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Alternatives To Metformin For Type 2 Diabetes

List Of Medications Available For Diabetes

List Of Medications Available For Diabetes

Diabetes is a disorder of blood sugar levels. There are two main types of diabetes, plus rarer forms such as diabetes that can happen during pregnancy, known as gestational diabetes. Type 1 diabetes results in high blood sugar levels because the body stops producing insulin, the hormone that regulates sugar levels. Type 2 diabetes leads to high blood sugars because the insulin in the body does not work effectively. The broad differences in treatment between the two types are: Type 1 diabetes is treated with insulin injection. Careful diet and activity planning is needed to avoid complications of treatment. Type 2 diabetes is treated with lifestyle measures, drugs taken by mouth, and sometimes also insulin if the other treatments fail. Medications for type 1 diabetes Treatment for type 1 diabetes is always with insulin, to replace the body's absent insulin and keep blood sugar levels under control. Insulin treatments Insulin is usually given by injection - by patients themselves, injecting it under the skin, or if hospitalized, sometimes directly into the blood. It is also available as a powder that patients can breathe in. Insulin injections vary by how quickly they act, their peak action, and how long they last. The aim is to mimic how the body would produce insulin throughout the day and in relation to energy intake. 1. Rapid-acting injections take effect within 5 to 15 minutes but last for a shorter time of 3 to 5 hours: Insulin lispro (Humalog) Insulin aspart (NovoLog) Insulin glulisine (Apidra) 2. Short-acting injections take effect from between 30 minutes and 1 hour, and last for 6 to 8 hours: Regular insulin (Humulin R and Novolin R) 3. Intermediate-acting injections take effect after about 2 hours, and last for 18 to 26 hours: Insulin isophane, also called NPH i Continue reading >>

Incretin-based Therapy: Alternatives To Metformin

Incretin-based Therapy: Alternatives To Metformin

Incretin-Based Therapy: Alternatives to Metformin Metformin is the drug of choice for treating type 2 diabetes (T2D), when lifestyle changes alone fail to control blood glucose, and is especially useful for overweight patients.1-3 Metformin may prevent the cardiovascular complications of diabetes and has emerging use in treating cancers (diabetes-related and others).4 In T2D, the treatment goal is tight glycemic control, but as beta cell function declines progressively, many patients need treatment intensification with a second glucose-lowering agent.5 Patients with T2D may have abnormalities that affect the release, or action, of incretin hormones, specifically glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones control almost all postprandial insulin release. Since 2005, incretin- based therapies have been available. Practice guidelines include incretin-based therapies as alternative monotherapy agents when metformin is contraindicated or as a component of combination therapy.1-3 GLP originates in the small intestine and colon and is released after eating. GLP-1 stimulates insulin secretion, but glucose must be present in the bloodstream for it to activate. GLP-1 delays stomach emptying, slows carbohydrate absorption, prevents the subsequent rise in the blood glucose level after meals, and suppresses appetite. Animal studies and in vitro work indicate GLP-1 may promote pancreatic beta cell regeneration and slow apoptosis (programmed cell death), lengthening existing beta cells lives.6,7 GIP is released when glucose comes into contact with cells in the upper small intestine. GIP stimulates insulin secretion from pancreatic beta cells to promote beta cell proliferation and improve beta cell survival.6,8 The dipeptidyl Continue reading >>

Drug Treatment Of Type 2 Diabetes Mellitus In Patients For Whom Metformin Is Contraindicated

Drug Treatment Of Type 2 Diabetes Mellitus In Patients For Whom Metformin Is Contraindicated

Go to: Metformin has long been considered the initial drug therapy choice in the treatment of type 2 diabetes mellitus (T2DM). The most widely recognized clinical guidelines and consensus recommendations endorse its use when monotherapy is initially preferred to treat hyperglycemia.1–4 However, treatment with metformin is not suitable for all patients diagnosed with T2DM. Patients may initially receive metformin but not be able to tolerate common side effects, mainly its gastrointestinal adverse effects. Likewise, some practitioners may be cautious in using metformin in patients at risk for but who do not necessarily currently have specific contraindications to its use. While the specific contraindications to use of metformin have changed to an extent over the last decade, significant renal impairment or conditions that could acutely alter renal function remain a consistent theme in delineating who should not receive the medication. Some of the common sources and specific contraindications to the use of metformin based on renal function are provided in Table 1. Inconsistencies between these sources remain. Current guidelines/consensus recommendations for specific therapies to initiate in patients who cannot tolerate or have a contraindication to metformin use provide some insight on the issue but also conflict with each other. The American Diabetes Association/European Association for the Study of Diabetes recommend a sulfonylurea, meglitinide, pioglitazone, or dipeptidyl peptidase 4 (DPP-4) inhibitor when metformin cannot be used.3 They also recommend using a glucagon-like peptide-1 (GLP-1) agonist if weight loss is warranted. The American Association of Clinical Endocrinologists state GLP-1 agonists, DPP-4 inhibitors, and alpha-glucosidase inhibitors are acceptable Continue reading >>

Breaking Down Diabetes: A Quick Guide To The Plethora Of Medications

Breaking Down Diabetes: A Quick Guide To The Plethora Of Medications

Stanford University School of Medicine blog Breaking down diabetes: A quick guide to the plethora of medications As part of the "Breaking down diabetes" series, physician Randall Stafford provides a straightforward guide to medications that can treat Type 2 diabetes. There is consensus that metformin is the best drug for treating Type 2 diabetes. As I wrote recently , it does not cause blood sugar to fall below normal, it often produces weight loss, and its inexpensive. Debate rages on over the role of other drugs that are typically added once metformin alone is not enough to bring high blood sugar levels back towards normal. All of the available alternatives have some problems, both the older, inexpensive drugs and the newer, very costly medications. I realize the medication guide below is a lot to digest. But I also know that patients, and their families, are hungry for reliable, accessible information about their alternatives. So please, proceed. Sulfonylureas are an older group of drugs, with generic glipizide , which was approved by the Food and Drug Administration in 1984, the leading medication. It costs pharmacies only $0.07 per day. These drugs work by increasing the amount of insulin produced by the pancreas. Lowering blood sugar too much can be a side effect, so skipping meals can cause big problems. Of all patients in the U.S. with diabetes, 17 percent take a sulfonylurea. DPP inhibitors (short for dipeptidyl peptidase) are newer, very expensive medications ($14 per day for sitagliptin , brand name Januvia, approved in 2006). It works by interfering with the bodys hormone glucagon that would normally keep blood sugar levels higher. These drugs can cause low blood sugar (though not as much as glipizide) and may increase the risk of heart problems. Nearly a q Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>

Alternatives To Metformin

Alternatives To Metformin

What Are the Alternatives to Metformin? Metformin (Glucophage®) is a prescription medication used for the treatment of type 2 diabetes. A long-acting form, metformin ER (Glucophage XR®), is also available. For most people, metformin is effective in treating their diabetes, and most people tolerate it well. However, as with all medicines, side effects can occur. In other cases, the medicine may not completely control a person's diabetes. Fortunately, there are several alternatives to metformin. Some of the metformin alternatives include: Lifestyle Changes for Type 2 Diabetes Many lifestyle changes have been shown to be very effective for controlling type 2 diabetes (especially early type 2 diabetes). These lifestyle changes include weight loss, becoming more physically active (see Diabetes and Exercise), and changes in diet (see Diabetic Diet). In fact, these changes are important for all people with type 2 diabetes, including people taking diabetes medications. For many people, lifestyle changes alone may not be enough to adequately control type 2 diabetes. For these people, medications (including oral and injectable medications) may be necessary. Fortunately, there are many different types of oral medications available to treat type 2 diabetes, including: Sulfonylureas Sulfonylureas are medications that force the pancreas to produce more insulin. Because of this, they are very effective, but are also more likely to cause dangerously low blood sugar (hypoglycemia). These medications include: Meglitinides Meglitinides are similar to sulfonylureas, in that they force the pancreas to produce more insulin. However, they are short-acting and are less likely to cause dangerously low blood sugar. They are usually taken before every meal. Meglitinides include: Thiazolidinedio Continue reading >>

Berberine For Diabetes – Is It A Natural Alternative To Metformin?

Berberine For Diabetes – Is It A Natural Alternative To Metformin?

Incidence of insulin resistance, obesity, and other metabolic diseases have reached massive proportions in our culture. The current popular glucose-lowering drug treatment, Metformin comes with some potential serious side effects. However, there is a natural Metformin alternative that can help the body efficiently process sugar, thereby being safer than pharmaceutical interventions. It’s known as Berberine. What is Berberine and Where Does it Come From? Berberine is a plant photochemical that’s found in several different plants, including goldenseal, European barberry, phellodendron, goldthread, Oregon grape, and tree turmeric. It possesses powerful anti-diabetic properties, as well as being anti-bacterial and immune system enhancing. As well as diabetes it can be used as a treatment for a number of other health problems including hyperlipidemia, heart disease, and cancer. It can regulate blood glucose, increase insulin sensitivity as well as metabolizing fats (burning fat). Berberine has been widely studied, with nearly 1000 studies published on it in the last 5 years alone. There is a body of evidence supporting it’s efficacy in lowering blood-glucose and increasing insulin sensitivity for both humans and animals. However, Berberine is not a new discovery. For thousands of years the Chinese and Ayurvedic communities has been aware of the amazing benefits of Berberine. The blood-sugar lowering effects have been documented in China and India for hundreds of years. Although it was primarily used for treating inflammation, infections, and diarrhea, as diabetes was not as common then as it is now (1). A Natural Substitute For Metformin? However, as the incidence of diabetes has grown, the recent studies have focused on it’s ability to treat the condition. The studi Continue reading >>

Herbal Alternatives To Metformin

Herbal Alternatives To Metformin

Metformin (Glucophage, Glumetza, Fortamet) is typically prescribed to counteract the effects of insulin resistance -- the body's sluggish response to the blood-sugar-lowering hormone insulin. Insulin resistance can lead to high blood sugars and may eventually progress to prediabetes or type 2 diabetes (T2DM). Metformin improves insulin sensitivity of the body tissues and reduces liver glucose production, both of which help lower blood sugar levels. The American Diabetes Association recommends metformin as a first-choice medicine to treat T2DM. It is also sometimes used in combination with exercise and weight loss in people with prediabetes. Some evidence suggests that a few herbs might mimic some of the effects of metformin. However, no herb is a proven alternative to metformin. Video of the Day Goat’s rue, or Galega officinalis, is an age-old remedy. In times past, it was used for assorted ailments, including diabetes. Metformin is a man-made chemical that's closely related to a substance found in goat’s rue. Animal studies from the 1970s and 1980s established that substances in goat's rue have blood-sugar-lowering effects. Some of these chemicals can be toxic, however, so human studies are lacking. A recent animal study was published in April 2008 in the "British Journal of Pharmacology." Researchers found that mice fed galegine -- a chemical found in goat's rue -- ate less, lost weight and had reduced blood sugar levels, compared to mice that weren't fed the chemical. Goat's rue is not approved for diabetes treatment by the U.S. Food and Drug Administration or Germany's Commission E, a scientific advisory board that reviews and approves herbal medicines. Commission E noted significant health risks with goat's rue and the availability of more effective diabetes tr Continue reading >>

New Treatments Provide Alternatives To Metformin

New Treatments Provide Alternatives To Metformin

Three new treatments for type 2 diabetes have been recommended by NICE, for patients who cannot use metformin, sulfonylurea or pioglitazone. The treatments are also suitable for patients who are not controlling their blood glucose levels with diet and exercise alone, to manage their condition. 'We know that different people with type 2 diabetes may respond favourably to different medications,’ said Simon O’Neill, director of health intelligence and professional liaison at Diabetes UK. ‘So this guidance offers more choice for clinicians to individualise the care they provide, which can have a significant impact on the quality of life of some people with Type 2 diabetes.’ As many as 31,000 people with the condition may be eligible for the new drugs, canagliflozin, dapagliflozin, and empagliflozin. The drugs are designed to help patients who cannot take more commonly prescribed treatments control their blood sugar. ‘[The new drugs] give people with type 2 diabetes and their healthcare team more options when metformin is not appropriate,’ added Mr O’Neil. Many people with type 2 may not suit treatment with drugs such as metformin, which can cause side effects such as nausea and diarrhoea. Those with kidney damage are also unable to take such drugs. ‘For many people whose blood glucose levels aren’t controlled by diet and exercise, metformin is the first drug treatment that they’ll be offered,’ said Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation. ‘For people who can’t take a sulfonylurea or pioglitazone, then the three drugs recommended in this guidance can be considered. This is as an alternative to the separate group of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors.’ According to NICE, in the UK, Continue reading >>

Alternate Medications Other Than Metformin For Type 2 Diabetes

Alternate Medications Other Than Metformin For Type 2 Diabetes

As of 2006 diabetes was the seventh cause of death in the United States, according to the American Diabetes Society. By 2007 the medical costs of diagnosed diabetes exceeded $100 billion. Medication is a major factor in treating diabetes. Metformin is often the drug prescribed to newly diagnosed diabetics, notes FamilyDoctor.org. However there are other medications that be used in addition to metformin. Video of the Day Alpha-glucosidase inhibitors are a form of oral diabetes medication that target the digestive system. These drugs decrease the absorption of blood sugar by the stomach and intestines, explains FamilyDoctor.org. Alpha-glucosidase inhibitors may cause abdominal pain, loose bowel movement, or bloatedness. Dipeptidyl peptidase-4 Inhibitors Dipeptidyl peptidase-4 inhibitors, or DPP-4 inhibitors, are oral medicines that aid the body in producing insulin after meals. DPP-4 inhibitors accomplish this by preventing the destruction of a biochemical called GLP-1. This biochemical helps reduce blood sugar levels, according to the American Diabetes Association. Exenatide is an incretin mimetic. Incretin mimetics are injectable diabetic medications that typically lower blood sugar by stimulating insulin release. Incretin mimetics can cause nausea and possibly hypoglycemia, explains the American Diabetes Association. Insulin is a biochemical that is normally produced by the pancreas, and utilized to regulate blood sugar levels, according to the American Diabetes Association. However diabetes either prevents the body from producing insulin, or renders the body unable to utilize the insulin produced. As such, it is necessary for some diabetics to use artificial insulin. However because insulin breaks down upon contact with digestive juices insulin must injected directly Continue reading >>

8 Natural Alternatives To Actos And Metformin

8 Natural Alternatives To Actos And Metformin

8 Natural Alternatives to Actos and Metformin 8 Natural Alternatives to Actos and Metformin If you suffer from Type 2 diabetes, there is a good chance that youve had a discussion with your doctor about the prescription drug Metformin. It is often initiated at the diagnosis of diabetes and helps to reduce blood sugars in an effective way. The problem however with this solution is its inability to work for everyone. Additionally, many users of Metformin may find the side effects of this drug extremely bothersome. The first thing to remember is that the development of Type 1 diabetes is not your fault, no matter what your medical providers might have you believe. Diabetes is caused by your bodys inability to process, driving up your blood sugars. However, Type 2 diabetes (adult onset) can be avoided many times and even reversed with the right diet, exercise program and proper natural herbs and vitamins . Maintaining your blood sugar levels into acceptable ranges is critically necessary to maintain your quality of life, which means your routines are going to be changing no matter what you do. High blood sugars can cause nerve and kidney damage, so it is important to act now. Whether you want to avoid prescription medication, or suffer with current side effects, many natural alternatives exist for Metformin. These options may be able to effectively treat your diabetes and help you feel back in control again For many that suffer with Type 2 diabetes, basic lifestyle changes are often the primary thing that is necessary for treatment of their disease. For many people, this means an increased level of exercise and an improvement in their overall nutrition. The goal of these lifestyle changes is to get on an effective weight loss plan that is combined with higher levels of phys Continue reading >>

Diabetes Drugs You Inject That Aren't Insulin

Diabetes Drugs You Inject That Aren't Insulin

Insulin isn't the only type of injectable diabetes medicine your doctor might prescribe for you. Other drugs include: Albiglutide (Tanzeum) What it is: It's a man-made version of a hormone called GLP-1 (glucagon-like peptide-1). Your intestines normally release this substance when you eat. It helps control your blood sugar. Who can take it: Adults who have type 2 diabetes and haven’t had success with other treatment. If you're planning to get pregnant, talk with your doctor, since researchers haven't studied albiglutide in pregnant women. What it does: After you eat, albiglutide helps your pancreas release insulin, which moves blood sugar (glucose) into your cells. It also limits how much of the hormone glucagon your body makes. This substance spurs your liver to release stored sugar. The drug also slows down digestion. Side effects: The most common ones are upper respiratory tract infection, diarrhea, nausea, and skin reactions where you give yourself the shot. All GLP-1 drugs, including albiglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don't know whether it has the same effect in people, though. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect. Exenatide (Bydureon, Byetta) What it is: Exenatide was the first GLP-1 drug approved by the FDA. Byetta came first. You take it as a shot twice daily. Bydureon is the newer, extended-release version, which you inject once a week. You can't take both drugs. Who can take it: Adults with type 2 diabetes for whom other treatment hasn't worked. If you think you might get pregnant, talk to your doctor. Researchers haven't studied this drug in pregnant women. What it does: Like other GLP-1 drugs, Continue reading >>

Avoid The Metformin Bandwagon

Avoid The Metformin Bandwagon

From diabetes to cancer, berberine matches - or beats - this patent medicine every time! As many know, metformin is the number one prescription medication for type-2 diabetes. The patent for the name-brand of this patent medicine, Glucophage®, expired years ago and as a result generic-brand competition (metformin) brought this patent medicine’s price down so that it’s relatively inexpensive, especially when compared with nearly any other medication still covered by a patent. Mainstream medical research has found other uses for this un-natural molecule, including (but not limited to) lipid, blood pressure, and insulin resistance lowering effects, anti-cancer effects, improvement of polycystic ovarian syndrome, combatting Alzheimer’s disease, and extending life span in mice. Surprising guests on the metformin bandwagon Some proponents of natural therapies – including, surprisingly, two nationally and internationally circulated health magazines – have climbed on the metformin bandwagon, writing articles about the “health benefits” of metformin, and even advocating that otherwise healthy people take this patent medicine every day as a preventive. They admit that there are known side effects, but write that these are few, and that the benefits outweigh the risks. If there aren’t any natural treatment alternatives that are as effective, or more effective, than a patent medicine or other un-natural molecule – especially in serious or life-threatening situations – then the use of a patent medication of course makes sense. But when there are natural alternatives that work just as well or better, the rule is – and always should be – to “Copy Nature.” Human bodies are formed from the molecules of planet Earth, and powered by the energies of this planet Continue reading >>

After Metformin, Are Newer Drugs Better For Type 2 Diabetes?

After Metformin, Are Newer Drugs Better For Type 2 Diabetes?

After Metformin, Are Newer Drugs Better for Type 2 Diabetes? Use of a sulfonylurea as second-line therapy after metformin for type 2 diabetes is just as effective as a newer agent but far less costly, a new study based on claims data finds. The results were published online February 26 in Diabetes Care by Yuanhui Zhang, a PhD candidate at North Carolina State University, Raleigh, and colleagues. "In light of an incomplete understanding of the pros and cons of second-line medications and the high cost associated with newer medications, the decision to use newer medications should be weighed against the additional cost burden to patients and/or the health system," study coauthor Brian Denton, PhD, of the University of Michigan, Ann Arbor, told Medscape Medical News. However, the use of retrospective data means that the study is subject to both ascertainment and physician-choice bias, said Alan J. Garber, MD, PhD, of Baylor College of Medicine, Houston, Texas, when asked to comment for Medscape Medical News. Moreover, noted Dr. Garber, the study doesn't adequately account for the adverse effects of sulfonylurea-induced hypoglycemia. "Patients value things differently. If you had a hypoglycemic episode and you don't like that, you're willing to pay a lot more of your discretionary income to avoid having another one." The researchers explain that there are currently 11 classes of approved glucose-lowering medications. Metformin has a long-standing evidence base for efficacy and safety, is inexpensive, and is regarded by most as the primary first-line treatment for type 2 diabetes. When metformin fails to achieve or maintain glycemic goals, another agent needs to be added. However, there is no consensus or sufficient evidence supporting the use of one second-line agent over Continue reading >>

Alternatives To Metformin And Diabetes | Diabetesteam

Alternatives To Metformin And Diabetes | Diabetesteam

anyone know a doctor in penticton that is taking new patients? i have type 2 diabetes and have had it for about 2 years now...I am on metformin twice daily (500 mg twice daily)...lately my blood sugars have been high alot (not all the time ) in the morning and at supper and that's only having not much to eat for breakfast and not much to eat after supper...today i had a piece of toast with no sugar addeded jam and a banana ...after taking my meds my blood sugar is 14.4...feel tired and dizzy and light headed...i read more Continue reading >>

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