. 2017 Nov 14;9(1):349–361. doi: 10.1007/s13300-017-0333-9

Table 4.

Possible indications for use of metformin as an adjunct to insulin therapy in type 1 diabetes

Patient subgroup	Relative indications for use of metformin
Pre-pubertal children	Not evaluated for use
Peri-pubertal adolescents and adults	Double diabetes Features of insulin resistance: Obesity/overweight (BMI ≥ 25 kg/m² or ≥ 23 kg/m² for South Asians or ≥ 85th percentile in adolescents) Acanthosis nigricans High insulin dose High insulin dose requirement (total daily dose ≥ 1 U/kg/day) Rapid weight gain with insulin Polycystic ovary syndrome Concomitant CV risk factors (central obesity, dyslipidemia, hypertension, family history of CVD) or established CV disease

Patient subgroup

Relative indications for use of metformin

Pre-pubertal children

Not evaluated for use

Peri-pubertal adolescents and adults

Double diabetes

Features of insulin resistance:

Obesity/overweight (BMI ≥ 25 kg/m² or ≥ 23 kg/m² for South Asians or ≥ 85th percentile in adolescents)

Acanthosis nigricans

High insulin dose

High insulin dose requirement (total daily dose ≥ 1 U/kg/day)

Rapid weight gain with insulin

Polycystic ovary syndrome

Concomitant CV risk factors (central obesity, dyslipidemia, hypertension, family history of CVD) or established CV disease