Addressing insulin resistance in Type 1 diabetes

Diabet Med. 2008 Sep;25(9):1015-24. doi: 10.1111/j.1464-5491.2008.02493.x.


Type 1 diabetes is recognised to include an element of insulin resistance. Insulin resistance is an independent risk factor for the development of macro- and microvascular complications of Type 1 diabetes and may also contribute to the development of the disease. This understanding comes at a time when the incidence of Type 1 diabetes appears to be rising and the public health burden from its vascular complications is high. A variety of safe and efficacious manoeuvres are available to redress insulin resistance in Type 2 diabetes. So far however, clinical trials addressing insulin resistance in Type 1 diabetes have been small with only short periods of follow-up. Regardless, these trials have yielded promising results. This review examines the evidence for insulin resistance in the pathophysiology of Type 1 diabetes and its complications, the problems associated with its measurement, and summarizes the trials aimed at reducing insulin resistance in Type 1 diabetes. This includes a meta-analysis of controlled trials of adjuvant metformin in Type 1 diabetes.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Resistance / physiology*
  • Metformin / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Thiazolidinediones / therapeutic use*


  • Blood Glucose
  • Hypoglycemic Agents
  • Thiazolidinediones
  • Metformin