Recently, my daughter’s doctor asked her to begin taking Glucophage [metformin, a pill for Type 2 diabetes]. My daughter is a Type 1 diabetic, diagnosed at age 8, currently age 19, and on the insulin pump. The doctor wants her to lose more weight and thus recommended Glucophage (500 mg twice a day). What is the history of Glucophage use with type 1 diabetics this young? Are there any long-term advantages or disadvantages?

Officially Glucophage is not recommended for type 1 insulin dependent diabetics. If there is no family history of type 2 diabetes in your family, then the excessive weight gain may be secondary to overaggressive insulin therapy and may be best treated by cutting back on food and insulin. If there is a strong family history of obesity or type 2 diabetes, then your child might have both type 1 diabetes (insulin deficient) and a component of insulin resistance due to the obesity. Theoretically, in this case Glucophage may be of some help, though I am not aware of any studies evaluating this.

You have to be careful with Glucophage if your child is prone to spilling ketones. This can increase the risk of the rare side effect of Glucophage of lactic acidosis.

TGL