Metformina asociada a insulinoterapia en pacientes diabéticos tipo 1 / Metformin associated with insulin therapy in type 1 diabetic patients

In patients with diabetes type 1 (T1D) glycemic control remains suboptimal, despite the availability of new insulin analogues and continuous infusion systems. Metformin may be a complementary therapy regarding to intensified insulin therapy since a significant percentage of T1D have insulin resistance (IR). Objective: To analyze the clinical, anthropometric and metabolic effects of the combination of metformin to insulin therapy in T1D patients. Subjects and Method: 34 T1D patients, 15 men and 19 women, mean age 41 years (range 20-64) metformin 850 mg / day was associated for 6 months (group 1) and retrospectively evaluated 18 T1D, 9 men and 9 women, age average 34 years (range 17-58), who received metformin for 36 months (group 2). It was recorded before and after treatment with metformin: nutritional status, waist circumference, index waist / hip, glucose fasting, glycosylated hemoglobin (HbA1c), HDL cholesterol, triglycerides, systolic and diastolic blood pressure (BP), glucose uptake (UG) and insulin dose (U/kg). Statistical analyses. Clinical and biochemical parameters were expressed as median, range or percentage (percent). For the statistical significance were used chi2and Fisher exact and Mann Whitney test; and was established as significant at p <0.05. Results: In group 1 significantly decreased waist circumference in men and women and improved fasting glucose, HbA1c, systolic blood pressure and triglycerides. In group 2, waist circumference and systolic blood pressure was also reduced. Conclusion: In T1D patients with clinical signs of IR the association of metformin to insulin therapy may be useful.

Ten-year follow-up in pediatric patients with allergic bronchial asthma: evaluation of specific immunotherapy.

Specific immunotherapy as a treatment for bronchial asthma has been a controversial field. A collaborative study was designed in an attempt to further define the possible contribution of specific immunotherapy in a pediatric population. One hundred and sixty-six patients were treated with immunotherapy and 248 received no immunotherapy. The results were compared during 10 years of follow-up in both groups. There was a significant decrease in the number of acute crisis in the treated group (p < 0.05). However, no differences were seen in the number of hospital admissions or in the quality of life between the treated and untreated groups. The treated group required significantly fewer drugs (p < 0.05). Thus, it is probable that the untreated group shows the same clinical indexes as the treated group due to their increased use of medication. Specific immunotherapy represents an effective treatment that changes the natural course of allergic bronchial asthma in pediatric patients.