ORCID Profile
0000-0001-8559-8387
Current Organisations
Garvan Institute of Medical Research
,
St Vincent's Hospital Sydney
,
Westmead Hospital
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Publisher: Wiley
Date: 16-04-2021
DOI: 10.1111/DME.14564
Abstract: Insulin resistance is an under-recognised metabolic defect and cardiovascular risk factor in Type 1 diabetes. Whether metformin improves hepatic, muscle or adipose tissue insulin sensitivity has not been studied in adults with Type 1 diabetes. We initiated the INTIMET study (INsulin resistance in Type 1 diabetes managed with METformin), a double-blind randomised, placebo-controlled trial to measure the effect of metformin on tissue-specific insulin resistance in adults with Type 1 diabetes. We will study 40 adults aged 20-55 years with Type 1 diabetes (HbA1c The INTIMET study is the first clinical trial to quantify the impact of metformin on liver, muscle and adipose insulin resistance in adults with Type 1 diabetes. This study may identify factors that predict an in idual's response to metformin in Type 1 diabetes. ACTRN12619001440112.
Publisher: The Endocrine Society
Date: 17-06-2020
Publisher: BMJ
Date: 04-2020
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.HLC.2017.02.030
Abstract: Patients with type 2 diabetes have an increased risk of developing adverse cardiovascular (CV) outcomes. The evidence relating to the effects of glucose-lowering medications on CV outcomes is of variable quality and there are numerous trials ongoing. In this review, we summarise the available literature on CV outcomes of the following diabetes treatments: metformin, the sulfonylureas, acarbose, glucagon-like peptide 1 (GLP1) receptor agonists, dipeptidyl peptidase-4 inhibitors (DPP4i), sodium-glucose co-transporter 2 inhibitors (SGLT2i), thiazolidinediones (TZDs) and insulin. Insulin is required if glucose levels are very high. Otherwise, metformin, acarbose, some GLP1 receptor agonists and one SGLT2i appear beneficial for CV outcomes.
Publisher: American Diabetes Association
Date: 12-07-2019
DOI: 10.2337/DC19-0730
Publisher: Wiley
Date: 30-06-2022
DOI: 10.5694/MJA2.51637
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.TEM.2019.11.007
Abstract: In iduals with type 1 diabetes (T1D) frequently fail to achieve glycemic goals and have excess cardiovascular risk and premature death. Adjunctive agents may play a role in reducing morbidity, mortality, and the adverse sequelae of insulin treatment. A surge in type 2 diabetes drug development has revealed agents with benefits beyond glucose lowering, including cardiovascular risk reduction. Could these benefits translate to T1D? Specific trials for T1D demonstrate substantial hemoglobin (Hb)A1c reductions with sodium glucose cotransporter inhibitors (SGLTis) and glucagon-like peptide (GLP)1 agonists, and modest improvements with metformin, dipeptidyl peptidase-4 inhibitor (DPP4i), and pramlintide. Studies exploring cardiovascular risk reduction are warranted. This review synthesizes the emerging literature for researchers and clinicians treating people with T1D. Challenges in T1D research are discussed.
Publisher: AMPCo
Date: 28-02-2021
DOI: 10.5694/MJA2.50946
Publisher: Wiley
Date: 14-10-2019
DOI: 10.1111/CEN.14083
Publisher: The Endocrine Society
Date: 04-2020
DOI: 10.1210/JENDSO/BVAA046.2038
Abstract: Background: Insulin resistance is an under-recognised cardiovascular risk factor in type 1 diabetes (T1D). In iduals with T1D exhibit insulin resistance relative to those without diabetes. In T1D, tissue-specific insulin resistance (muscle, hepatic, adipose) is likely to partly drive increased cardiovascular risk. Adjunctive metformin improves muscle insulin sensitivity in T1D adolescents, but factors that predict responsiveness remain unknown.Objective: To report the rationale and design of the INTIMET study, a double-blind randomised, placebo-controlled trial of metformin in T1D.Methods: Forty adults aged 20-50 years with T1D, and 20 age- gender- and BMI- matched non-diabetic controls will be studied. T1D inclusion criteria are diagnosis & 10 years, HbA1c 9.5% and fasting C-peptide & 0.3nmol/L. Liver and muscle insulin sensitivity will be determined by the 2-stage hyperinsulinemic (20 and 60 mUm2)-euglycemic (5.5 mmol/L) cl method with deuterated glucose. Subjects with T1D will be randomised to metformin extended-release 1500mg/d or matched placebo for 26 weeks. The primary endpoint is the change in hepatic insulin sensitivity, measured by suppression of endogenous glucose production (EGP) with the low-dose insulin cl . Secondary endpoints include change in muscle and adipose tissue insulin sensitivity, arterial stiffness, HbA1c, glucose variability, frequency of hypoglycemia, insulin dose, anthropometry, body composition, lipid profile, liver fat and stiffness. Conclusion: The INTIMET study will quantify muscle, liver and adipose insulin-resistance in T1D, determine whether metformin is effective in improving insulin resistance in T1D and identify factors that predict metformin-responsiveness. The trial is registered (Australian New Zealand Clinical Trial Registry, ACTRN12619001440112) and is actively recruiting in Sydney, Australia.
Publisher: Elsevier BV
Date: 09-2016
Publisher: Elsevier BV
Date: 03-2019
No related grants have been discovered for Jennifer Snaith.