Diabetes Type 2
Many people with type 2 diabetes are prescribed tablets to help control their blood glucose levels. Metformin is the first-line medication for diabetes in the UK but there are many more types of medication for type 2 diabetes discussed below. Most people had tried initially to control their blood glucose with a regimen of diet and exercise before being given oral medication. Many people took metformin alone to control blood glucose, and some were taking metformin and gliclazide. Both medications help to reduce blood glucose but work differently. Metformin reduces the amount of glucose produced in the liver, and also makes muscle tissue absorb more glucose; gliclazide increases the amount of insulin produced by the pancreas. While people found that the medication they took had helped reduce and control their blood glucose, many had experienced side effects. Metformin can cause diarrhoea and other digestive problems and many people went back to their GPs for advice. Some people felt concerned about the risks they might face from certain drugs after reading negative reports in the media (see 'Misunderstandings about diabetes'). Rosiglitazone has been linked to an increased risk of heart attack and stroke. Since these interviews were conducted in 2008, there has been growing concern about the potential harmful effects of rosiglitazone (Avandia, but also contained in Avandamet and Avaglim) and from September 2010 in the UK and Europe, new prescribing of this drug has stopped, and most people who were taking the drug have been changed to alternative medication. Most people we interviewed had been prescribed higher dosages of medication to control their blood glucose as their diabetes got worse over time. Some people had transferred to insulin while continuing on metformin (se Continue reading >>
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 with type 2 diabetes reduce their blood sugar levels, they all work very differently in the body. Scheiner explains exactly how metformin works in the body: Metformin does not increase insulin levels and does not cause hypoglycemia. Instead, it decreases the amount of sugar produced by the liver and tends to suppress appetite. – “Until There is a Cure,” page 81 In every human body, the liver releases small amounts of glucose throughout the day. The primary effect of taking metformin is that this release of glucose from the liver is lessened, resulting in lower blood sugars. Metformin als Continue reading >>
Scientists Figure Out How Diabetes Drug Lowers Blood Sugar
Scientists figure out how diabetes drug lowers blood sugar Posted by David Scott-Melbourne November 6th, 2013 You are free to share this article under the Attribution 4.0 International license. New research solves the mystery of how the drug metformin lowers blood sugar for people with type 2 diabetes. Published in the journal Nature Medicine , the study shows that metformin reduces fat in the liver, which allows insulin to work better. The finding may help scientists develop more effective therapies for diabetes. “This work, the result of a great international collaboration, has the potential to help develop more effective treatments for type 2 diabetes, which currently affects 4 percent of Australians and represents an ever growing burden on our health system,” says Professor Bruce Kemp, from the University of Melbourne and St. Vincent’s Institute of Medical Research, who has worked closely on the project. Senior author on the study Greg Steinberg, an associate professor at McMaster University in Canada, says the key is that metformin doesn’t work to lower blood glucose by directly working on the glucose. “It works on reducing harmful fat molecules in the liver, which then allows insulin to work better and lower blood sugar levels.” Sandra Galic from St Vincent’s Institute and co-lead author on the study, was keen to work out the mechanism of action of metformin. “We knew that metformin activates the metabolic sensor AMP-activated protein kinase (AMPK), but didn’t know how that action resulted in the improvements seen in patients taking the drug. “When we introduced mutations into two proteins in the AMPK pathway in mice so that they could no longer be switched off by AMPK, we found that that the mice developed fatty liver and pre-diabetes, but di Continue reading >>
Glucophage (metformin) And Diabetes
Tweet Glucophage and Metformin are often mentioned in relation to diabetes treatment. But what exactly is Glucophage and how does Glucophage help control type 2 diabetes? The following guide to Glucophage should help you to understand more about this medication, its side effects and its value. What is Glucophage? Glucophage tablets (and Glucophage SR tablets) each have an active ingredient called Metformin hydrochloride. Metformin is widely used to aid in the control of blood glucose levels amongst people with type 2 diabetes. How does Glucophage help people with type 2 diabetes? Amongst people with type 2 diabetes, the pancreas fails to produce sufficient levels of insulin. Furthermore, the cells in the body may be resistant to any insulin that is present. Normally, insulin would instruct cells to remove sugar from the blood, but in people with diabetes blood sugar levels can climb too high. As we said before, Glucophage contains the ingredient Metformin. Metformin (Metformin hydrochloride) is a type of medicine known as a biguanide. This works to lower the amount of sugar in the blood of people with diabetes. It does this by lowering the amount of sugar produced in the liver, and also increasing the sensitivity of muscle cells to insulin. The cells are therefore more able to remove sugar from the blood. Metformin also slows the absorption of sugars from the intestines. Metformin lowers blood sugar levels between and after meals. Who is Glucophage prescribed to? Glucophage is usually prescribed as a treatment for people with type 2 diabetes who are overweight or obese. When diet and exercise fail to adequately control blood glucose levels, Glucophage is prescribed. Sometimes, this medicine is used in conjunction with other anti-diabetic medication. How often do people Continue reading >>
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The Multiple Benefits Of Metformin
Metformin (brand name "Glucophage") has been used in the treatment of type II diabetes for the past 40 years.1 This drug counteracts many of the underlying factors that result in the manifestation of this insidious disease. Metformin also produces helpful side benefits that can protect against the lethal complications of type II diabetes. Frequently prescribed anti-diabetic drugs fail to address the fundamental causes of type II diabetes and can induce serious side effects. Type II diabetes affects between 16 to 19 million Americans. About 75% of type II diabetics will die from a cardiovascular-related disease. Conventional doctors often prescribe drugs for the purpose of lowering blood sugar levels. These drugs do not adequately address the multiple underlying pathologies associated with the type II diabetic state. Type II diabetes is characterized by cellular insulin resistence. The result is excess accumulation of glucose in the bloodstream as cells become resistant to the effects of insulin. Type II diabetes is characterized by cellular insulin resistence. The result is excess accumulation of glucose in the bloodstream because cells become resistant to the effects of insulin and fail to take up glucose As the type II diabetic condition progresses, many people gain weight and develop more fat cells.2 Treating type II diabetes with insulin-enhancing therapy increases the risk of cardiovascular complications, induces weight gain, and fails to correct the underlying cause of the disease. Many type II diabetics produce too much insulin in a futile attempt to drive glucose into insulin-resistant cells. When doctors prescribe insulin-enhancing drugs to these type II diabetics, a temporarily reduction of serum glucose may occur, but the long-term effects of this excess insu Continue reading >>
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Metformin
A popular oral drug for treating Type 2 diabetes. Metformin (brand name Glucophage, Glucophage XR, Glumetza, Riomet) is a member of a class of drugs called biguanides that helps lower blood glucose levels by improving the way the body handles insulin — namely, by preventing the liver from making excess glucose and by making muscle and fat cells more sensitive to available insulin. Metformin not only lowers blood glucose levels, which in the long term reduces the risk of diabetic complications, but it also lowers blood cholesterol and triglyceride levels and does not cause weight gain the way insulin and some other oral blood-glucose-lowering drugs do. Overweight, high cholesterol, and high triglyceride levels all increase the risk of developing heart disease, the leading cause of death in people with Type 2 diabetes. Another advantage of metformin is that it does not cause hypoglycemia (low blood glucose) when it is the only diabetes medicine taken. Metformin is typically taken two to three times a day, with meals. The extended-release formula (Glucophage XR) is taken once a day, with the evening meal. The most common side effects of metformin are nausea and diarrhea, which usually go away over time. A more serious side effect is a rare but potentially fatal condition called lactic acidosis, in which dangerously high levels of lactic acid build up in the bloodstream. Lactic acidosis is most likely to occur in people with kidney disease, liver disease, or congestive heart failure, or in those who drink alcohol regularly. (If you have more than four alcoholic drinks a week, metformin may not be the best medicine for you.) Unfortunately, many doctors ignore these contraindications (conditions that make a particular treatment inadvisable) and prescribe metformin to people Continue reading >>
Metformin 101: Blood Sugar Levels, Weight, Side Effects
As a type 2 diabetic, you've probably heard of Metformin, or you might even be taking it yourself. Metformin (brand name “Glucophage” aka “glucose-eater”) is the most commonly prescribed medication for type 2 diabetes worldwide…and for good reason. It is one of the safest, most effective, least costly medication available with minimal, if any, side effects. There are always lots of questions around Metformin – how does metformin lower blood sugar, does metformin promote weight loss or weight gain, will it give me side effects – and lots more. Today we'll hopefully answer some of those questions. How Metformin Works Metformin belongs to a class of medications known as “Biguanides,” which lower blood glucose by decreasing the amount of sugar put out by the liver. The liver normally produces glucose throughout the day in conjunction with the pancreas’ production of insulin to maintain stable blood sugar. In many people with diabetes, both mechanisms are altered in that the pancreas puts out less insulin while the liver is unable to shut down production of excess glucose. This means your body is putting out as much as 3 times as much sugar than that of nondiabetic individuals, resulting in high levels of glucose in the bloodstream. Metformin effectively shuts down this excess production resulting in less insulin required. As a result, less sugar is available for absorption by the muscles and conversion to fat. Additionally, a lower need for insulin slows the progression of insulin resistance and keeps cells sensitive to endogenous insulin (that made by the body). Since metformin doesn’t cause the body to generate more insulin, it does not cause hypoglycemia unless combined with a sulfonylurea or insulin injection. Metformin is one of the few oral diabe Continue reading >>
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Description And Brand Names
Drug information provided by: Micromedex US Brand Name Fortamet Glucophage Glucophage XR Glumetza Riomet Descriptions Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral antidiabetic medicine called a sulfonylurea, or with insulin, will help to lower blood sugar when it is too high and help restore the way you use food to make energy. Many people can control type 2 diabetes with diet and exercise. Following a specially planned diet and exercise will always be important when you have diabetes, even when you are taking medicines. To work properly, the amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet or exercise, you will want to test your blood sugar to find out if it is too low. Your doctor will teach you what to do if this happens. Metformin does not help patients does not help patients who have insulin-dependent or type 1 diabetes because they cannot produce insulin from their pancreas gland. Their blood glucose is best controlled by insulin injections. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Tablet Tablet, Extended Release Solution Copyright © 2017 Truven Health Analytics Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Continue reading >>
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Stopping Metformin: When Is It Ok?
The most common medication worldwide for treating diabetes is metformin (Glumetza, Riomet, Glucophage, Fortamet). It can help control high blood sugar in people with type 2 diabetes. It’s available in tablet form or a clear liquid you take by mouth before meals. Metformin doesn’t treat the underlying cause of diabetes. It treats the symptoms of diabetes by lowering blood sugar. It also increases the use of glucose in peripheral muscles and the liver. Metformin also helps with other things in addition to improving blood sugar. These include: lowering lipids, resulting in a decrease in blood triglyceride levels decreasing “bad” cholesterol, or low-density lipoprotein (LDL) increasing “good” cholesterol, or high-density lipoprotein (HDL) If you’re taking metformin for the treatment of type 2 diabetes, it may be possible to stop. Instead, you may be able to manage your condition by making certain lifestyle changes, like losing weight and getting more exercise. Read on to learn more about metformin and whether or not it’s possible to stop taking it. However, before you stop taking metformin consult your doctor to ensure this is the right step to take in managing your diabetes. Before you start taking metformin, your doctor will want to discuss your medical history. You won’t be able to take this medication if you have a history of any of the following: alcohol abuse liver disease kidney issues certain heart problems If you are currently taking metformin, you may have encountered some side effects. If you’ve just started treatment with this drug, it’s important to know some of the side effects you may encounter. Most common side effects The most common side effects are digestive issues and may include: diarrhea vomiting nausea heartburn abdominal cramps Continue reading >>
Metformin | Diabetesnet.com
Thu, 11/18/2010 - 15:57 -- Richard Morris Two drugs from the biguanide class, metformin and phenformin, were developed in 1957. Unfortunately, phenformin reached the U.S. market first and resulted in several deaths from lactic acidosis. When this risk surfaced, phenformin was pulled from drugstore shelves worldwide. Metformin was eventually found to be 20 times less likely to cause lactic acidosis, but it was tainted by the history of its cousin. Metformin first became available in France in 1979 and has been widely used in Europe since then, but it was not cleared for use in Type 2 diabetes in the U.S. until 1994. Target Organ: Liver, secondary effects on muscle and fat. Action: Lower glucose production by liver, increase number of insulin receptors Side Effects: bloating, fullness, nausea, cramping, diarrhea, vit B12 deficiency, headache, metallic taste, agitation, lactic acidosis Contraindications: DKA, alcoholism, binge drinking, kidney or liver disease, congestive heart failure, pregnancy, use of contrast media, surgery, heart attack, age > 80 Metformin is a chemical kin to the French lilac plant, which was noted in the early 1900’s to lower the blood sugar. However, French lilac, like phenformin, turned out to be too toxic for use in humans. Metformin, with a much shorter action time than phenformin, has a much lower risk for severe side effects and is quite safe for use by anyone who is otherwise healthy. In fact, in the major UKPDS study, it was the only drug that reduced diabetes-related death rates, heart attacks, and strokes. It should not be used by those who use more than two ounces or two drinks of alcohol a day, who have congestive heart failure, or who have significant kidney, liver, or lung disease. Metformin lowers fasting blood glucose levels by an Continue reading >>
Wait Times: How Long Until Your Med Begins Working
Photography by Mike Watson Images/Thinkstock There are many type 2 medications, and each drug class works in the body in a different way. Here’s a quick guide to help you understand how long each drug will generally take to work: These short-acting oral medications, taken with meals, block the breakdown of complex sugars into simple sugars in the gastrointestinal (GI) tract. “Simple sugars are more easily absorbed and cause the blood sugar to ultimately go up,” Sam Ellis, PharmD, BCPS, CDE, associate professor in the Department of Clinical Pharmacy at the University of Colorado says. These drugs are minimally absorbed into the blood, so a certain blood level concentration is not necessary for them to work. You will see the effect immediately with the first dose. “You take it before a meal, and with that meal you see the effect,” says George Grunberger, MD, FACP, FACE, President of the American Association of Clinical Endocrinologists. While researchers aren’t exactly sure how these oral medications work, it’s likely that the meds block some absorption of glucose in the GI tract. “You’ll see most of the effect in the first week with these drugs,” says Ellis. alogliptin, linagliptin, saxagliptin, sitagliptin These drugs work to block the enzyme responsible for the breakdown of a specific gut hormone that helps the body produce more insulin when blood glucose is high and reduces the amount of glucose produced by the liver. Take a DPP-4 inhibitor (they come in pill form) and it’ll work pretty fast—you’ll see the full effect in about a week. “It’s blocking that enzyme after the first dose a little bit, but by the time you get out to dose five, you’re blocking the majority of that enzyme,” Ellis says. albiglutide, dulaglutide, exenatide, exe Continue reading >>
Metformin: Improving Insulin Sensitivity
Metformin is the only medication in the biguanides category of blood glucose-lowering drugs approved by the U.S. Food and Drug Administration (FDA). Metformin has been available in the United States since the mid-1990s, when it received FDA approval. You may also know it by its brand name when it was under patent, Glucophage. Metformin is now widely available as a relatively inexpensive generic medication. Metformin’s main action is to decrease the overproduction of glucose by the liver, a common problem in prediabetes and type 2 diabetes. The action of metformin helps lower blood sugar levels particularly during the night to keep fasting glucose levels under control, but it also helps control blood glucose throughout the day. Metformin also increases the uptake of glucose by your muscles. Overall, metformin decreases insulin resistance and improves insulin sensitivity, thereby helping the insulin your body still makes work more effectively. People with prediabetes and in the early years of type 2 diabetes often continue to make some insulin, just not enough to control blood sugar levels alone. Metformin is not formally approved for use in prediabetes, and any use to treat prediabetes is considered off-label by providers. Since its approval, metformin has become the most commonly recommended blood glucose-lowering medication to treat type 2 diabetes. In recent years it has significantly replaced sulfonylureas, such as glipizide and glyburide. Today both the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD), and the American Association of Clinical Endocrinologists (AACE) generally recommend that people with type 2 diabetes start taking metformin when they are diagnosed to help treat insulin resistance and maximize insulin s Continue reading >>
Metformin: Uses, Action, Dosage, Side Effect And Brand Information
What is metformin used for? Controlling blood sugar levels in adults, adolescents and children aged 10 years and over with type 2 diabetes. Metformin is used when diet alone has failed to fully control blood sugar. It may be used on its own, in combination with other oral antidiabetic medicines, or with insulin. Polycystic ovary syndrome (PCOS). This is an off-licence use of metformin, so you won't find it mentioned in the information leaflets that come with the medicine. However, metformin is a widely used and established treatment option for this condition. How does metformin work? In type 2 diabetes the cells in the body, particularly muscle, fat and liver cells, become resistant to the action of insulin. Insulin is the main hormone responsible for controlling the level of sugar (glucose) in the blood. It makes cells in the body remove sugar from the blood. When the cells are resistant to insulin this makes blood sugar levels rise too high. Metformin hydrochloride is a type of antidiabetic medicine called a biguanide. It works in a number of ways to lower blood sugar levels in people with type 2 diabetes. Firstly, it increases the sensitivity of muscle cells to insulin. This enables these cells to remove sugar from the blood more effectively. Secondly, it reduces the amount of sugar produced by cells in the liver. Finally, it delays the absorption of sugar from the intestines into the bloodstream after eating so that there is less of a spike in blood sugar levels after meals. Metformin is taken regularly every day to help control blood sugar levels both between and directly after meals. In polycystic ovary syndrome or PCOS many women have high insulin levels, and as a result their cells become resistant to the action of insulin. The high insulin levels also cause an Continue reading >>
New Information On How Metformin Works
Not only has new research told us how metformin really works, but a new biomarker was found that can determine the optimal dose of metformin that should be used to get the best results for each patient. Research from the Johns Hopkins Children’s Center reveals that the drug most commonly used in Type 2 diabetics who don’t need insulin works on a much more basic level than once thought, treating persistently elevated blood sugar — the hallmark of Type 2 diabetes — by regulating the genes that control its production. investigators say they have zeroed in on a specific segment of a protein called CBP made by the genetic switches involved in overproduction of glucose by the liver that could present new targets for drug therapy of the disease. In healthy people, the liver produces glucose during fasting to maintain normal levels of cell energy production. After people eat, the pancreas releases insulin, the hormone responsible for glucose absorption. Once insulin is released, the liver should turn down or turn off its glucose production, but in people with Type 2 diabetes, the liver fails to sense insulin and continues to make glucose. The condition, known as insulin resistance, is caused by a glitch in the communication between liver and pancreas. Metformin, introduced as frontline therapy for uncomplicated Type 2 diabetes in the 1950s, up until now was believed to work by making the liver more sensitive to insulin. The Hopkins study shows, however, that metformin bypasses the stumbling block in communication and works directly in the liver cells. Senior investigator, Fred Wondisford, M.D., who heads the metabolism division at Hopkins Children’s, tells us that, "Rather than an interpreter of insulin-liver communication, metformin takes over as the messenger itself Continue reading >>
The Mechanism Of Metformin's (glucophage) Lowering Fasting Glucose Levels And Hepatogluconeogenesis
Summary: It is well known that patients with type 2 diabetes mellitus are characterized as having insulin resistance, a decrease in insulin mediated glucose uptake by peripheral tissues, and excessive basal rates of hepatic glucose production. Impairment in peripheral glucose uptake and suppression of gluconeogenesis both contribute to worsening postprandial (post-meal) hyperglycemia whereas excessive basal rates of hepatic glucose production primarily contributes to the worsening of fasting glucose levels. The most common biguanide, metformin, has been shown to "slow down" the accelerated basal rates of hepatic gluconeogenesis by inhibiting 2 key enzymes in hepatic gluconeogenesis (glucose 6-phosphate and phosphoenolpyruvate carboxykinase) without an apparent effect on lactate turnover for gluconeogenesis or increases in insulin secretion. Thus fasting blood sugars are most affected. The average reductions in fasting blood glucose levels and hemoglobin A1c while on metformin are approximately 44 to 53 mg/dL (2.4-2.9 mmol/L) and 1.4-2%, respectively. Editor-in-Chief: Anthony J. Busti, MD, PharmD, FNLA, FAHA Reviewers: Jon D. Herrington, PharmD, BCPS, BCOP and Donald S. Nuzum, PharmD, BCACP, CDE It is well known that patients with type 2 diabetes mellitus (T2DM) are characterized as having insulin resistance, a decrease in insulin mediated glucose uptake by peripheral tissues (despite elevated insulin levels) and excessive basal rates of hepatic gluconeogenesis.1,2 An impairment in peripheral glucose uptake and suppression of gluconeogenesis both contribute to worsening postprandial (post-meal) hyperglycemia whereas excessive basal rates of hepatic gluconeogenesis primarily contributes to the worsening of fasting glucose levels. To date, the biguanide class of medication Continue reading >>
