How Diabetes Medications Work

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How Does Metformin Work?

Metformin is a type of oral medication used to treat type 2 diabetes — and according to Gary Scheiner, CDE, in his book, “Until There is a Cure,” metformin is the most prescribed medication for type 2 diabetes, and one of those most widely used drugs in the world. But type 1 diabetics can take metformin, too, explains Scheiner, if they’re struggling with insulin resistance and persistent high blood sugars. The brand names for metformin are Glucophage, Glucophage XR, Glumetza, Fortamet, and Riomet. Metformin has also been combined with other medications, giving you two diabetes treatment methods in one medication. Those combo-medications are: glyburide (Glucovance), glipizide (Metaglip), rosiglitazone (Avandamet), pioglitazone (Actoplus Met), sitagliptin (Janumet) and repaglinide (PrandiMet). [Download our free Guide to Type 2 Diabetes Medications] Metformin is taken in pill-form. It is generally taken twice per day, at breakfast and at dinner. For those with higher levels of insulin resistance, your doctor may prescribe metformin to be taken at all three meals: breakfast, lunch, and dinner. Benefits of Metformin: While there are a variety of oral medications to help people Continue reading >>

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Popular Questions

  1. farmsrock

    My dog has recently been diagnosed with diabetes. She is not responding to Vetsulin, plus it is way too expensive for us. So the vet switched us to Humulin N, but the dosage is nearly half of the Vetsulin dose. She has been on 15 units of Vetsulin, and the vet wants us to give her 8 units of Humulin N.
    My husband does not understand why this would be. I told him that the vet tech said Humulin was 2.5 times stronger than Vetsulin. We realize that Vetsulin is a U-40 and Humulin N is a U-100, but he still does not understand. And I don't have a clue either.
    Is the reason only because of the relative strengths of the different insulins? My husband can't believe that we would only give the dog that little bit of Humulin out of a U-100 needle. We bought 1cc/29 ga/1/2" needle length needles, which is the same as what we were using for the Vetsulin except for them being U-100 and not U-40.
    This whole thing has been very confusing for us, a lot of which has to do with the vet not communicating with us properly, nor communicating properly with her staff. At times I think she is more interested in making money.
    Any help you can give us would be appreciated.

  2. k9diabetes

    The vet tech is correct only technically... the NPH solution is 2.5 times more concentrated than the Vetsulin solution. There are 100 units of insulin in a mL of NPH and only 40 units in an mL of Vetsulin.
    All that means is you give more fluid to give 15 units of NPH than you give to inject 15 units of Vetsulin.
    Most dogs require about the same number of units when you switch. Vetsulin suggests, when switching a dog from NPH to Vetsulin, to reduce the dose about 25%. So that's what I would do when switching the other way... IF the dog is already fairly well regulated.
    If the blood sugar is still extremely high when the switch is made, I might not decrease the number of units much or at all.

    This whole thing has been very confusing for us, a lot of which has to do with the vet not communicating with us properly, nor communicating properly with her staff. At times I think she is more interested in making money.
    Any help you can give us would be appreciated. Sorry they were apparently confused about this and confused you as well.
    We can help. Please fill us in with as much detail as you can.
    Date diagnosed
    Vetsulin once or twice a day?
    NPH is given twice a day, yes?
    how you're monitoring his regulation
    results of any curves or other tests the vet has done.

  3. farmsrock

    Well, I am finding that I get pretty sketchy information from the vet tech, and sometimes totally contradictory information as well. And then, the vet accuses me of getting confused. I am about to look for a new vet.
    My dog is a 9 year old female Lab. She was diagnosed mid-June when I brought her in for a UTI, and the diabetes was diagnosed with bloodwork and urine samples. While I was still in shock, the vet pushed the home glucose monitoring system on me and the Vetsulin. Once I calmed down a little, I crunched numbers and discovered that it would cost over $3000 to treat her in this manner, if it was successful. The glucose strips alone would cost over $1000 a year and we just don't have that kind of money. And this was getting supplies from outside sources, etc. We cannot afford that, so I asked for a cheaper route. Which I think did not sit well with the vet. Too bad. She never gave me options or suggestions on cheaper places to get medicine, supplies, etc. In the past, she has literally ripped me off on dietary supplements, so I didn't expect any help from her this time.
    My dog was on Nutro Large Breed Senior which she loved to eat. She was around 85 lbs. The vet switched her to Purina OM, and she hates it. In the last two weeks, she has been skipping meals, refusing to eat. She has dropped at least 10 lbs since mid-June. My dog is very sick. She has gotten sicker since she was diagnosed. Plus she has had an ear hematoma and a leg wound that she caused by licking and biting that required massive doses of antibiotics. The ear hematoma was drained on Friday, and I think the ear is filling up again, so I am at my wits' end.
    At the start, we were able to get her glucose levels down in the 300s. Rarely below 200. This past week, if she gets in the 400s, with the Vetsulin, it's been a good day. This is monitoring twice a day. My meter has read HI a few times, which means that her numbers were over 750. One of my issues is that I am not able to monitor 3 times a day like a lot of people, and I can't stay home from work if she doesn't eat in the morning and wait until she does. We were doing the Vetsulin 15 IU 2x day, and the new insulin is the same number of doses, but only 8 units each time, which is not 25% less in my mind, but maybe I am still not understanding things.
    I started the new insulin (actually Novolin N from Wal-Mart) tonight. I realize I made a mistake in buying the 1cc syringes because the vet wants me to start with 8 units of the new stuff which hard to do with that size. But I am not getting good advice from her or much help, so I am floundering, and I bought the same size as I was using with the Vetsulin, when I probably should have bought the 1/3cc. This is all so new to me. The vet gave me the number of another dog owner who has been doing this, but I can't say she was all that helpful. I felt as if I was supposed to know what to ask, instead of her telling me how she does it and giving me tips. Plus her situation is different from mine.
    Plus my dog has arthritis, and her back legs are collapsing a lot, so I can't get her exercise, which I know would be a part of regular diabetes treatment protocol.
    The vet wants to do a glucose curve one day. She has mentioned it once, but never followed up. Wanted to do it two weeks after the leg wound treatment. Then the ear thing came up, so I never scheduled it. I don't expect the vet to call and ask about a glucose curve. Yesterday, her staff called to ask how my dog was, right as my husband was driving her to get her compression bandage off from the ear drainage, a scheduled visit. That is how out of touch and out of communication this practice is. Just when you need help and time to process things, they aren't there for you. Driving me nuts.
    I am at this point trying to give my dog a fighting chance with the resources we have. If we fail, I can at least say I tried. My husband is not liking the expense (even with insurance), so he is reaching his limit pretty fast, and I would like to show him some progress.
    Thanks for your reply so quickly. I really appreciate it.

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