A cheap and versatile drug could cut the risk of heart disease in diabetics, according to a new global study.
The Removal trial, led in Scotland, found metformin could improve cardiovascular and metabolic outcomes in adults with longstanding type 1 diabetes.
Heart disease is the most common cause attributed to cutting life expectancy for people with the condition.
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Professor John Petrie, from the University of Glasgow's Institute of Cardiovascular and Medical Sciences, said: "The results from this trial are significant because currently cardiovascular disease is a major cause of reduced life expectancy in type 1 diabetes, and cardiovascular disease rates are more than double those of the background population.
"Type 1 diabetes is not caused by lifestyle issues. Insulin therapy is required to control glucose and reduce complications but can cause weight gain which in turn is associated with high cholesterol.
"This may be one of the reasons that cardiovascular complications remain such a problem for people with type 1 diabetes."
The main objective of the trial was to test if up to three years of treatment with the drug reduced the risk of heart disease in higher-risk adults over 40 with longstanding type 1 diabetes.
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Metformin is currently recommended for those with the condition to reduce insulin intake and stabilise weight, but its effects on the heart and blood vessels have been unknown.
The drug is already used as an inexpensive first-line treatment for type 2 diabetes.
Removal is the largest clinical trial of metformin therapy in type 1 diabetes to date.
A total of 428 men and women in the UK, USA, Australia, Canada, Denmark and the Netherlands with type 1 diabetes for five years or more took part.
Of those, 219 were given metformin while 209 were given placebos.
The results showed a reduction in the thickening of the arteries over three years in those who took the drug.
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Researchers believe this points to a stronger case for using metformin more widely as a long-term strategy to reduce heart disease risk.
In Scotland, only 15% of adults with type 1 diabetes have ever received metformin, and only 8% are taking it at any one time.
Karen Addington, UK chief executive of the type 1 diabetes charity JDRF, said: We are committed to eradicating type 1 diabetes and its complications.
"Findings such as these are crucial in developing ways of using an accessible drug such as metformin to ensure people living with type 1 stay healthy for longer."
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