
Can I Stop My Diabetes Medications?
I was recently diagnosed with type 2 diabetes. I am taking 10 mg of glipizide and 500 mg of metformin twice a day. My A1C was 12.5, but I have been feeling better, and I even stopped taking the glipizide every morning. My blood glucose average is now 170. Is that good, or should I continue to take my glipizide every morning? Continue reading >>

How To Wean Off Of Diabetes Medication
One of my greatest pleasures in life is to help patients achieve remission of their type 2 diabetes. This means their blood sugar levels have become normal in the absence of any diabetes medication. Many clinicians and patients are interested in learning my views about how to go about decreasing and discontinuing diabetes medications. The main role for medications is to help reduce or delay the risk of nasty complications of diabetes, particularly the damage to the retina, kidney, nerves, and circulation. The higher the average blood sugar level, as indicated by the hemoglobin A1c level, the greater the complication risk (which increases exponentially with increasing A1c). We know from clinical trials that using medication to keep the A1c at or below 7% can help reduce the risk of these complications. There is broad agreement that clinicians should recommend starting or increasing diabetes medications to patients who cannot get their A1c level to 7% or less via lifestyle change. Many patients come to me because the A1c is already over 7% and their primary care provider proposes increasing their diabetes medication, unless the patient can get to 7% or less with improved eating and/or exercise habits. Some of these patients are already on many pills, and insulin shots are the frequently the next appropriate treatment. Many patients would rather make the lifestyle changes than take more medication, so when the doctor frames the issue in this way, then a patient might become inspired to renew or increase the lifestyle efforts. The clinician might say “lets recheck the A1c in 3 months, and start the new medication if it is still above 7.0%”. My goal with patients is to use the lifestyle strategies I’ve discussed previously in this blog to drive the A1c as low as possib Continue reading >>
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Stop The Metformin Madness
I have never been a fan of Metformin. It seemed too good to be true. Many years ago I had a conversation with a researcher about all of its possible therapeutic indications. His lab was actively pursuing the anti-cancer angle. That should have been a clue that Metformin might be causing more damage than we recognized, but it wasn’t. At that point, I was still enamored with the wonders of pharmacology and hadn’t yet begun my path toward understanding medication adverse reactions. Indeed, it wasn’t until very recently, when a family member began suffering from one of these reactions, that I began my investigation in full. This is what I learned. Type 2 Diabetes is Big Business The global profits from Type 2 diabetes medications rested at a paltry $23 billion dollars in 2011 but are expected to grow to over $45 billion annually by 2020. The market growth is bolstered in large part by the ever-expanding demand for therapeutics like Metformin or Glucophage. Metformin is the first line of treatment and standard of care for insulin resistance across all populations of Type 2 diabetics with over 49 million Americans on Metformin in 2011-2012. It is particularly popular in women’s health with an increasing reliance on Metformin for the metabolic dysfunction observed in women with PCOS, PCOS-related infertility and even gestational diabetes. Metformin is prescribed so frequently and considered so innocuous that it is sometimes euphemistically referred to as vitamin M. If we quickly scan the safety research for metformin, there is little immediate evidence suggesting any side effects whatsoever. In fact, in addition to controlling blood sugar by blocking the hepatic glucose dump, this drug is suggested to promote weight loss, increase ovulation in women, (thereby helping a Continue reading >>

The Effects Of Stopping Metformin
The medication metformin is a drug in the biguanide family that is used to treat type 2 or adult-onset diabetes mellitus. Drugs.com notes that metformin is often the first prescribed medication for individuals with type 2 diabetes and may also be used in combination with other diabetes medications or insulin. This medication is sold under the brand name Glucophage, Glucophage XR and Fortamet. Metformin helps to reduce glycemic or sugar levels in the blood in a number of ways. If an individual with type 2 diabetes stops taking metformin, they may experience serious immediate and long-term effects of uncontrolled high levels of blood glucose. Video of the Day A primary mode of action of metformin is increasing the sensitivity of the body’s muscles, tissues and cells to insulin--a hormone that is essential for transporting glucose from the blood to the body. Drugs.com notes that individuals with type 2 diabetes have insulin resistance. This causes the cells to ignore the effects of insulin and not allow glucose to be transported into the muscles and tissues where it is vital to produce energy. The body tries to compensate by secreting more insulin, which only leads to hyperinsulinemia in the blood. If a patient stops taking metformin, the type 2 diabetes effects occur due to insulin resistance causing symptoms such as severe thirst, hunger and urinary frequency. The chronic levels of hyperinsulinemia and hyperglycemia also contribute to diseases of the heart and vascular-blood vessel-system. Gluconeogenesis is the production of glucose by the liver. A storage supply of glucose is reserved in the liver and released into the bloodstream when the body requires energy due to stress or hunger. The MayoClinic.com notes that another one of the mechanisms of metformin to reduce Continue reading >>

When Can I Stop Taking Glyburide And Metformin?
You may take glyburide and metformin (brand name: Glucovance), a combination medication for type 2 diabetes, for years. Alternatively, there may be reasons for you to stop taking glyburide and metformin at some point. It may cause side effects that are difficult to tolerate, for instance. Or you may need to have surgery, in which case experts say that you should stop taking glyburide and metformin temporarily before your operation; you can start it up again later. If you're pregnant or breastfeeding, your doctor may recommend that you stop taking glyburide and metformin and take insulin instead. If you need to stop, don't do it on your own. Work with your doctor to find the safest way to stop taking glyburide and metformin -- and to substitute another method for controlling your diabetes and your blood sugar levels. Continue Learning about Antidiabetic Videos Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs. Continue reading >>

Metformin
Metformin may rarely cause a serious, life-threatening condition called lactic acidosis. Tell your doctor if you have kidney disease. Your doctor will probably tell you not to take metformin. Also, tell your doctor if you are over 65 years old and if you have ever had a heart attack; stroke; diabetic ketoacidosis (blood sugar that is high enough to cause severe symptoms and requires emergency medical treatment); a coma; or heart or liver disease. Taking certain other medications with metformin may increase the risk of lactic acidosis. Tell your doctor if you are taking acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), or zonisamide (Zonegran). Tell your doctor if you have recently had any of the following conditions, or if you develop them during treatment: serious infection; severe diarrhea, vomiting, or fever; or if you drink much less fluid than usual for any reason. You may have to stop taking metformin until you recover. If you are having surgery, including dental surgery, or any major medical procedure, tell the doctor that you are taking metformin. Also, tell your doctor if you plan to have any x-ray procedure in which dye is injected, especially if you drink or have ever drunk large amounts of alcohol or have or have had liver disease or heart failure. You may need to stop taking metformin before the procedure and wait 48 hours to restart treatment. Your doctor will tell you exactly when you should stop taking metformin and when you should start taking it again. If you experience any of the following symptoms, stop taking metformin and call your doctor immediately: extreme tiredness, weakness, or discomfort; nausea; vomiting; stomach pain; decreased appetite; deep and rapid breathing or shortness of breath; dizzi Continue reading >>

Effects Of Withdrawal From Metformin On The Development Of Diabetes In The Diabetes Prevention Program
Go to: Abstract OBJECTIVE— In the Diabetes Prevention Program (DPP), metformin significantly reduced the risk of diabetes in individuals with impaired glucose tolerance. Diabetes status was assessed by oral glucose tolerance tests (OGTTs) performed while participants were still taking metformin or placebo. To determine whether the observed benefit was a transient pharmacological effect or more sustained, we performed a repeat OGTT after a short “washout” period during which medications (metformin or placebo) were withheld. RESEARCH DESIGN AND METHODS— All participants assigned to medication who had not developed diabetes at the end of the DPP were asked to have a repeat OGTT after discontinuing the study medication for 1–2 weeks. The predesignated outcome was the odds of diabetes in metformin versus placebo comparisons during the trial and washout combined. RESULTS— There were 1,274 participants who participated in the washout study and 529 who did not because they had already developed diabetes. Before the washout, the odds of diabetes in the metformin group was lower than that in the placebo group (odds ratio 0.66, 95% CI 0.54–0.82, P < 0.001). After the washout, diabetes was somewhat more frequently diagnosed in the metformin participants (1.49, 0.93–2.38, P = 0.098). Combining diabetes conversions during the DPP and during the washout, diabetes was diagnosed significantly less frequently in the metformin than the placebo group (0.75, 0.62–0.92, P = 0.005). CONCLUSIONS— The primary analysis of the DPP demonstrated that metformin decreased the risk of diabetes by 31%. The washout study shows that 26% of this effect can be accounted for by a pharmacological effect of metformin that did not persist when the drug was stopped. After the washout the inc Continue reading >>

Already Taking Metformin?
JANUMET tablets contain 2 prescription medicines: sitagliptin (JANUVIA®) and metformin. Once-daily prescription JANUMET XR tablets contain sitagliptin (the medicine in JANUVIA®) and extended-release metformin. JANUMET or JANUMET XR can be used along with diet and exercise to lower blood sugar in adults with type 2 diabetes. JANUMET or JANUMET XR should not be used in patients with type 1 diabetes or with diabetic ketoacidosis (increased ketones in the blood or urine). If you have had pancreatitis (inflammation of the pancreas), it is not known if you have a higher chance of getting it while taking JANUMET or JANUMET XR. Metformin, one of the medicines in JANUMET and JANUMET XR, can cause a rare but serious side effect called lactic acidosis (a buildup of lactic acid in the blood), which can cause death. Lactic acidosis is a medical emergency that must be treated in a hospital. Call your doctor right away if you get any of the following symptoms, which could be signs of lactic acidosis: feel cold in your hands or feet; feel dizzy or lightheaded; have a slow or irregular heartbeat; feel very weak or tired; have unusual (not normal) muscle pain; have trouble breathing; feel sleepy or drowsy; have stomach pains, nausea, or vomiting. Most people who have had lactic acidosis with metformin have other things that, combined with the metformin, led to the lactic acidosis. Tell your doctor if you have any of the following, because you have a higher chance of getting lactic acidosis with JANUMET or JANUMET XR if you: have severe kidney problems or your kidneys are affected by certain x-ray tests that use injectable dye; have liver problems; drink alcohol very often, or drink a lot of alcohol in short-term “binge” drinking; get dehydrated (lose large amounts of body fluids, w Continue reading >>

Diabetes Medication Metformin: Why Patients Stop Taking It
Gretchen Becker, author of The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed , has been taking metformin for more than 20 years after receiving a diagnosis of type 2 diabetes in 1996. I never had any problems with metformin until I took a pill that I thought was the extended-release version, but it wasnt, Becker told Healthline. Beckers doctor had accidentally prescribed the regular form of metformin. I had very loose bowels for several months until I figured out what the problem was, Becker said. After getting the proper prescription, it took several months for Beckers digestive system to recover. Corinna Cornejo, who received a diagnosis of type 2 diabetes in 2009, told Healthline that her digestive woes didnt start until shed been taking metformin for more than a year. At first, I thought it was a response to dairy, but my doctor eventually switched my prescription to the extended-release version, Cornejo recalled. That has helped, but the side effect has not gone away completely. For some people, however, metformins unpleasant side effect of loose stools provides a much-needed balance to the side effects that can result from other diabetes drugs theyre taking. GLP-1 drugs, like Victoza or Byetta, can cause constipation, explained Robinson. Taking metformin with a GLP-1 drug means they actually complement each other, balancing out those side effects. And for some, metformin simply isnt the right drug. No matter what you do, some patients just dont tolerate the side effects well, said Robinson. Although there are many diabetes drugs on the market today, doctors will likely push metformin first. There has never been as many diabetes treatment options available as there are now, explained Robinson. But doctors look at cost, and metformin is th Continue reading >>

What Will Happen If I Stop Taking Metformin For Pcos?
Metformin helps you manage the symptoms of the disease. There is no no doubt that it works. But it does not offer a cure. You can discontinue metformin on only one condition - you should exercise more and cut out all refined sugars and processed foods or just look around to what other diabetics do for insulin resistance. I cannot emphasize home-cooked food enough. Home cooked-food without those processed sauces and canned ingredients. Try it for a short time after you are on an exercise regimen for atleast a month.Keep checking your sugar from time to time. You will know that you need to get back on your metformin if the cravings and the bluesy moods come back. If the cravings don’t come back well and good, but if it does, you should get back on metformin. What I can assure you is that there is no harm in trying - PCOS is a lifelong thing - so nothing that you do can kill or cure you in a day or week. Whatever works will work over months. So give exercise and no sugar a try for two -three months. In the first month continue with the metformin with the exercise and in the next, reduce use by either reducing dosage or eating one every two days. And then if things look positive stop completely. Losing weight also helps reduce metformin dependence. While you are at it one basic advice I can give you is - don’t get into tiring exercise regimes (walking for an hour is also good), don’t get into diets unless your gynaecologist/endocrinologist has recommended one (even then don’t get into anything punishing because sustaining it will be stressful) and do everything it takes to keep a healthy mind - remove or modify habits from your life that induce stress - be it your job, family or friends. Identify them and pull the plug. Be nice to yourself. Please note that if you a Continue reading >>

Quit Metformin And Finally Started To Lose Weight!
Quit Metformin and finally started to lose weight! I see that a lot of you have seen an endo doctor. Can you tell me what to expect and if there are any questions that I should ask when I see her on November 30th? Since having my uterus taken out (which was 3 times larger than it should have been)I am still experiencing a lack of interest in sex. Facial and leg hair growth have excellerated greatly. I was diagnosed with diabetes and it DOES NOT run in my family. My hormone levels are normal however my DHEA was 59. Both my gyno's refused to look at my numbers and dismiss my other symptoms with a solution of one it is your colon, and the other one's answer was bc for 2 months if still in pain let's take the ovaries. Which by the way looked good when I did the hysterectomy. My gp put me on met 500mg at night when my bg test came back as diabetes. Numbers were 148, and my vitamin D was down still so now take 50,000mg a week. So far the met does not seem to be helping with my weight. However it does seem as if my midsection is less swollen then it ever has been. So basically any help that anyone can offer is greatly appreciated. I started Metformin 6 years ago and it did take time for me to get used to it. I was nauseated a lot, and would actually get sick often times. If I "forgot" or was honestly lazy and didn't take a dose of my medicine, it would all come back to me. Once I was on the medicine and my body got used to it, it was better. I take it mainly for diabetes prevention, as I am prediabetic. It has helped me lose weight because it controls my sugar/carb cravings. It has taken time for me to get on the right dosage. I went from immediate release 500 mg a day to 2000 mg a day, and I also now take the ER/extended release version. The change to the current 2000 mg ER Continue reading >>

How One Man Stopped Metformin After Losing Weight
Exercise and weight loss lower blood sugar because they both reduce the body's insulin resistance, the key problem in people with type 2 diabetes. Therefore, increasing exercise or losing weight can sometimes lower or eliminate your need for diabetes medication. It's easier to keep your blood sugar in check without medication if your body is more sensitive to the insulin your body does make (most people with type 2 diabetes make at least some of the hormone). I was able to stop taking metformin, the drug I had been taking to lower my glucose—Louis Sarkes, Type 2 Diabetes Patient Louis Sarkes, 50, was diagnosed with type 2 diabetes in 2006 after a routine blood test during his annual physical exam. "I was surprised, but motivated to do something right away," said Sarkes, who is a money manager based in Baltimore, Md. He went to an all-day session on weight loss at Johns Hopkins University (where his doctor is based). He listened to doctors, nutritionists, and other patients talk about weight loss and exercise strategies, setbacks and successes. More about diabetes and exercise "I chose a diet low in sugars and high in fruits, vegetables and whole grains, and kept carbohydrates at 30 to 35 grams per meal, or no more than 100 grams in a day," says Sarkes. He didnt count every calorie, but kept a general sense and tried to keep the daily limit of calories to 1,800. "To get as much information as I could, especially on tips for sticking with the diet, I met with the nutritionist on my own, and also read everything on the Internet I could find," he said. He followed the advice of his nutritionist and didn't feel guilty if he went over his carbohydrate or calorie limithe just started again as soon a possible. He found healthy snacks he liked and avoided high-fat, high calori Continue reading >>

Metformin - Oral, Glucophage
are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure Serious urinary tract infections (UTI), some that lead to hospitalization, occu Continue reading >>

6 Reasons Why Metformin Might Not Be Safe For Pcos
Have you been prescribed metformin for PCOS and are wondering what the side affects are? Metformin is often described as a ‘safe’ drug, but read on to find out why this might not be the case. When I was diagnosed with PCOS, the first thing I asked my GP was what I could take to ‘fix’ it. She gently explained that there was no pill or surgery that could cure my condition. However, there was a drug that could help with the elevated insulin levels caused by it. Metformin, she claimed, was a safe drug with no major side effects that would help with insulin resistance and weight loss. Sign me up. At first, I thought metformin was the wonder drug. I lost about 5kg in 4 months, more than I had ever been able to lose previously. I was ecstatic. I had a quick look online to see whether there were any side effects and initially found that diarrhea, loose stools, fatigue, and muscle soreness were commonly experienced. But I thought that it was small price to pay for finally being able to lose some weight. However, when I investigated further I found that that there are some much more sinister side effects of metformin that aren’t so widely publicised. These include: – Depleting our bodies of essential nutrients. – Increasing the risk of having a baby with a neural tube defect by up to 9 times. – Reducing energy levels by almost 50%. – Killing beneficial gut bacteria. This article is not intended to be a case against metformin for PCOS. There is no doubt that metformin helps to reduce weight, lowers blood glucose levels, and promotes ovulation. My concern is the lack of studies about the safety of long-term use of metformin for PCOS, especially in utero. Drugs can help with the associated symptoms of a disease, but they cannot fix the root cause of it. Metformin i Continue reading >>

Stopping Diabetes Medicines
“I want to get off some of these drugs,” Ellen told me. “But my doctor says I need them. I’m on three for glucose, two for blood pressure, and one for depression. They’re costing me hundreds every month. What can I do?” Ellen is a health-coaching client of mine, age 62 with Type 2 diabetes. She works as an executive secretary in an insurance company. It’s stressful. She’s usually there from 8 AM until 6 PM or later and comes home “too tired to exercise.” She mentioned that just “putting herself together” for work every day requires an hour of prep time. “You have to look good for these executives,” she says. I asked about her drugs. She said she takes metformin (Glucophage and others), sitagliptin ( brand name Januvia), and pioglitazone (Actos) for diabetes, lisinopril (Privinil, Zestril) for blood pressure, simvastatin (Zocor) for cholesterol, and paroxetine (Paxil) for depression. Her A1C is now at 7.3%, down from a high of 9.9% a year ago, when she was on only two medicines. “I think the drugs are depressing me,” she said. “The cost, the side effects… I have nausea most days, I have cough from the lisinopril. That doesn’t help at work. I don’t know what’s worse, the drugs or diabetes.” What would you have said to Ellen? Although I strongly believe in reducing drug use, I told her what most experts say, that she can get off some, possibly all diabetes drugs, but it will take a lot of work. Asqual Getaneh, MD, a diabetes expert who writes for Everyday Health, says that doctors want to be “assured that an A1C will stay down” if a person goes off medicines. She says doctors usually won’t reduce medicines until A1C drops below 7.0%. In the ADA publication Diabetes Forecast, pharmacist Craig Williams, PharmD, writes, “Unf Continue reading >>