People with Type 1 diabetes need insulin to control their blood sugar (glucose) levels and to survive, but the majority of people with Type 1 diabetes are not able to achieve the recommended glucose control targets, placing them at high risk of complications.  A new strategy is testing adding (to insulin) glucose control treatments usually used in Type 2 diabetes. Metformin tablets have been used for over 60 years in people with Type 2 diabetes, with benefits on glucose, blood fats, weight and vascular complications.  The REMOVAL Trial in high cardiovascular disease risk adults with Type 1 diabetes demonstrated that metformin addition improved weight, LDL-cholesterol, insulin dose and protected against progression of damage to arteries and to the kidney. Results can already guide clinical practice. Can Ongoing studies relate to its effect on the efficiency of heart contraction and relaxation.

See ANZCTR for full trial details >

Trial Summary:

This study was conducted in the UK, Australia, Canada, Denmark and the Netherlands to investigate the effects of metformin in type 1 diabetes. Metformin is a commonly used drug for type 2 diabetes to reduce the risk of heart attacks and stroke. As people with type 1 diabetes are also at risk of these conditions, the study aimed to discover whether metformin can slow or prevent the early changes that lead to atherosclerosis. Atherosclerosis was measured by progression of carotid intima-media thickness over a 3-year period.

Supported By:

NHS Greater Clyde and Glasgow; University of Glasgow; Juvenile Diabetes Research Foundation; NHMRC


Adults aged 40 and over with type 1 diabetes and known cardiovascular complications or risk factors.

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Professor John Petrie (international); Professor Alicia Jenkins (Australia)