The Effect Of Metformin On Blood Pressure, Plasma Cholesterol And Triglycerides In Type 2 Diabetes Mellitus: A Systematic Review.
The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review. Bethesda General Hospital, Hoogeveen, The Netherlands. The UKPDS 34 showed that intensive treatment with metformin significantly reduces macrovascular end-points and mortality in individuals with newly diagnosed type 2 diabetes compared with intensive treatment with insulin or sulphonylurea derivatives, despite similar glycaemic control. How this should be explained is as yet unclear. We hypothesized that metformin may have a glucose-lowering independent effect on blood pressure and lipid profile. In order to test this hypothesis we systematically reviewed the literature and pooled the data obtained in a meta-analysis. Included were randomized-controlled trials in patients with type 2 diabetes mellitus and metformin treatment lasting at least 6 weeks. To identify all eligible trials we conducted electronic searches using the bibliographic databases Medline and Embase, contacted the manufacturer and checked obtained publications for cross-references. Forty-one studies (3074 patients) provided data on blood pressure and/or lipid profile. When compared with control treatment, metformin associated effects on systolic and diastolic blood pressure and HDL cholesterol were small and statistically not significant [-1.09 mmHg 95% confidence interval (-3.01-0.82), P = 0.30; -0.97 (-2.15-0.21) mmHg, P = 0.11 and +0.01 (-0.02-0.03) mmol L(-1), P = 0.50, respectively]. Compared with control treatment, however, metformin decreased plasma triglycerides, total cholesterol and LDL cholesterol significantly [-0.13 (-0.21--0.04) mmol L(-1), P = 0.003; -0.26 (-0.34--0.18) mmol L(-1), P < 0.0001 and -0.22 (-0.31--0.13) mmol L(-1), P < 0.00001, respectively]. We Continue reading >>
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Diabetes Update: Two New Studies Support Utility Of Metformin
Two New Studies Support Utility of Metformin UPDATE: Sept 16, 2009: Mouse study finds metformin blocks breast cancer stem cells. This is a mouse study, which means it may be irrelevant to humans, but added to the other data linking metformin to reduced cancer incidence, it's worth noting. Science Daily: Diabetes Drug Kills Cancer Stem Cells in Combination Treatment in Mice. It's well known that people with diabetes have a higher risk of cancer. In some cases, undetected cancer may be causing the diabetes--diabetes is, rarely, an early symptom of pancreatic cancer. In others the many years of exposure to high blood sugar may feed baby cancer cells which do not apparently need insulin to be able to take in and metabolize glucose. Until now, all we could advise people with family histories of diabetes to do, to prevent or slow cancer, was to strive for early diabetes or pre-diabetes diagnosis and to lower blood sugars aggressively once abnormal blood sugars were found. Now new data from a British epidemiological study suggests that metformin may exert an anti-cancer effect. The study is: New Users of Metformin Are at Low Risk of Incident Cancer: A cohort study among people with type 2 diabetes. Gillian Libby et al. Diabetes Care September 2009 vol. 32 no. 9 1620-1625.doi: 10.2337/dc08-2175 The study made use of medical records collected in Tayside, Scotland UK. The researchers compared 4085 people with type 2 diabetes who were new users of metformin in 19942003 to a group of people with diabetes diagnosed the same year who were not given metformin. Cancer was diagnosed among 7.3% of 4,085 metformin users compared with 11.6% of 4,085 comparators, with median times to cancer of 3.5 and 2.6 years, respectively (P < 0.001). The unadjusted hazard ratio (95% CI) for cancer was Continue reading >>
6 Medications That Can Cause High Triglycerides
Though they don’t factor in to your total cholesterol level, blood fats called triglycerides still have an impact on your health. Extremely high triglycerides—500 mg/dL or higher—can put you at risk for pancreatitis. This inflammation of the pancreas gland can cause stomach pain, digestive problems, and, eventually, diabetes. Almost one-third of American adults have high triglycerides. Obesity, family history, excess alcohol consumption, and a sedentary lifestyle often play a role. But certain medications for other health conditions also can influence your triglyceride level. If you take one of these drugs, ask your health care provider how often you should have a lipid panel. This measures your triglycerides and your cholesterol. Always talk with your health care provider before stopping or starting any medication. 1. Blood pressure medicines High blood pressure also increases your risk for heart disease. If you can’t control your numbers through lifestyle changes, your health care provider may recommend treatment with medications called thiazide diuretics (commonly called “water pills”) or beta-blockers. 2. Corticosteroids The term may bring to mind athletes and performance-enhancing supplements. But these strong drugs aren’t the same as body-builders’ steroids. In fact, they bear a greater similarity to hormones produced by your body’s adrenal glands. Corticosteriods treat a wide range of health problems, including asthma, arthritis, autoimmune diseases, eczema and other skin conditions, and certain types of cancer. 3. Antipsychotics Though they were developed to treat schizophrenia, bipolar disorder, and other severe forms of mental illness, health care providers now prescribe these drugs to children and adults for a wide range of psychological com Continue reading >>
The Multiple Benefits Of Metformin
Metformin (brand name "Glucophage") has been used in the treatment of type II diabetes for the past 40 years.1 This drug counteracts many of the underlying factors that result in the manifestation of this insidious disease. Metformin also produces helpful side benefits that can protect against the lethal complications of type II diabetes. Frequently prescribed anti-diabetic drugs fail to address the fundamental causes of type II diabetes and can induce serious side effects. Type II diabetes affects between 16 to 19 million Americans. About 75% of type II diabetics will die from a cardiovascular-related disease. Conventional doctors often prescribe drugs for the purpose of lowering blood sugar levels. These drugs do not adequately address the multiple underlying pathologies associated with the type II diabetic state. Type II diabetes is characterized by cellular insulin resistence. The result is excess accumulation of glucose in the bloodstream as cells become resistant to the effects of insulin. Type II diabetes is characterized by cellular insulin resistence. The result is excess accumulation of glucose in the bloodstream because cells become resistant to the effects of insulin and fail to take up glucose As the type II diabetic condition progresses, many people gain weight and develop more fat cells.2 Treating type II diabetes with insulin-enhancing therapy increases the risk of cardiovascular complications, induces weight gain, and fails to correct the underlying cause of the disease. Many type II diabetics produce too much insulin in a futile attempt to drive glucose into insulin-resistant cells. When doctors prescribe insulin-enhancing drugs to these type II diabetics, a temporarily reduction of serum glucose may occur, but the long-term effects of this excess insu Continue reading >>
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Can Exenatide And Dapagliflozin Reduce Weight, Blood Pressure, And Triglycerides?
This study examined the effects ofdapagliflozin (Farxiga)andexenatide(Byetta)in different groups of people with type 2 diabetes (T2D). It was determined that a combination of the drugs reduces weight, blood pressure, and triglycerides (type of fat found in the blood) more than either alone. The greatest reductions were seen in people who started with high weight, high blood pressure, and normal triglyceride levels. Metformin(Glucophage) is the first drug given to most people with T2D. Eventually, many people with T2D will need more than one therapy. Exenatideis a glucagon-like peptide 1 receptor agonist (GLP1RA). Glucagon-like peptide 1 (GLP1) is made in the intestines and released after a meal. GLP-1 stimulates the release of insulin (the hormone that lowers blood glucose) and inhibits the release of glucagon (hormone that raises blood glucose). These hormonal changes control blood glucose levels. GLP1RAs are drugs that mimic the effects of GLP1. Dapagliflozinis an SGLT2 inhibitor. SGLT2 is a protein in the kidneys that is important in controlling blood glucose levels. It allows glucose to re-enter the blood from the kidneys. SGLT2 inhibitors are a type of treatment that prevents this. People with T2D are at increased risk of developing cardiovascular diseases, which can cause heart attacks and strokes. People who are also overweight or obese, who have high blood pressure, or high triglycerides (type of fat in the blood) are at an even higher risk. Therapies that reduce weight, blood pressure, and triglycerides may also reduce the risk of cardiovascular disease. Exenatideanddapagliflozinhave both been shown to do this, in addition to their effects on glucose levels. However, it is not clear how different groups of people with T2D are affected. Just under 600 adults wi Continue reading >>
Triglycerides Are Through The Roof. :jawdropsmiley
Triglycerides are through the roof. :jawdropsmiley Triglycerides are through the roof. :jawdropsmiley Just diagnosed a couple of weeks ago with T2. Was reading 443 bg. Doc put me on Glipizide and Metformin. Since then, I'm slowly trending down on my bg. My fasting bg this morning was 175 (down from 301 on 11/19). Yesterday morning with a fasting bg of 205 doc added invokana to my menu. After the appointment and before lunch I tested and was 98... doc says quit the Glipizide. My bloodwork results from 11/19 were back and my A1C showed 10.0. and my triglycerides were 2,395 (That's not a typo. I didn't know they could get that high). I had been taking pravastatin for cholesterol for a couple of years. He changed that to Crestor and added a triglyceride specific medication (can't remember the name right now. Doc says that bg can do funny things to the triglycerides and he's concerned but won't be worried until the bg is down (and not spiking). He's more worried about the bg levels. He tells me that next stop is an endocrinologist. Question- Is it common for triglycerides to get that high with the bg levels I've had?? Check out the blog of Dr Michael Eades. He specializes in treating high trigs, obesity and diabetes. He has his patients go on low carb diets and sees their trigs drop like a stone. Most type 2's are Insulin resistant. When you eat carbs, even healthy carbs your body stores them as fat in your liver. So try eating meat, eggs and cheese and cut the carbs to decrease those trigs. Also take good quality fish oil and eat omega 3 foods. 115 pounds, Breast Cancer dx'd 6/16, 6 months of chemo and 6 weeks of radiation 2000 metformin ER, 100 mg Januvia,Glimperide, Prolia, Gabapentin, Meloxicam, Probiotic with a Prebiotic, , Lisinopril, B-12, B-6, Tumeric, Magnesium, Ca Continue reading >>
Metformin For Triglycerides
Carrie Cross has been writing for profit and pleasure for more than 35 years. Her background includes business, real estate, entrepreneurship, management, health and nutrition. A registered nurse, she has published various pieces, including web content, numerous newspaper and magazine articles and columns and six books. A pharmacist is listening to a man.Photo Credit: monkeybusinessimages/iStock/Getty Images Metformin, also known as glucophage, is a prescription drug normally used to help lower blood glucose levels in type 2 diabetics, by decreasing glucose absorption in the intestines and improving your cells' insulin sensitivity, DrugLib.com explains. It is also used as a weight loss aid in diabetic and non-diabetic individuals. Studies show that metformin may help lower high triglycerides, a part of your cholesterol profile. Cholesterol is a fat found only in meat, including shellfish, and dairy products, and is produced naturally in your liver. There is no cholesterol in plant-based foods. Cholesterol is a waxy substance and is needed for cell building and hormone production. It is carried through your blood in fats, or lipids, by proteins called lipoproteins. When you have your cholesterol tested, it shows the levels of two types of lipoproteins -- LDL or low-density, and HDL or high-density. LDL, or "bad" cholesterol, carries the fat through your body, and HDL, "good" cholesterol, clears it out of your body. A total cholesterol reading of over 240 mg/dL is considered high. Your triglyceride level refers to a second type of fat, or lipid, also measured during a cholesterol, or lipid, panel. Triglyceride levels measure the circulating fat in your blood. After a meal, your triglyceride level is high prior to being used by your cells for energy or being stored as fat Continue reading >>
Triglyceride High-density Lipoprotein Ratios Predict Glycemia-lowering In Response To Insulin Sensitizing Drugs In Type 2 Diabetes: A Post Hoc Analysis Of The Bari 2d
Triglyceride High-Density Lipoprotein Ratios Predict Glycemia-Lowering in Response to Insulin Sensitizing Drugs in Type 2 Diabetes: A Post Hoc Analysis of the BARI 2D 1Albert Einstein College of Medicine, Montefiore Clinical Diabetes Center, Bronx, NY 10461, USA 2Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15260, USA 3Case Western Reserve University and Cleveland VA Medical Center, Cleveland, OH 44106, USA 5Montreal Heart Institute, Hotel-Dieu CHUM (Centre Hospitalier de lUniversit de Montral), Montreal, QC, Canada H2W 1T8 6Toronto General Hospital, Toronto, ON, Canada M5G 2C4 7Lahey Clinic Medical Center, Burlington, MA 01805, USA 8University of Sao Paulo Heart Institute, 01246903 So Paulo, SP, Brazil 9Case Western Reserve University, Cleveland, OH 44106, USA 10University of Pittsburgh, Pittsburgh, PA 15260, USA Received 11 March 2015; Revised 10 May 2015; Accepted 11 May 2015 Copyright 2015 Joel Zonszein et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Glycemic management is central in prevention of small vessel and cardiovascular complications in type 2 diabetes. With the plethora of newer medications and recommendations for a patient centered approach, more information is necessary to match the proper drug to each patient. We showed that BARI 2D, a five-year trial designed to compare two different glycemic treatment strategies, was suitable for assessing different responses according to different phenotypic characteristics. Treatment with insulin sensitizing medications such as thiazolidinediones and metformin was more effective in impr Continue reading >>
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10 Causes Of High Triglycerides In Diabetes
10 Causes of High Triglycerides in Diabetes 10 Causes of High Triglycerides in Diabetes Reasons You Have High Triglycerides With Diabetes By Elizabeth Woolley | Reviewed by Richard N. Fogoros, MD It's not surprising to have high triglyceride levels if you have type 2 diabetes . About 80% of people with diabetes struggle with this problem. Elevated triglyceride levels are also a component of metabolic syndrome , a group of disorders that increase your risk of heart disease, stroke, and type 2 diabetes. Other symptoms of this syndrome include high blood sugar, high blood pressure, low HDL (good cholesterol), and excess belly fat. Triglycerides are fat molecules that make up most of your body fat and the fat found in food. Along with cholesterol , they are one of the lipids that circulate in your blood. The medical term for having elevated levels of triglycerides is hypertriglyceridemia. In fasting laboratory tests, a normal triglyceride level is below 150 mg/dL. Borderline high is 150 to 199 mg/dL. High is considered 200 to 499 mg/dL. Very high is over 500 mg/dL. High triglyceride levels can increase your risk for heart disease, stroke, and nerve damage. There is a link between chronically elevated triglyceride levels and atherosclerosis , as well as insulin resistance . There are many causes for high triglyceride levels. The list below includes common causes for people who have type 2 diabetes and related problems: Poorly controlled type 2 diabetes: When your diabetes is not under good control,you likely have high levels of both glucose (blood sugar) and insulin in your body. We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Insulin helps convert glucose int Continue reading >>
Metformin Lowers Plasma Triglycerides By Promoting Vldl-triglyceride Clearance By Brown Adipose Tissue In Mice.
Metformin lowers plasma triglycerides by promoting VLDL-triglyceride clearance by brown adipose tissue in mice. Department of General Internal Medicine, Endocrinology, and Metabolic Diseases, Leiden University Medical Center, Leiden, the Netherlands. Diabetes. 2014 Mar;63(3):880-91. doi: 10.2337/db13-0194. Epub 2013 Nov 22. Metformin is the first-line drug for the treatment of type 2 diabetes. Besides its well-characterized antihyperglycemic properties, metformin also lowers plasma VLDL triglyceride (TG). In this study, we investigated the underlying mechanisms in APOE*3-Leiden.CETP mice, a well-established model for human-like lipoprotein metabolism. We found that metformin markedly lowered plasma total cholesterol and TG levels, an effect mostly due to a decrease in VLDL-TG, whereas HDL was slightly increased. Strikingly, metformin did not affect hepatic VLDL-TG production, VLDL particle composition, and hepatic lipid composition but selectively enhanced clearance of glycerol tri[(3)H]oleate-labeled VLDL-like emulsion particles into brown adipose tissue (BAT). BAT mass and lipid droplet content were reduced in metformin-treated mice, pointing to increased BAT activation. In addition, both AMP-activated protein kinase 1 (AMPK1) expression and activity and HSL and mitochondrial content were increased in BAT. Furthermore, therapeutic concentrations of metformin increased AMPK and HSL activities and promoted lipolysis in T37i differentiated brown adipocytes. Collectively, our results identify BAT as an important player in the TG-lowering effect of metformin by enhancing VLDL-TG uptake, intracellular TG lipolysis, and subsequent mitochondrial fatty acid oxidation. Targeting BAT might therefore be considered as a future therapeutic strategy for the treatment of dyslipidemi Continue reading >>
Treating Hyperglycemia And Dyslipidemia In People With Diabetes: Achieving Optimal Treatment Targets
Treating Hyperglycemia and Dyslipidemia in People With Diabetes: Achieving Optimal Treatment Targets The target audience of this activity is primary care providers (MDs, DOs, NPs, PAs) who treat patients with diabetes and its related conditions. This activity will encourage widespread achievement of targeted A1C and LDL cholesterol levels in people with diabetes, in order to reduce the risk of cardiovascular disease for these individuals, by presenting a balanced, evidence-based, and clinically relevant interpretation of the data supporting aggressive treatment of hyperglycemia and dyslipidemia. Participants will be provided with clinically relevant, evidence-based information. At the completion of the activity, the participant should be able to: Describe the long-term vascular implications of diabetes; Identify appropriate treatment targets for key components of the metabolic syndrome, particularly the hyperglycemia of type 2 diabetes and accompanying dyslipidemia; Design and initiate comprehensive preventive and treatment strategies focused on achieving targeted glycemia and lipid levels to reduce cardiovascular risk and the incidence of macrovascular complications in people with diabetes; and Implement glucose-control and lipid-control strategies in people who have obstacles to treatment (including medication contraindications or adverse experiences) to effectively approach recommended treatment targets. As part of its accreditation with the Accreditation Council for Continuing Medical Education, Joslin Diabetes Center, Boston, must disclose to the audience of a Joslin continuing medical education activity the existence of any relevant financial relationships between Joslin and/or its planning committee members, speakers, and their spouses/partners and commercial en Continue reading >>
Thoughts On Metformin Effect And Insulin Effect
Thoughts on Metformin effect and Insulin effect I had some thoughts on Metformin and Insulin. These thoughts are not meant to make anybody uncertain about their treatment. I just hope the following discussion can give some insights. The focus is the finding that the life threatening risks for T2 diabetics are related to the tryglycerine levels in the blood. Higher levels lead to cardiovascular and other changes. Typical complications of uncontrolled diabetes are related to the blood glucose of course. Still it seems very important to watch and control the tryglicerine levels. Now my thoughts: Normally the liver acts as our deposit of the digested carhoydates. The deposit is a huge amount of glucose. Hormones from the adrenal gland will order the liver to release glucose. The glucose in the blood stream is fueling the processes that happen in our body. It can be expected that the released amount is regulated by the blood glucose. But like some of you know sports or just waking up can make the gland/liver to proactively release glucose (dawn effect for example). Now Metformin regulates the glucose production of the liver. It is turning the release rate of glucose down. The result is convincing because the blood glucose looks much better. But the question is: now the energy to fuel the processes is missing. I mean the release had a purpose and now we are modulating the release down. I assume the processes will utilize other energy sources like fatty deposits. But this could lead to free tryglycerines in the blood stream or am I wrong? Is this absence of energy the reason for people on Metformin for feeling fatigue? One effect of the presence of Insulin is that fatty deposits will be build. The insulin acts as an indicator of the carbohydrates and fat coming from digestion Continue reading >>
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A popular oral drug for treating Type 2 diabetes. Metformin (brand name Glucophage, Glucophage XR, Glumetza, Riomet) is a member of a class of drugs called biguanides that helps lower blood glucose levels by improving the way the body handles insulin — namely, by preventing the liver from making excess glucose and by making muscle and fat cells more sensitive to available insulin. Metformin not only lowers blood glucose levels, which in the long term reduces the risk of diabetic complications, but it also lowers blood cholesterol and triglyceride levels and does not cause weight gain the way insulin and some other oral blood-glucose-lowering drugs do. Overweight, high cholesterol, and high triglyceride levels all increase the risk of developing heart disease, the leading cause of death in people with Type 2 diabetes. Another advantage of metformin is that it does not cause hypoglycemia (low blood glucose) when it is the only diabetes medicine taken. Metformin is typically taken two to three times a day, with meals. The extended-release formula (Glucophage XR) is taken once a day, with the evening meal. The most common side effects of metformin are nausea and diarrhea, which usually go away over time. A more serious side effect is a rare but potentially fatal condition called lactic acidosis, in which dangerously high levels of lactic acid build up in the bloodstream. Lactic acidosis is most likely to occur in people with kidney disease, liver disease, or congestive heart failure, or in those who drink alcohol regularly. (If you have more than four alcoholic drinks a week, metformin may not be the best medicine for you.) Unfortunately, many doctors ignore these contraindications (conditions that make a particular treatment inadvisable) and prescribe metformin to people Continue reading >>
New Triglyceride-lowering Drug
Home / Resources / Articles / New Triglyceride-Lowering Drug Possibly a new option for reducing triglyceride levels and risk of developing insulin resistance. Elevated triglyceride levels are often associated with insulin resistance, metabolic syndrome, diabetes, cardiovascular events, and pancreatitis. Triglycerides can be elevated due to many factors such as genetics, smoking, obesity, and overconsumption of alcohol and carbohydrates. Normal levels should be less than 150 mg/dl. However, many patients present with much higher levels. Current treatment of hypertriglyceridemia includes niacin, fibrates, and diets high in fish oil, but not all patients respond to treatments. ISIS 304801 is a new experimental drug in its second of three required trials for approval in the United States. ISIS 304801 is a second-generation antisense inhibitor of apolipoprotein C-III (APOC3) synthesis, which is an important regulator of plasma triglyceride levels that slows the breakdown of triglycerides. The inhibition of APOC3 will speed up the breakdown of triglycerides and allow it to leave the body quickly, resulting in lower triglyceride levels and possibly reducing the risk of developing insulin resistance and metabolic syndrome. The study was a randomized, double-blinded, placebo-controlled trial, which included a total of 57 patients who were either treated with the drug or a placebo to evaluate ISIS 304801 in untreated patients with fasting triglyceride levels between 350 mg/dl and 2,000 mg/dl. The study also included 28 patients who were treated with stable fibrate therapy that had fasting triglyceride levels between 225 mg/dl and 2,000 mg/dl. Patients received weekly doses for over a course of 13 weeks. The primary outcome was the percentage change in APOC3 from baseline. ISIS 3 Continue reading >>
High Triglyceride Levels (hypertriglyceridemia)
Tweet High triglyceride levels, also known as hypertriglyceridemia, are often the result of either an additional medical condition or having a high calorie diet. High triglyceride levels tend to be particularly common in patients with uncontrolled type 2 diabetes. If you have triglyceride levels that are too high, it is important to take steps to bring your triglyceride levels down. Lifestyle changes can help with reducing high triglyceride levels. Your doctor will be able to advise you on how to address the problem. What are triglycerides? Triglycerides are blood fats that are a flexible source of energy. The body can convert triglycerides into glucose and triglycerides can also be stored in adipose tissue (fat cells). The process of converting triglycerides into glucose is known as gluconeogenesis and is performed by the liver. Are there symptoms of raised triglyceride levels? High triglyceride levels will not usually result in symptoms but, if you have diabetes and live in the UK, you should be given a cholesterol test at least once each year which will test your triglycerides in addition to cholesterol. Whilst it is less common, some people may develop fat deposits under the skin called xanthomas. These are yellow lumps that can develop anywhere on the body but are more commonly found around the eyelids and around joints such as the knees, elbows and knuckles. Diagnosis - testing triglyceride levels Your health team can test your serum triglyceride levels (amount of triglycerides in the blood) through a blood test and this will usually be done as part of a cholesterol test. Recently eaten food and drink, within the last few hours, can raise triglyceride levels so to get a fair result, you need to fast before the test. If you have type 1 diabetes or are otherwise on Continue reading >>