The first patient has just been recruited to join a new, large-scale JDRF-funded clinical trial. This major international research project is seeking to reduce the risk of cardiovascular disease in people with type 1 diabetes.
The five-year, £4.25m trial, is being led by researchers at the Universities of Glasgow and Dundee. Known as REMOVAL (Reducing with MetfOrmin Vascular Adverse Lesions in type 1 diabetes), the trial will investigate the effects of a drug called metformin on people aged 40 and over who have type 1 diabetes.
People involved in the trial will be asked to continue their regular insulin treatment but will be asked to add a daily tablet to their treatment regimen.
They will be given either metformin or a placebo.
Metformin has been used for 40 years in the treatment of type 2 diabetes. Although it works by preventing high blood glucose levels, evidence also exists that it can improve blood vessel function, reduce risk factors for cardiovascular disease, and improve the action of insulin on the liver, even for people without diabetes. Small clinical trials using metformin with people with type 1 have been conducted in the past, but the studies have been too small to draw any firm conclusions. The REMOVAL trial should be able to provide doctors with a definitive answer as to whether metformin can help people living with type 1.
Over three years, researchers will monitor the effect of the treatment on the participants’ glucose control, and monitor if there is an effect on their ‘intima media thickness’: a measure of cardiovascular health that can help to predict the likelihood of heart attacks or strokes. This is measured using a simple ultrasound scan of the neck.
Ten hospitals around the UK are participating in the trial, along with sites in Australia, Canada, Denmark and the Netherlands. The research team need to recruit 499 more people from around the world (about 250 from the UK) to get involved in the trial.
So if you have type 1, are over 40, and would like to help find out if adding a simple pill to type 1 treatment could help prevent cardiovascular complications of diabetes, why not find out if a hospital near you is involved in the study?