| Title: |
Metformin and carotid intima media thickness in never smokers with type 1 diabetes: the REMOVAL trial |
| Authors: |
Timmons, JG; Greenlaw, N; Boyle, JG; Chaturvedi, N; Ford, I; Brouwers, M; Tillin, T; Hramiak, I; Hughes, AD; Jenkins, AJ; Klein, B; Klein, R; Ooi, TC; Rossing, P; Stehouwer, C; Sattar, N; Colhoun, HM; Petrie, JR; REMOVAL Study Group, . |
| Source: |
Diabetes, Obesity and Metabolism , 23 (6) pp. 1371-1378. (2021) |
| Publication Year: |
2021 |
| Collection: |
University College London: UCL Discovery |
| Description: |
Aim: To determine whether metformin's effects on carotid artery intima-media thickness (cIMT) in type 1 diabetes differ according to smoking status. Methods: Regression model effect estimates for the effect of metformin versus placebo (double-blind) on carotid IMT were calculated as a subgroup analysis of the REMOVAL trial. Results: In 428 randomized participants (227 never-smokers, 201 ever-smokers), averaged mean carotid IMT progression (per year) was reduced by metformin versus placebo in never-smokers (−0.012 mm, 95% CI −0.021 to −0.002; p = .0137) but not in ever-smokers (0.003 mm, 95% CI −0.008 to 0.014; p = .5767); and similarly in non-current smokers (−0.008 mm, 95% CI −0.015 to −0.00001; p = .0497) but not in current smokers (0.013 mm, 95% CI −0.007 to 0.032; p = .1887). Three-way interaction terms (treatment*time*smoking status) were significant for never versus ever smoking (p = .0373, prespecified) and non-current versus current smoking (p = .0496, exploratory). Averaged maximal carotid IMT progression (per year) was reduced by metformin versus placebo in never-smokers (−0.020 mm, 95% CI −0.034 to −0.006; p = .0067) but not in ever-smokers (−0.006 mm, 95% CI −0.020 to 0.008; p = .4067), although this analysis was not supported by a significant three-way interaction term. Conclusions: This subgroup analysis of the REMOVAL trial provides additional support for a potentially wider role of adjunct metformin therapy in cardiovascular risk management in type 1 diabetes, particularly for individuals who have never smoked cigarettes. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10122194/1/Hughes_dom.14350.pdf; https://discovery.ucl.ac.uk/id/eprint/10122194/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10122194/1/Hughes_dom.14350.pdf; https://discovery.ucl.ac.uk/id/eprint/10122194/ |
| Rights: |
open |
| Accession Number: |
edsbas.9225EA82 |
| Database: |
BASE |