diabetestalk.net

Does Metformin Become Less Effective

The Surprising Truth About Metformin

The Surprising Truth About Metformin

The “natural” blood-sugar remedy that had been sidelined for far too long What I’m about to tell you may be shocking. And it’s sure to ruffle the feathers of many of the “natural know-it-alls.” But the science is clear, so I’m not afraid to say it: If you have unmanaged Type II diabetes, you should consider the drug metformin as a first line of treatment. And you won’t get the full story anywhere else, since the natural health industry wouldn’t be caught dead recommending a drug. So, please allow me to do the honors here… Think of it as your emergency “get out of jail free card” Diabetes is deadly. High blood sugar coursing through your body destroys your eyes, kidneys, heart, brain, and more. So the sooner you bring it down the better. (Just like high blood pressure, for which I also recommend tried and true medications as a first-line treatment for unmanaged hypertension.) And in this case, the science is clear—the drug metformin has been proven safe and effective for most people. And since it’s now a generic drug, it’s highly cost effective, too. Now don’t get me wrong…I’m not saying diet and exercise isn’t important. In fact, they’re the best means for preventing and even reversing Type II diabetes entirely. Something metformin can’t do. And there are certainly dietary supplements that can help with maintaining healthy blood sugar (like berberine). But Type II diabetes doesn’t develop overnight. And let’s face it, changing the habits and consequences that got us there in the first place isn’t an overnight task either. So if you need additional help, this is one rare instance where you shouldn’t be afraid to look at a mainstream therapy. And when an option this effective comes along to help kick-start your efforts saf Continue reading >>

When Type 2 Diabetes Treatment Fails, What’s Next?

When Type 2 Diabetes Treatment Fails, What’s Next?

For most people, type 2 diabetes changes over time — even for those who follow their treatment plan exactly as directed. As the disease progresses, your diabetes care team can help you adjust your treatment plan and manage your blood sugar levels. If a change is needed, your doctor may add new diabetes medications or suggest starting an insulin regimen. This doesn’t mean you did something wrong — shifting gears is a natural part of managing a changing chronic disease like type 2 diabetes. There are a number of factors that can contribute to a decline in blood sugar control, says Margaret Powers, PhD, RD, CDE, past-president of health care and education for the American Diabetes Association and a research scientist at the International Diabetes Center at Park Nicollet Health Services in Minneapolis, Minnesota. When type 2 diabetes first develops, you may be insulin resistant, which means you make a lot of insulin but your body can’t use it effectively, Dr. Powers says. Then, over time, you make less insulin and become insulin deficient. “This is seen a lot, but it doesn’t happen overnight — it’s a gradual process,” says Powers. Other factors, including a significant change in weight, activity level, or diet, or starting new medications, can also affect blood sugar, she says. Stress is another factor that can impact your treatment. An additional illness or a major change like a divorce, job loss, or a loved one’s death can increase stress, which can raise blood sugar. These life changes may affect how well people take their medication, says Susan Weiner, RDN, a certified diabetes educator in New York and the 2015 Educator of the Year of the American Association of Diabetes Educators. “Before, there may have been someone who helped motivate and suppor Continue reading >>

A Comprehensive Guide To Metformin

A Comprehensive Guide To Metformin

Metformin is the top of the line medication option for Pre-Diabetes and Type 2 Diabetes. If you must start taking medication for your newly diagnosed condition, it is then likely that your healthcare provider will prescribe this medication. Taking care of beta cells is an important thing. If you help to shield them from demise, they will keep your blood sugar down. This medication is important for your beta cell safety if you have Type 2 Diabetes. Not only does Metformin lower blood sugar and decrease resistance of insulin at the cellular level, it improves cell functioning, lipids, and how fat is distributed in our bodies. Increasing evidence in research points to Metformin’s effects on decreasing the replication of cancer cells, and providing a protective action for the neurological system. Let’s find out why Lori didn’t want to take Metformin. After learning about the benefits of going on Metformin, she changed her mind. Lori’s Story Lori came in worrying. Her doctor had placed her on Metformin, but she didn’t want to get the prescription filled. “I don’t want to go on diabetes medicine,” said Lori. “If I go on pills, next it will be shots. I don’t want to end up like my dad who took four shots a day.” “The doctor wants you on Metformin now to protect cells in your pancreas, so they can make more insulin. With diet and exercise, at your age, you can reverse the diagnosis. Would you like to talk about how we can work together to accomplish that?” “Reverse?” she asked. “What do you mean reverse? Will I not have Type 2 Diabetes anymore?” “You will always have it, but if you want to put it in remission, you are certainly young enough to do so. Your doctor wants to protect your beta cells in the pancreas. If you take the new medication, Continue reading >>

Metformin: An Old But Still The Best Treatment For Type 2 Diabetes

Metformin: An Old But Still The Best Treatment For Type 2 Diabetes

Abstract The management of T2DM requires aggressive treatment to achieve glycemic and cardiovascular risk factor goals. In this setting, metformin, an old and widely accepted first line agent, stands out not only for its antihyperglycemic properties but also for its effects beyond glycemic control such as improvements in endothelial dysfunction, hemostasis and oxidative stress, insulin resistance, lipid profiles, and fat redistribution. These properties may have contributed to the decrease of adverse cardiovascular outcomes otherwise not attributable to metformin’s mere antihyperglycemic effects. Several other classes of oral antidiabetic agents have been recently launched, introducing the need to evaluate the role of metformin as initial therapy and in combination with these newer drugs. There is increasing evidence from in vivo and in vitro studies supporting its anti-proliferative role in cancer and possibly a neuroprotective effect. Metformin’s negligible risk of hypoglycemia in monotherapy and few drug interactions of clinical relevance give this drug a high safety profile. The tolerability of metformin may be improved by using an appropiate dose titration, starting with low doses, so that side-effects can be minimized or by switching to an extended release form. We reviewed the role of metformin in the treatment of patients with type 2 diabetes and describe the additional benefits beyond its glycemic effect. We also discuss its potential role for a variety of insulin resistant and pre-diabetic states, obesity, metabolic abnormalities associated with HIV disease, gestational diabetes, cancer, and neuroprotection. Introduction The discovery of metformin began with the synthesis of galegine-like compounds derived from Gallega officinalis, a plant traditionally em Continue reading >>

Metformin: Improving Insulin Sensitivity

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 >>

How Long The Effectiveness Metformin ?

How Long The Effectiveness Metformin ?

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community I have an important question . Regarding the duration of metformin It means that I am allowed to eat food after the dose I don't have idea Metformin is best taken whilst you are eating as that helps reduce any stomach problems. I am sorry my language betray me I mean how long Stability of blood sugar even if eaten after four hours I hope you understand me I am sorry my language betray me I mean how long Stability of blood sugar even if eaten after four hours I hope you understand me Ah. OK. Metformin doesn't work that way. It works by helping to reduce the amount of natural glucose produced by the liver and sent to the blood stream. It also helps a little bit with insulin resistance. It is mainly an appetite suppressant. so it helps overweight people the most. It doesn't do anything to stabilise blood glucose. It also accumulates in your body and doesn't "run out" every day like some medicines do. As long as you take the Metformin with food, it doesn't matter when you take it or when you eat. Does that help? Metformin does not work like insulin or other medication that induce insulin production. It works by reducing glucose production by the liver and reducing insulin resistance allowing the body to make better use of its own insulin. Consequently you do not take metformin is response or in preparation to a meal. You take it at fixed times as prescribed by your doctor and it then acts throughout the day. So in answer to your question you do not have to eat within a fixed time of taking metformin. As metformin can cause upset stomachs as a side effect for some people, it is customary to take metformin with a meal as this has been found to reduce the ch 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 >>

How Effective Does Metformin Remain When Taken For Long Periods?

How Effective Does Metformin Remain When Taken For Long Periods?

How effective does Metformin remain when taken for long periods? The most widely prescribed of these drugs is metformin (Glucophage). Metformin is a drug with a profile that is generally more favorable than the other oral diabetes drugs for most type 2 diabetics requiring medication. Although studies have found that metformin alone shows a decrease in heart attacks and all diabetes-related deaths, it does not work at all in about 25 percent of cases and tends to lose its effectiveness over time. When it does lose effectiveness, it is usually combined with a sulfonylurea. On their own, these drugs are of limited value, and there is some evidence that sulfonylureas actually have harmful long-term side effects. For example, in a famous study conducted by the University Group Diabetes Program (UDGP), it was shown that the rate of death due to a heart attack or stroke was 2.5 times greater in the group taking tolbutamide (a sulfonylurea) than in the group controlling type 2 diabetes by diet alone. Though newer sulfonylureas are considered safer than tolbutamide, there still remains considerable concern regarding their effects on the heart. In addition, sulfonylureas promote weight gain, thereby fighting against the diabetic's necessary efforts to lose weight. The combination of metformin with glyburide or gliblencamide, like taking a sulfonylurea alone, actually increases premature mortality. Continue reading >>

Metformin, Oral Tablet

Metformin, Oral Tablet

Metformin oral tablet is available as both a generic and brand-name drug. Brand names: Glucophage, Glucophage XR, Fortamet, and Glumetza. Metformin is also available as an oral solution but only in the brand-name drug Riomet. Metformin is used to treat high blood sugar levels caused by type 2 diabetes. FDA warning: Lactic acidosis warning This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects. Lactic acidosis is a rare but serious side effect of this drug. In this condition, lactic acid builds up in your blood. This is a medical emergency that requires treatment in the hospital. Lactic acidosis is fatal in about half of people who develop it. You should stop taking this drug and call your doctor right away or go to the emergency room if you have signs of lactic acidosis. Symptoms include tiredness, weakness, unusual muscle pain, trouble breathing, unusual sleepiness, stomach pains, nausea (or vomiting), dizziness (or lightheadedness), and slow or irregular heart rate. Alcohol use warning: You shouldn’t drink alcohol while taking this drug. Alcohol can affect your blood sugar levels unpredictably and increase your risk of lactic acidosis. Kidney problems warning: If you have moderate to severe kidney problems, you have a higher risk of lactic acidosis. You shouldn’t take this drug. Liver problems warning: Liver disease is a risk factor for lactic acidosis. You shouldn’t take this drug if you have liver problems. Metformin oral tablet is a prescription drug that’s available as the brand name drugs Glucophage, Glucophage XR, Fortamet, and Glumetza. Glucophage is an immediate-release tablet. All of the other brands are extended-r Continue reading >>

How Effective Is Metformin

How Effective Is Metformin

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community How effective is Metformin at lowering BG? I have recently kicked myself into touch and my recent HbA1c was 39mmol/mol, so quite pleased with that result. This was achieved through diet and exercise. I also lost a stone in weight and my BMI is now 27 instead of 30. I already take 2,000 Metformin sr and sitigliptin. But would eventually like to ditch the tablets when I am under better control. I don't really think that the meds have made much difference to my levels, as I seem to get better results through diet and exercise. Has anyone ditched the meds and had good results? Forgot to add that my HbA1c has gone down from 61mmol/mol to 39mmol/mol. In old money that's 7.7 down to 5.7 I've achieved this in 3 months with diet and exercise. I noticed that Metformin did not appear to be doing much regarding my blood sugar levels so I asked to stop taking them for three months. I didn't notice the difference to be honest but the doctor got a bit wound up when she found out. The HCP's are very insistent that you take them but give vague future benefits as to why that is. At the moment I am awaiting my test results after six months off all medication and according to my finger prick tests during that time I am expecting an acceptably low Hba1c. Metformin is pretty effective in Type 2 Diabetes. The research showed something like these figures .. ( from memory) doses of 2500 doesn't show much improvement on 2000 so it is usually said the minimum effective dose is 1500-2000 and people titrate up to that through 500 and 1000 to lessen initial gastrointestinal effects. If your A1c is 5.7 with metformin it would presumably be 6.9 without it. And of course the Sitaglip Continue reading >>

Metformin Forever

Metformin Forever

Metformin controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That’s what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri. “Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.” Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease. Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant. “I treat insulin resistance with that drug even if they aren’t fully diabetic.” he says. “If they have high triglyceride levels and low HDL levels, particularly if they are centrally obese, they should probably be on metformin. It helps slow the progression of the disease from one thing to the next.” But he goes further. He prescribes metformin to almost all of his patients who have type 2 diabetes — no matter how low their A1C level is. And he tells his patients that their levels should be 5.0 or less — not the American Diabetes Association’s less stringent recommendation of 7.0 or less. “If their A1C is at 5, their diabetes is in complete remission. So I have that as a goal.” And he still prescribes metformin to them after they reach that goal. “The two important issues are that it will prevent progression and it should be used in the earliest phases of insulin resistance. We vastly underutilize me Continue reading >>

Diabetes Drugs: Metformin

Diabetes Drugs: Metformin

Editor’s Note: This is the second post in our miniseries about diabetes drugs. Tune in on August 21 for the next installment. Metformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U.S. market in 1977. This situation most likely slowed the approval of metformin, which was not used in the U.S. until 1995. (By comparison, metformin has been used in Europe since the 1960’s.) The U.S. Food and Drug Administration (FDA) required large safety studies of metformin, the results of which demonstrated that the development of lactic acidosis as a result of metformin therapy is very rare. (A finding that has been confirmed in many other clinical trials to date.) Of note, the FDA officer involved in removing phenformin from the market recently wrote an article highlighting the safety of metformin. Metformin works primarily by decreasing the amount of glucose made by the liver. It does this by activating a protein known as AMP-activated protein kinase, or AMPK. This protein acts much like an “energy sensor,” setting off cellular activities that result in glucose storage, enhanced entry of glucose into cells, and decreased creation of fatty acids and cholesterol. A secondary effect of the enhanced entry of glucose into cells is improved glucose uptake and increased storage of glycogen (a form of glucose) by the muscles. Additionally, the decrease in fatty acid levels brought about by metformin may indirectly improve insulin resistance and beta cell func Continue reading >>

One Of The Most Effective Diabetes Drugs

One Of The Most Effective Diabetes Drugs

You may recall that I recently wrote a series on various medicines and how they can affect your diabetes (see "The Ups and Downs of Meds and Diabetes [Part 1]" as well as Part 2, Part 3, Part 4, and Part 5). One kind reader, who happens to be a nurse, asked me to devote a post to metformin with regard to its effects on kidneys and special considerations to keep in mind with this drug. I wrote about metformin back in December 2006 (was it that long ago?) and its link to vitamin B12 deficiency (see “Metformin and Risk For Vitamin B12 Deficiency”). But there are other important facts to know about this very popular diabetes drug. Raise your hand if you take metformin. OK, obviously I can’t see you, but I’ll wager that many of you reading this are on this medication. Metformin is the generic name for Glucophage, Glucophage XR, Glumetza, Fortamet, and Riomet. It also comes combined with other diabetes medications, including glyburide (in Glucovance), glipizide (in Metaglip), rosiglitazone (in Avandamet), pioglitazone (in Actoplus Met), sitagliptin (in Janumet), and repaglinide (in PrandiMet). I’ve read that approximately 35 million prescriptions were written for metformin in 2006, making this one of the top 10 best selling generic drugs. And you may not be aware that the American Diabetes Association, in its 2006 practice guidelines for health-care professionals, recommended metformin over sulfonylureas as the first drug of choice for people with Type 2 diabetes. This really isn’t surprising. Metformin has a long track record for being safe and causing relatively few serious side effects—plus, it also works! Chances are, if you have Type 2 diabetes and need to start on medication, your health-care provider will recommend you take metformin. How It Works Just a Continue reading >>

Diabetes Drugs: Some Work Better Than Others

Diabetes Drugs: Some Work Better Than Others

MORE Not all diabetes drugs are equally effective at preventing death and heart disease over a decade-long period, a new study suggests. Diabetes patients who take some versions of drugs called insulin secretagogues are 20 to 33 percent more likely to die from any cause over a 10-year period than patients who take the diabetes drug metformin, the study said. Insulin secretagogues have been around since the 1950s and work by stimulating cells to produce insulin, while metformin works by reducing excess sugar seen in Type 2 diabetes. But the findings do not suggest that insulin secretagogues are harmful to people only that some seem to be less effective than metformin , said study researcher Dr. Tina Ken Schramm, a senior resident at the Heart Center at Rigshospitalet Copenhagen University Hospital in Denmark. Metformin is doctors' first choice for treating Type 2 diabetes, Schramm said. But the drug "is contraindicated in patients with renal failure, severe heart failure and when patients are intolerant to metformin," she told MyHealthNewsDaily, which explains why not all diabetes patients can take metformin. The study was published today (April 6) in the European Heart Journal. The drugs' effects Schramm and her colleagues examined the health status of 107,806 Danish people ages 20 and older who were being treated with insulin secretagogues or metformin between 1997 and 2006. More than half the people in the study were on insulin secretagogues. Researchers found that people who took the insulin secretagogues glimepiride, glyburide, gliclazide and tolbutamide had a greater risk of having a heart attack or stroke or dying from any cause during the 10-year period, compared with those who took only metformin. Also, for patients who have had a heart attack before, those who Continue reading >>

Hopes Of New Diabetes Drug With No Side Effects

Hopes Of New Diabetes Drug With No Side Effects

The drug, which costs as little as 2p a day, is the gold standard treatment for obesity-triggered Type 2 diabetes and has been safely used for more than 50 years to control blood sugar levels. Yet one in 10 patients suffers side effects – nausea, loss of appetite and vomiting – and it can also become ineffective over time. One in 10 diabetics suffers side effects – nausea, loss of appetite and vomiting – and it can also become ineffective over time Now experts at the University of Pennsylvania School of Medicine have found that metformin works in a different way than previously thought. A team led by Dr Morris Birnbaum found in experiments on laboratory mice that the drug suppresses the ability of the hormone glucagon to generate a signalling molecule that stimulates glucose production. He said this new understanding means scientists can work on developing a new drug that works by mimicking the way the molecule is blocked by metformin. Type 2 diabetes patients suffer from an impaired production or effectiveness of insulin, the hormone made in the pancreas that helps control blood sugar levels. Metformin works by helping stop the liver from producing excess glucose and overcoming insulin resistance by making insulin carry glucose into muscle cells more effectively. Dr Birnbaum, whose findings are published in the journal Nature, said: “Overall metformin lowers blood glucose by decreasing liver production of glucose. But we didn’t really know how the drug accomplished that.” A revolutionary new treatment could transform lives of patients susceptible to metformin’s side effects. Type 2 sufferers are at higher risk of a host of debilitating conditions from heart disease, strokes and kidney failure to amputations and blindness. There are 2.9 million sufferers Continue reading >>

More in diabetes