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Can I Take Metformin To Prevent Diabetes?

Prediabetes - Medications

Prediabetes - Medications

XIAFLEX® is a prescription medicine used to treat adults with Dupuytren's contracture when a "cord" can be felt. It is not known if XIAFLEX® is safe and effective in children under the age of 18. Do not receive XIAFLEX® if you have had an allergic reaction to collagenase clostridium histolyticum or any of the ingredients in XIAFLEX®, or to any other collagenase product. See the end of the Medication Guide for a complete list of ingredients in XIAFLEX®. XIAFLEX® can cause serious side effects, including: Tendon rupture or ligament damage. Receiving an injection of XIAFLEX® may cause damage to a tendon or ligament in your hand and cause it to break or weaken. This could require surgery to fix the damaged tendon or ligament. Call your healthcare provider right away if you have trouble bending your injected finger (towards the wrist) after the swelling goes down or you have problems using your treated hand after your follow-up visit Nerve injury or other serious injury of the hand. Call your healthcare provider right away if you get numbness, tingling, increased pain, or tears in the skin (laceration) in your treated finger or hand after your injection or after your follow-up visit Hypersensitivity reactions, including anaphylaxis. Severe allergic reactions can happen in people who receive XIAFLEX® because it contains foreign proteins. Call your healthcare provider right away if you have any of these symptoms of an allergic reaction after an injection of XIAFLEX®: hives swollen face breathing trouble chest pain low blood pressure dizziness or fainting Increased chance of bleeding. Bleeding or bruising at the injection site can happen in people who receive XIAFLEX®. Talk to your healthcare provider if you have a problem with your blood clotting. XIAFLEX® may not b Continue reading >>

Magnesium And Diabetes: Reduce Blood Sugar Now!

Magnesium And Diabetes: Reduce Blood Sugar Now!

Magnesium is the second most abundant mineral in our body. Considering we have so much, it’s obviously needed for a ton of stuff. It’s a vital nutrient that drives close to 300 different biochemical reactions in the body. One of these critical functions is ensuring that our blood sugar remains within the right range. The connection between having adequate magnesium and diabetes prevention is deep. Magnesium can help prevent diabetes if you don’t have it yet. If you are diabetic, it can help you control blood sugar better. We’re meant to get magnesium from a variety of foods, including dairy. And yet an astounding 80% of Americans are deficient in this mineral. Is it any wonder then that heart diseases, hypertension, and diabetes are on such a sharp rise in the United States? The relationship between magnesium and diabetes mellitus is crucial. Here’s why: Magnesium helps muscle cells relax, so insulin resistance goes down. Cells allow more sugar in. Blood sugar goes down. The heart is a muscle. Magnesium helps the heart relax and lowers risk of cardiac issues in diabetics. When magnesium is sufficient, it prevents calcium deposition in the inner walls of blood vessels. This helps prevent hardening of arteries. Magnesium is important for the production of energy. Diabetics often feel tired because proper energy production is an issue. Magnesium helps convert excess of glucose in the blood into glycogen. This gets stored in the liver. Excess sugar is removed from the blood. Magnesium helps antioxidants like Glutathione do their job in our body. Antioxidants help slow down aging. Diabetics face more oxidative stress than non-diabetics. This causes diabetic complications across the whole body. Diabetics often complain of feeling pins and needles or numbness in thei Continue reading >>

Stopping Metformin: When Is It Ok?

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 >>

Take Metformin If You Have Prediabetes

Take Metformin If You Have Prediabetes

Do you have prediabetes? You might be able to ward it off with the help of one of the diabetes drugs. Metformin might stop you from getting diabetes and could also help you in other ways. But persuading your doctor to prescribe it could be a challenge. The biggest and perhaps the best study of people who have prediabetes showed that taking metformin cuts the risk of diabetes by 31 percent. While this was less than the reduction of 58 percent that the “lifestyle intervention” provided, in real life we usually aren’t able to get that much guidance from our medical team. By “lifestyle intervention” the researchers meant being in a program that provided information, guidance, and support to help participants lose 7 percent or more of their weight and to get moderately intense physical activity — like brisk walking — for at least 150 minutes a week. But without that guidance, it typically takes a long time to help, and in fact it most people just don’t do it. Who Metformin Helps Most The study showed that metformin helped the most among younger people, and with people who had a high body mass index (BMI) or a high fasting blood glucose level. It doesn’t help seniors much. But the biggest problem with metformin is to have your doctor prescribe it. Only 3.7 percent of insured adults who had a prediabetes diagnosis were taking it between 2010 and 2012, according to a study that the Annals of Internal Medicine published last year. This very low proportion is probably because the U.S. Food and Drug Administration hasn’t approved metformin — or any other drug — for prediabetes. While doctors are free to prescribe it “off label,” some of them are hesitant to do that. Some Side Effects Like any drugs, metformin sometimes has unwanted side effects. The mos Continue reading >>

Prediabetes

Prediabetes

What Is Prediabetes? Prediabetes is a “pre-diagnosis” of diabetes—you can think of it as a warning sign. It’s when your blood glucose level (blood sugar level) is higher than normal, but it’s not high enough to be considered diabetes. Prediabetes is an indication that you could develop type 2 diabetes if you don’t make some lifestyle changes. But here's the good news: . Eating healthy food, losing weight and staying at a healthy weight, and being physically active can help you bring your blood glucose level back into the normal range. Diabetes develops very gradually, so when you’re in the prediabetes stage—when your blood glucose level is higher than it should be—you may not have any symptoms at all. You may, however, notice that: you’re hungrier than normal you’re losing weight, despite eating more you’re thirstier than normal you have to go to the bathroom more frequently you’re more tired than usual All of those are typical symptoms associated with diabetes, so if you’re in the early stages of diabetes, you may notice them. Prediabetes develops when your body begins to have trouble using the hormone insulin. Insulin is necessary to transport glucose—what your body uses for energy—into the cells via the bloodstream. In pre-diabetes, your body either doesn’t make enough insulin or it doesn’t use it well (that’s called insulin resistance). If you don’t have enough insulin or if you’re insulin resistant, you can build up too much glucose in your blood, leading to a higher-than-normal blood glucose level and perhaps prediabetes. Researchers aren’t sure what exactly causes the insulin process to go awry in some people. There are several risk factors, though, that make it more likely that you’ll develop pre-diabetes. These are Continue reading >>

Could Taking Metformin Prevent Type 1 Diabetes?

Could Taking Metformin Prevent Type 1 Diabetes?

The Scottish Universities of Exeter and Dundee are combining efforts for a trailblazing new study that aims to find out if lifestyle and environmental factors affect the development of type 1 diabetes and if the most common diabetes drug can be the solution. Metformin is a widely prescribed diabetes drug most often used in the treatment of type 2 diabetes because it increases the body’s sensitivity to insulin, decreases the amount of sugar excreted by the liver, and increases the amount of sugar absorbed by the muscles. Scientists want to find out if metformin can prevent type 1 diabetes by essentially taking some stress off of the body’s hypothetically overworked beta cells. The study is being conducted in Scotland because according to the press release, the country has the 3rd highest incidence of type 1 diabetes in the world, highly organized records of its type 1 diabetes citizens, and a unified group of pediatric diabetologists. JDRF, the charity dedicated to funding type 1 diabetes research is backing the study’s initial costs of $1.7 million. Can Metformin Prevent Type 1 Diabetes in At-Risk Individuals? Researchers plan on contacting every one of the 6,400 families in Scotland with a type 1 diabetes diagnosis and asking children between the ages of 5 and 16 who either have a sibling or a parent with type 1 diabetes diagnosed before the age of 25 to get a blood test. This test will be used to check for antibodies to find out if they are at high risk for developing type 1 diabetes. Those at high risk will be asked to participate in the study called the Accelerator Prevention Trial (adAPT) which will put the children into two groups. One of the groups will take metformin for four months and the other a placebo. The children will be checked three times during t Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

This Issue The oral biguanide metformin (Glucophage, and others) is generally the drug of choice for initial treatment of type 2 diabetes. It has also been used to prevent or at least delay the onset of diabetes in patients considered to be at high risk for the disease. Recent guidelines recommend considering use of metformin in patients with prediabetes (fasting plasma glucose 100-125 mg/dL, 2-hr post-load glucose 140-199 mg/dL, or A1C 5.7-6.4%), especially in those who are <60 years old, have a BMI >35 kg/m2, or have a history of gestational diabetes.1 Metformin has not been approved for such use by the FDA. Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it? For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl. Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%. But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for t Continue reading >>

Therapeutic Use Of Metformin In Prediabetes And Diabetes Prevention

Therapeutic Use Of Metformin In Prediabetes And Diabetes Prevention

People with elevated, non-diabetic, levels of blood glucose are at risk of progressing to clinical type 2 diabetes and are commonly termed ‘prediabetic’. The term prediabetes usually refers to high–normal fasting plasma glucose (impaired fasting glucose) and/or plasma glucose 2 h following a 75 g oral glucose tolerance test (impaired glucose tolerance). Current US guidelines consider high–normal HbA1c to also represent a prediabetic state. Individuals with prediabetic levels of dysglycaemia are already at elevated risk of damage to the microvasculature and macrovasculature, resembling the long-term complications of diabetes. Halting or reversing the progressive decline in insulin sensitivity and β-cell function holds the key to achieving prevention of type 2 diabetes in at-risk subjects. Lifestyle interventions aimed at inducing weight loss, pharmacologic treatments (metformin, thiazolidinediones, acarbose, basal insulin and drugs for weight loss) and bariatric surgery have all been shown to reduce the risk of progression to type 2 diabetes in prediabetic subjects. However, lifestyle interventions are difficult for patients to maintain and the weight loss achieved tends to be regained over time. Metformin enhances the action of insulin in liver and skeletal muscle, and its efficacy for delaying or preventing the onset of diabetes has been proven in large, well-designed, randomised trials, such as the Diabetes Prevention Program and other studies. Decades of clinical use have demonstrated that metformin is generally well-tolerated and safe. We have reviewed in detail the evidence base supporting the therapeutic use of metformin for diabetes prevention. Notes Ulrike Hostalek and Steven Hildemann are employees of Merck KGaA, a pharmaceutical sponsor of several for Continue reading >>

Pre-diabetes

Pre-diabetes

What Is It? In pre-diabetes, blood sugar levels are slightly higher than normal, but still not as high as in diabetes. If diabetes is "runaway blood sugar" think of pre-diabetes as blood sugar that is "halfway out the door." People almost always develop pre-diabetes before they get type 2 diabetes. The rise in blood sugar levels that is seen in pre-diabetes starts when the body begins to develop a problem called "insulin resistance." Insulin is an important hormone that helps you to process glucose (blood sugar). If usual amounts of insulin can't trigger the body to move glucose out of the bloodstream and into your cells, then you have insulin resistance. Once insulin resistance begins, it can worsen over time. When you have pre-diabetes, you make extra insulin to keep your sugar levels near to normal. Insulin resistance can worsen as you age, and it worsens with weight gain. If your insulin resistance progresses, eventually you can't compensate well enough by making extra insulin. When this occurs, your sugar levels will increase, and you will have diabetes. Depending on what a blood sugar test finds, pre-diabetes can be more specifically called "impaired glucose (sugar) tolerance" or "impaired fasting glucose." Impaired fasting glucose means that blood sugar increase after you haven't eaten for a while – for example, in the morning, before breakfast. Impaired glucose tolerance means that blood sugar levels reach a surprisingly high level after you eat sugar. To diagnose impaired glucose tolerance, doctors usually use what is called a "glucose tolerance test." For this test you drink a sugary solution, and then you have blood drawn after a short time. Having pre-diabetes does not automatically mean you will get diabetes, but it does put you at an increased risk. Pre- Continue reading >>

Prevention Of Diabetes Mellitus Type 2

Prevention Of Diabetes Mellitus Type 2

Main article: Diabetes mellitus type 2 Prevention of diabetes mellitus type 2 can be achieved with both lifestyle changes and use of medication.[1] The American Diabetes Association categorizes prediabetes as a high-risk group that has glycemic levels higher than normal but does not meet criteria for diabetes. Without intervention people with prediabetes progress to type 2 diabetes with a 5% to 10% rate. Diabetes prevention is achieved through weight loss and increased physical activity, which can reduce the risk of diabetes by 50% to 60%.[2] Lifestyle[edit] Many interventions to promote healthy lifestyles have been shown to prevent diabetes. A combination of diet and physical activity promotion through counselling and support programs decrease weight, improve systolic blood pressure, improve cholesterol levels and decrease risk of diabetes.[2] Increasing physical activity may be helpful in preventing type 2 diabetes, particularly if undertaken soon after a carbohydrate rich meal that increases blood sugar levels.[3][4][5] The American Diabetes Association (ADA) recommends maintaining a healthy weight, getting at least 2½ hours of exercise per week (several brisk sustained walks appear sufficient), having a modest fat intake (around 30% of energy supply should come from fat), and eating sufficient fiber (e.g., from whole grains). Some preliminary evidence suggests that resistant starch, used as a substitute for refined carbohydrate, may increase insulin sensitivity[6] and may reduce the risk of type 2 diabetes.[7] The U.S. Food and Drug Administration requires claims that resistant starch can reduce the risk of type 2 diabetes to be qualified with a declaration that scientific evidence in support of this claim is limited.[8] Foods with low glycemic index rich in fiber Continue reading >>

Type 2 Diabetes Can Be Prevented With Early Pharmacological Intervention

Type 2 Diabetes Can Be Prevented With Early Pharmacological Intervention

In the U.S., ∼21 × 106 individuals have type 2 diabetes, and twice as many have impaired glucose tolerance (IGT). Approximately 40–50% of individuals with IGT will progress to type 2 diabetes over their lifetime. Therefore, treatment of high-risk individuals with IGT to prevent type 2 diabetes has important medical, economic, social, and human implications. Weight loss, although effective in reducing the conversion of IGT to type 2 diabetes, is difficult to achieve and maintain. Moreover, 40–50% of IGT subjects progress to type 2 diabetes despite successful weight reduction. In contrast, pharmacological treatment of IGT with oral antidiabetic agents that improve insulin sensitivity and preserve β-cell function—the characteristic pathophysiological abnormalities present in IGT and type 2 diabetes—uniformly have been shown to prevent progression of IGT to type 2 diabetes. The most consistent results have been observed with the thiazolidinediones (Troglitazone in the Prevention of Diabetes [TRIPOD], Pioglitazone in the Prevention of Diabetes [PIPOD], Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication [DREAM], and Actos Now for the Prevention of Diabetes [ACT NOW]), with a 50–70% reduction in IGT conversion to diabetes. Metformin in the U.S. Diabetes Prevention Program (DPP) reduced the development of type 2 diabetes by 31% and has been recommended by the American Diabetes Association (ADA) for treating high-risk individuals with IGT. The glucagon-like peptide-1 analogs, which augment insulin secretion, preserve β-cell function, and promote weight loss, also would be expected to be efficacious in preventing the progression of IGT to type 2 diabetes. Because individuals in the upper tertile of IGT are maximally/near-maximally insulin resi Continue reading >>

The 10-year Cost-effectiveness Of Lifestyle Intervention Or Metformin For Diabetes Prevention

The 10-year Cost-effectiveness Of Lifestyle Intervention Or Metformin For Diabetes Prevention

OBJECTIVE The Diabetes Prevention Program (DPP) and its Outcomes Study (DPPOS) demonstrated that either intensive lifestyle intervention or metformin could prevent type 2 diabetes in high-risk adults for at least 10 years after randomization. We report the 10-year within-trial cost-effectiveness of the interventions. RESEARCH DESIGN AND METHODS Data on resource utilization, cost, and quality of life were collected prospectively. Economic analyses were performed from health system and societal perspectives. RESULTS Over 10 years, the cumulative, undiscounted per capita direct medical costs of the interventions, as implemented during the DPP, were greater for lifestyle ($4,572) than metformin ($2,281) or placebo ($752). The cumulative direct medical costs of care outside the DPP/DPPOS were least for lifestyle ($26,810 lifestyle vs. $27,384 metformin vs. $29,007 placebo). The cumulative, combined total direct medical costs were greatest for lifestyle and least for metformin ($31,382 lifestyle vs. $29,665 metformin vs. $29,759 placebo). The cumulative quality-adjusted life-years (QALYs) accrued over 10 years were greater for lifestyle (6.89) than metformin (6.79) or placebo (6.74). When costs and outcomes were discounted at 3% and adjusted for survival, lifestyle cost $12,878 per QALY, and metformin had slightly lower costs and nearly the same QALYs as placebo. CONCLUSIONS Over 10 years, from a payer perspective, lifestyle was cost-effective and metformin was marginally cost-saving compared with placebo. Investment in lifestyle and metformin interventions for diabetes prevention in high-risk adults provides good value for the money spent. Intensive lifestyle and metformin interventions can delay or prevent progression from impaired glucose tolerance (IGT) to type 2 diabetes Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

The oral biguanide metformin (Glucophage, and others) is generally the drug of choice for initial treatment of type 2 diabetes. It has also been used to prevent or at least delay the onset of diabetes in patients considered to be at high risk for the disease. Recent guidelines recommend considering use of metformin in patients with prediabetes (fasting plasma glucose 100-125 mg/dL, 2-hr post-load glucose 140-199 mg/dL, or A1C 5.7-6.4%), especially in those who are <60 years old, have a BMI >35 kg/m2, or have a history of gestational diabetes.1 Metformin has not been approved for such use by the FDA. CLINICAL STUDIES — In the Diabetes Prevention Program (DPP) trial, 3234 nondiabetic adults with a BMI ≥24 kg/m2 (≥22 kg/m2 in Asian patients) and elevated fasting and post-load plasma glucose concentrations were randomized to receive intensive lifestyle intervention focusing on weight loss and exercise, metformin 850 mg twice daily, or placebo.2 After a mean follow-up of 2.8 years, the incidence of diabetes was reduced, compared to placebo, by 58% with intensive lifestyle intervention and by 31% with metformin. Metformin was as effective as lifestyle intervention among patients <60 years old or with a BMI ≥35 kg/m2. When the 3-year DPP trial ended, the intensive lifestyle intervention group was offered semi-annual counseling and the metformin group could continue to take the drug. During a follow-up of 15 years, the average annual incidence of diabetes, compared to placebo, was 27% lower in patients originally randomized to lifestyle intervention and 18% lower in those randomized to metformin.3 ADVERSE EFFECTS — No significant safety issues have been detected with long-term use of metformin. The drug can cause adverse gastrointestinal effects such as metallic taste Continue reading >>

Evidence-based Answers From The Family Physicians Inquiries Network

Evidence-based Answers From The Family Physicians Inquiries Network

clinical inquiries EvidEncE-basEd answEr A Does metformin prevent diabetes in at-risk adults? yes. Metformin therapy reduces the risk of developing diabetes for adults with one or more risk factors for at least 5 years (strength of recommendation [SOR]: A, consistent meta-analyses) and perhaps as long as 10 years (SOR: B, ran- domized clinical trial [RCT]). Lifestyle modification with diet and exercise is approximately twice as effective as metformin for preventing diabetes, es- pecially in older patients (SOR: B, RCTs). Evidence summary Three meta-analyses of studies lasting from 2 months to 5 years found that metformin re- duced the risk of developing overt diabetes in at-risk adults when compared with placebo (TABLE).1-3 Metformin is likely effective for as long as 10 years, based on long-term follow-up of patients in the Diabetes Prevention Program (DPP). In this trial, investigators randomized 3234 at-risk patients to 3 groups: metformin 850 mg twice daily; lifestyle modification (7% weight loss, 150 minutes of physi- cal activity per week, and a one-to-one 16-lesson curriculum covering diet, exercise, and behavior modification); or placebo.4 At a mean 2.8-year follow-up, the incidence of di- abetes was 31% lower in the metformin group (95% confidence interval [CI], 17%-43%) and 58% lower in the lifestyle modification group than in the placebo group (95% CI, 48%-66%; P<.001 for both comparisons). At the close of the DPP trial, investigators offered lifestyle intervention to all 3 groups. Patients in the original metformin group continued to take metformin (with partici- pants unblinded to assignment); patients in the original lifestyle intervention group were offered additional lifestyle support.5 At a median follow-up of 10 years after initial enrollment in the DP Continue reading >>

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