
Role Of Metformin In The Management Of Polycystic Ovary Syndrome
Go to: Background Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder affecting 4–12% of women [Diamanti-Kandarakis et al. 1999; Farah et al. 1999; Knochenhauer et al. 1998]. It has also been the most controversial medical condition and every aspect has received a lot of attention from the nomenclature to the management. Several descriptions of similar conditions took place in the 20th century and it was named Stein—Leventhal Syndrome in 1935 after the authors who described polycystic ovarian morphology in patients suffering from hirsutism, amenorrhoea and infertility [Leventhal, 1958; Stein and Leventhal, 1935]. PCOS was also called polycystic ‘ovarian’ syndrome implying that the primary pathology lies in or triggered by the ovary. Others have called it polycystic ovary disease (PCOD), which is the least used term for obvious reasons. Currently, PCOS refers to a disorder with a combination of reproductive and metabolic characteristics. This has evolved over time with controversy over the definition culminating in the latest consensus [ESHRE/ASRM, 2004] which instead of solving the issue created more controversy [Azziz et al. 2006]. In the European Society of Human Reproduction and Embryology/American Society of Reproductive Medicine (ESHRE/ASRM) consensus, at least two of the following features are needed to make the diagnosis; oligo/anovulation, hyperandrogenism, and polycystic features on ultrasound scan [ESHRE/ASRM, 2004]. The Androgen Excess Society, however, recommended that androgen excess should remain a constant feature of PCOS irrespective of the ovulatory status and morphological features of the ovaries [Azziz et al. 2006]. For almost three decades, PCOS has been regarded as a life course disease which besides its reproductiv Continue reading >>

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 metformin." But he has Continue reading >>

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 >>

How Long Should A Person Take Metformin?
Home Q & A Questions How long should a person take... As long as its needed to control your blood sugar. Still looking for answers? Try searching for what you seek or ask your own question . Diabetes, Type 2 - Do I really need to reduce my meds. doses ? I am a diabetic type 2 , taking? I'm type2 diabetic,taking metformin 500 mg daily,can I take alka zeltzer cold ? The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Available for Android and iOS devices. Subscribe to receive email notifications whenever new articles are published. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated Feb 28th, 2018), Cerner Multum (updated Mar 1st, 2018), Wolters Kluwer (updated Mar 1st, 2018) and others. To view content sources and attributions, please refer to our editorial policy . Continue reading >>

Timing Your Metformin Dose
The biggest problem many people have with Metformin is that it causes such misery when it hits their stomachs that they can't keep taking it even though they know it is the safest and most effective of all the oral diabetes drugs. In many cases all that is needed is some patience. After a rocky first few days many people's bodies calm down and metformin becomes quite tolerable. If you are taking the regular form of Metformin with meals and still having serious stomach issues after a week of taking metformin, ask your doctor to prescribe the extended release form--metformin ER or Glucophage XR. The extended release form is much gentler in its action. If that still doesn't solve your problem, there is one last strategy that quite a few of us have found helpful. It is to take your metformin later in the day, after you have eaten a meal or two. My experience with metformin--and this has been confirmed by other people--is that it can irritate an empty stomach, but if you take it when the stomach contains food it will behave. There are some drugs where it matters greatly what time of day you take the drug. Metformin in its extended release form is not one of them. As the name suggests, the ER version of the pill slowly releases the drug into your body over a period that, from my observations, appears to last 8 to 12 hours. Though it is supposed to release over a full 24 hours, this does not appear to be the case, at least not with the generic forms my insurer will pay for. Because there seems to be a span of hours when these extended release forms of metformin release the most drug into your blood stream, when you take your dose may affect how much impact the drug has on your blood sugars after meals or when you wake up. For example, the version I take, made by Teva, releases Continue reading >>
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Is It Safe To Use Metformin During Pregnancy?
Metformin is a commonly used drug for managing type 2 diabetes. It is considered an effective treatment option for many people with diabetes, but is it safe for pregnant women? Metformin is a drug that helps to lower blood sugar. It is considered one of the best first line treatments for type 2 diabetes. A review posted to Diabetology & Metabolic Syndrome notes that metformin helps to lower blood sugar levels, strengthens the endocrine system, improves insulin resistance, and reduces fat distribution in the body. Before taking any drugs, including metformin, a pregnant woman has to be absolutely sure that the drugs will not affect her or her baby. Effects of metformin use during and after pregnancy Some people are concerned about using metformin during and after pregnancy because it crosses the placenta. This means that when a pregnant woman takes metformin, so does her baby. However, the results of the few studies that have been carried out so far into the effects of taking metformin during pregnancy have been positive. A 2014 review posted to Human Reproduction Update found that the drug did not cause birth defects, complications, or diseases. The researchers did note, however, that larger studies should be carried out to make this evidence more conclusive. Metformin and gestational diabetes A separate review posted to Human Reproduction Update noted that women who took metformin to treat gestational diabetes (diabetes during pregnancy) gained less weight than women who took insulin. A 2-year follow-up study found that babies born to the women treated with metformin had less fat around their organs, which could make them less prone to insulin resistance later in life. This could mean that children who are exposed to metformin at a young age could gain long-term benefi Continue reading >>

'can I Take Metformin If I Want To Lose Weight?'
Metformin is a drug designed to treat patients with Type 2 diabetes, but it comes with an interesting side effect: weight loss. And Reddit is filled with stories from people who have lost weight on the drug. “Was trying to lose weight for a long time with no success,” one person wrote of being prescribed metformin. “I’m on 1000 mg a day and am down 10 pounds.” “I saw weight loss at first with 500 mg twice per day,” another wrote. “The difference was almost immediate.” While some people say the drug didn’t do much for them, others swear by it—even those that don’t have Type 2 diabetes, says Fatima Cody Stanford, M.D., an instructor of medicine and pediatrics at Harvard Medical School and obesity medicine physician at Massachusetts General Hospital. In fact, Cody Stanford says that she often prescribes the medication to overweight or obese people who don't have Type 2 diabetes. Here’s what you need to know about the drug. (Hit the reset button—and burn fat like crazy with The Body Clock Diet!) How It Works Metformin causes a decrease in the release of glucose from a person’s liver. This helps to lower a person’s blood sugar when it’s too high and restore the way someone uses food to make energy, according to the Mayo Clinic. "Weight loss can occur because it decreases appetite in some people who take it," says women's health expert Jennifer Wider, M.D. In order for the prescription to work effectively, the amount of metformin you take must be balanced against your diet and exercise because it helps level out your blood sugar, the clinic says. For that reason, if you change your diet or exercise, you doctor may need to change the amount of metformin you take. Check out these moves that can help you light those calories up! Can It Help You Continue reading >>

Metformin- How Long Do I Stay With It?
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Having only been taking the stuff for 4 days; I'm already thinking of giving it up. Nausea, diarrohea is difficult enough to handle at home but once outside it's impossible!Tomorrow I go back to work when I'll be in a car most of the day travelling and in people's homes to do OT assessments.I just can't see myself managing it. How long does this phase go on for? Does it ever stop?Should I be asking for something different now? I know it's a side effect but at present it means staying at home while I take it or stop taking it and go to work.I can't see a way of doing both. There must be lots of you who have been there and done that so how do you cope? If you are having probs with the standard Metformin then go back to your GP and ask to try the slow release version, it is said to be much kinder to the system without many of the known side effects. I believe that some peolple can't get to grips with Metformin, but i adapted to it in about a week. Still on it 5 years later. Try taking it in the middle of a meal, if you're not already. I used to suffer from diarrohea and flatulence on metformin. Switched to Glucophage SR and have had no problems since, plus the longer action of SR helps to reduce the morning highs. I have been taking Metformin for three weeks now. the first week was rough..really rough. by about ten days my toilet trips had settled down and now the pain has settled and I have absolutely no symptoms. I take the pill just after finishing eating. Keep at it if you can you may find it eases in a couple of days. I had some problems with metformin, though not very servere ones I just felt a bit sick sometimes, changing to the slow release versi Continue reading >>

Metformin Forever?
Hi all. We're new here. Just wondering about metformin. Dr wants hubby to start 1 pill a day soon. Is it forever or can he wean once his numbers are in check? Thanks! Moderator T2 since Oct 08, from insulin to no meds =) I can't really say much...but I've known of people going off the meds completely when their BG numbers are in checked...and just maintain it through diet and exercise...so I don't think metformin will be something forever if the BG numbers improves and comes down... Exercising and diet can help a lot in bringing down the BG as well...so if you exercise and ensure that you watch what you eat...you can actually help yourself in taking the meds off later on... Don't be surprise that you find that when the metformin starts, your gut will be really messed up...depending on person...if it happens...do not worry too much...its a common side effect of metformin and it will gradually go away...there are a few post on the forum on the side effect of metformin... ps: Do join the chat room...there are a few regulars there that would be more than willing to help answer any questions you have...cheers HbA1c: Oct 08 - 9.2% | Dec 08 - 5.5% | Feb 09 - 4.4% | June,Sep,Dec 09,Mar 10 - 5.2% | June, Aug 10 - 5% | Nov 10 - 5.3% | Dec 10 - 5.1% | Feb 11 - 5.2% | May 11 - 5.3% | Aug 11 - 4.6% | Dec 11 - 5% | March 12 - 5.1% | June 12 - 5.0% | Sept 12 - 4.9% | Dec 12 - 5.2% | March 13 - 4.8% | May 13 - 5.0% | Oct, Dec 13 - 5.2% | Mar 14 - 5.0% Hi and welcome to DD. Your question is very difficult to answer, many of us have not required any medication at all, yet. On the other hand, many have to take metformin or other oral medication for years and even then progressed onto insulin, we all react differently. Sorry I'm not able to give you any concrete answers. Hang in there, it Continue reading >>

Wait Times: How Long Until Your Med Begins Working
Photography by Mike Watson Images/Thinkstock There are many type 2 medications, and each drug class works in the body in a different way. Here’s a quick guide to help you understand how long each drug will generally take to work: These short-acting oral medications, taken with meals, block the breakdown of complex sugars into simple sugars in the gastrointestinal (GI) tract. “Simple sugars are more easily absorbed and cause the blood sugar to ultimately go up,” Sam Ellis, PharmD, BCPS, CDE, associate professor in the Department of Clinical Pharmacy at the University of Colorado says. These drugs are minimally absorbed into the blood, so a certain blood level concentration is not necessary for them to work. You will see the effect immediately with the first dose. “You take it before a meal, and with that meal you see the effect,” says George Grunberger, MD, FACP, FACE, President of the American Association of Clinical Endocrinologists. While researchers aren’t exactly sure how these oral medications work, it’s likely that the meds block some absorption of glucose in the GI tract. “You’ll see most of the effect in the first week with these drugs,” says Ellis. alogliptin, linagliptin, saxagliptin, sitagliptin These drugs work to block the enzyme responsible for the breakdown of a specific gut hormone that helps the body produce more insulin when blood glucose is high and reduces the amount of glucose produced by the liver. Take a DPP-4 inhibitor (they come in pill form) and it’ll work pretty fast—you’ll see the full effect in about a week. “It’s blocking that enzyme after the first dose a little bit, but by the time you get out to dose five, you’re blocking the majority of that enzyme,” Ellis says. albiglutide, dulaglutide, exenatide, exe Continue reading >>

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 >>

What Is Metformin?
MORE Metformin is a prescription drug used primarily in the treatment of Type II diabetes. It can be used on its own or combined with other medications. In the United States, it is sold under the brand names Fortamet, Glucophage, Glumetza and Riomet. "Metformin is very often prescribed as the first step in a diabetic's regime," said Ken Sternfeld, a New York-based pharmacist. How it works "When you're diabetic you lose the ability to use the insulin you need to offset the food," Sternfeld explained. "If you eat a carb or sugar that can't be metabolized or offset by the insulin you produce, your sugar levels will be higher. Metformin and drugs in that category will help your body better metabolize that food so that insulin levels will be able to stay more in line." Metformin aims to decrease glucose production in the liver, consequently lowering the levels of glucose in the bloodstream. It also changes the way that your blood cells react to insulin. "It makes them more sensitive to insulin," said Dr. Stephen Neabore, a primary care doctor at the Barnard Medical Center in Washington, D.C. "It makes the same amount of insulin work better. It transports the insulin to the cells in a more effective way." Metformin may have a preventive health role, as well. New research presented at the American Diabetes Association 2017 Scientific Sessions showed that long-term use of metformin is particularly useful in preventing the onset of type II diabetes in women who have suffered from gestational diabetes. Because metformin changes the way the body uses insulin, it is not used to treat Type I diabetes, a condition in which the body does not produce insulin at all. Metformin & PCOS Metformin is sometimes prescribed to treat polycystic ovarian syndrome (PCOS), according to Neabore. "I Continue reading >>

Metformin For The Treatment Of Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is a disorder of body metabolism that affects 5-10% of women and can cause infrequent periods, weight gain, acne, unwanted hair growth and infertility. PCOS should not be confused with the incidental finding of polycystic ovaries on an ultrasound scan which occur in about 20% of the female population and usually do not cause any symptoms. The cause of PCOS is not fully understood but is thought to have a genetic component. The small cysts seen in the ovaries do not cause PCOS but are the result of the underlying disturbance of metabolism. Most women with PCOS do not have every symptom and the treatment that a doctor recommends is usually chosen to treat the symptoms that bother the woman. In recent years there has been a lot of interest in the use of Metformin to treat the symptoms of PCOS. This information sheet aims to answer many of the questions that women have about this treatment. What is Metformin? Metformin is a medicine that is taken by mouth. It is from a family of drugs known as biguanides and was developed to treat type 2 (late onset) diabetes. Why is it used to treat PCOS? There are a number of similarities between PCOS and adult-onset diabetes. In both conditions, people have a resistance to the effects of insulin with resulting high levels of insulin in their blood stream. These high insulin levels cause an increased production of androgens (male-type hormones that can cause acne and unwanted hair growth) in the ovaries and adrenal glands. This in turn affects the pituitary hormones (LH and FSH) that normally stimulate the ovaries to produce eggs. The result is often irregular infertile periods. Metformin increases the effectiveness of insulin, resulting in a lowering of blood insulin levels which in turn lowers the androg Continue reading >>
- Type 1 Diabetes and Polycystic Ovary Syndrome: Systematic Review and Meta-analysis
- Polycystic Ovary Syndrome and Diabetes
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)

Metformin Weight Loss – Does It Work?
Metformin weight loss claims are something that are often talked about by health professionals to be one of the benefits of commencing metformin therapy, but are they true? At myheart.net we’ve helped millions of people through our articles and answers. Now our authors are keeping readers up to date with cutting edge heart disease information through twitter. Follow Dr Ahmed on Twitter @MustafaAhmedMD Metformin is possibly one of the most important treatments in Type II Diabetes, so the question of metformin weight loss is of the utmost importance, as if true it could provide a means to lose weight as well as control high sugar levels found in diabetes. What is Metformin? Metformin is an oral hypoglycemic medication – meaning it reduces levels of sugar, or more specifically glucose in the blood. It is so effective that the American Diabetes Association says that unless there is a strong reason not to, metformin should be commenced at the onset of Type II Diabetes. Metformin comes in tablet form and the dose is gradually increased until the maximum dose required is achieved. How Does Metformin Work & Why Would it Cause Weight Loss? Metformin works by three major mechanisms – each of which could explain the “metformin weight loss” claims. These are: Decrease sugar production by the liver – the liver can actually make sugars from other substances, but metformin inhibits an enzyme in the pathway resulting in less sugar being released into the blood. Increase in the amount of sugar utilization in the muscles and the liver – Given that the muscles are a major “sink” for excess sugar, by driving sugar into them metformin is able to reduce the amount of sugar in the blood. Preventing the breakdown of fats (lipolysis) – this in turn reduces the amount of fatt Continue reading >>

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 >>