresponding decrease in the amount of circulating endothelial cells, which indicates an improvement in vascular repair.
“These results confirm that as well as improving a patient’s blood sugar control, metformin is working to protect the heart,” explains Dr. Weaver.
The team will now be working to further the work with the goal of developing new therapies based on regulating the levels of microRNAs.
The study was funded by the Diabetes Research and Wellness Foundation and the Diabetes Research Fund at the Queen Elizabeth Hospital, Gateshead.
The study is published in the International Journal of Molecular Sciences.
A new way to prevent heart disease in type 1 diabetes. 2018, Oct. 19. Retrieved: https://www.eurekalert.org/pub_releases/2018-10/nu-nwt101818.php