Review of the effectiveness of metformin therapy in patients between 10-18 years of obes with insulin resistance

The medical records of 40 obese patients who were followed up in Bursa Uludağ University Faculty of Medicine, Division of Pediatric Endocrinology between January 1, 2010 and December 30, 2019 and were started on metformin therapy due to insulin resistance (IR), were retrospectively analysed. Anthropometric and metabolic parameters of obese patients receiving metformin treatment at the beginning, sixth month and first year of treatment were compared. The mean age of the cases was 13.60±1.47 years and 60% were female. The most common complaint at presentation was being overweight at a rate of 87.80%. All of the cases were in the pubertal period. A statistically significant (p<0.001) decrease was found in the 6th month and 1st year body weight standard deviation score (SDS), body mass index (BMI) and BMI SDS values in patients who used metformin treatment for 1 year, and no serious side effects were observed. At the same time, statistically significant improvement were found in the 1st year fasting glucose (p=0.009), fasting insulin (p=0.001), glycosylated hemoglobin (HbA1c) (p=0.009), HOMA-IR (homeostatic model evaluation of insulin resistance) (p=0.001), insulin sensitivity index (p=0.001) and Quick index (quantitative insulin sensitivity control index) (p=0.005). In the group in which lifestyle changes were applied in parallel to metformin treatment, BMI SDS (p=0.023), HOMA-IR (p=0.039), Quick index (p=0.044) and insulin sensitivity index (p=0.007) vales were significantly improved. In conclusion, anthropometric and metabolic parameters improved both in the 6th month and 1st year of the treatment in obese adolescents with insulin resistance and metformin treatment. Co-administration of metformin treatment with lifestyle changes seems to have a stronger effect in the short term. However, more studies are needed on the long-term effects of metformin treatment in the adolescent age group. Keywords: Adolescent, insulin resistance, obesity, metformin