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One size does NOT fit all

Ensuring the safe and effective use of medications given to children is crucial. Determining the appropriate dose for children is complicated by their unique physiological characteristics and the scarcity of data regarding medication safety and efficacy in this population. Metformin, a widely prescribed medication for children, is specifically approved for treating diabetes in pediatric patients. However, only 35% of metformin prescriptions are used for diabetes treatment, with the majority, 65%, prescribed for unapproved uses like obesity and polycystic ovary syndrome. This practice introduces dosing challenges, as physicians often rely on scaling doses standardized for adults based on arbitrary factors such as body weight or body surface area, which may not be appropriate for children. Metformin response can vary among children, from beneficial to toxic, depending on the activity of a specific drug transporter protein in the kidneys that regulates its elimination from the body. To address this challenge, my research focuses on identifying a transporter biomarker within children’s bodies as a potential diagnostic test for optimizing metformin dosing. This diagnostic biomarker will offer the potential to accurately predict kidney transporter function, allowing physicians to tailor metformin doses to individual children ensuring safe and optimal therapeutic outcomes for each child.