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The biguanides have been shown to reduce insulin requirements in type I (insulin-dependent) diabetic patients with an increase in insulin binding to insulin receptors. The aim of this was to measure the effect of metformin (850 mg/twice daily) on insulin sensitivity. Ten type I diabetic patients of normal weight received metformin or placebo in addition to their insulin therapy for seven days. On the last day of metformin or placebo treatment, tissue sensitivity was measured by the euglycemic hyperinsulinaemic clamp procedure using the artificial pancreas. An 18% improvement in glucose uptake was observed after metformin therapy (P less than 0.01). Metformin was therefore effective in improving the insulin action in type I diabetic patients, although its use in such circumstances requires consideration of several other factors.
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