Metabolic syndrome – metformin — RACP Paediatrics MCQ

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ModerateEndocrineMetabolic syndrome – metforminRACP Paediatrics

The same adolescent has failed intensive lifestyle modification after 6 months with no significant weight change. Metabolic parameters are worsening. What pharmacological adjunct should be considered?

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Correct answer: E — Metformin

Metformin can be considered as adjunctive pharmacotherapy in adolescents ≥10 years with BMI ≥35 and metabolic complications when lifestyle modification alone has failed. It reduces insulin resistance and may assist modest weight loss. GLP-1 receptor agonists (liraglutide, semaglutide) are emerging options with stronger weight loss efficacy and are now TGA-approved for adolescent obesity.

Reference: RCH Melbourne – 2023 – Obesity CPG; RACP Paediatric Curriculum – Endocrine