G433 Predictors of insulin resistance and the effect of metformin treatment in obese paediatric patients

Aims Paediatric obesity is a growing concern for the health service. There is currently no consensus for routine screening of metabolic profiles and medical treatment in obese paediatric patients. We aimed to determine medium-term outcomes of Metformin treatment on BMI, glucose and insulin levels in obese paediatric patients. Methods In a retrospective review, data were collected from obese paediatric patients treated with Metformin for insulin resistance between October-09 and October-14. Demographic data was collected from these patients including presence of acanthosis nigricans (AN) and family history of T2DM. Changes in BMI SDS, glucose and insulin were analysed. Paired sample T-tests were used to compare pre and post treatment results (treatment washout period of 1 month). Results 70 patients were treated with metformin (50=female) (35=British White, 18=Pakistani) at a mean age of 12.7 (6.1–17.2) years. Mean BMI 35.2 (24.2–48.5 kg/m 2 ) and BMI SDS 3.4 (2.2–4.7). All the patients had insulin resistance at start of treatment. 21 (30%) of these had both family history of T2DM and AN. An additional 22 patients had AN only (total with AN=43, 49%). Those with AN had significantly higher basal insulin levels (p Conclusions Acanthosis nigricans is a good clinical indicator for the presence of insulin resistance. Metformin treatment is significantly associated with reduction in BMI z-score from 6 months and reduced postprandial insulin levels after treatment. It should be considered as a treatment modality in normoglycaemic obese paediatric patients for weight stabilisation and improvement of insulin resistance, which may have longer term implications on metabolic health.