Metformin: Medicine To Treat Type 2 Diabetes - Nhs
Metformin is a medicine used to treat type 2 diabetes , and to help prevent type 2 diabetes if you're at high risk of developing it. Metformin is used when treating polycystic ovary syndrome (PCOS) , although it's not officially approved for PCOS. Type 2 diabetes is an illness where the body does not make enough insulin, or the insulin that it makes does not work properly. This can cause high blood sugar levels (hyperglycaemia) . PCOS is a condition that affects how the ovaries work. Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels. For women with PCOS, metformin lowers insulin and blood sugar levels, and can also stimulate ovulation. Metformin is available on prescription as tablets and as a liquid that you drink. Metformin works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin. Insulin is the hormone that controls the level of sugar in your blood. It's best to take metformin with a meal to reduce the side effects. The most common side effects are feeling and being sick, diarrhoea, stomach ache and going off your food. Metformin does not cause weight gain, unlike some other diabetes medicines. Metformin may also be called by the brand names Bolamyn, Diagemet, Glucient, Glucophage and Metabet. Liquid metformin is called by the brand name Riomet. Metformin is prescribed for adults, and children aged 10 years and older. Metformin is not suitable for some people. Tell your doctor before starting the medicine if you: have had an allergic reaction to metformin or other medicines in the past are being treated for heart failure or have recently had Continue reading >>
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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 >>
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 >>
Fatal Metformin Overdose Presenting With Progressive Hyperglycemia
Go to: CASE REPORT A 29-year-old man ingested metformin in a suicide attempt. The patient consumed the entire remaining contents of his father’s prescription metformin bottle that originally contained 100 tablets of 850 mg each. The father stated that the bottle had contained at least three-quarters of its original contents, putting the ingested dose between 64 and 85 grams. The patient also consumed ethanol, but denied any other co-ingestants. The parents discovered the overdose around 6:30 a.m., about 5 ½ hours post-ingestion, when the patient began complaining of vomiting, diarrhea, thirst, abdominal pain and bilateral leg pain. Paramedics were called, who found the patient to be agitated with a fingerstick glucose level of 180 mg/dL. The patient had a history of psychosis and depression, including prior suicide attempts by drug ingestion. He was not taking any prescribed medications, having discontinued olanzapine and sertraline several months earlier. The patient had no personal history of diabetes, despite the family history of type II diabetes in his father, who was taking no other anti-diabetic medications than metformin. The patient admitted to daily ethanol and tobacco use, but denied any current or past use of illicit drugs. He had no surgical history or known allergies. Vital signs on arrival to the Emergency Department (ED) were temperature of 35.2°C (rectal), pulse of 113 beats/min, blood pressure of 129/59 mmHg, respirations at 28 breaths/min with 100% saturation via pulse oximetry on room air. The patient was awake and oriented x4, but agitated and slightly confused (GCS=14). Pupils were equal and reactive at 4mm and the oral mucous membranes were dry. Other than tachycardia, the heart and lung exams were unremarkable. The abdomen was mildly tender t Continue reading >>
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 >>
About Metformin
Metformin is a medicine used to treat type 2 diabetes and sometimes polycystic ovary syndrome (PCOS). Type 2 diabetes is an illness where the body doesn't make enough insulin, or the insulin that it makes doesn't work properly. This can cause high blood sugar levels (hyperglycemia). PCOS is a condition that affects how the ovaries work. Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels. For women with PCOS, metformin stimulates ovulation even if they don't have diabetes. It does this by lowering insulin and blood sugar levels. Metformin is available on prescription as tablets and as a liquid that you drink. Key facts Metformin works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin. Insulin is the hormone that controls the level of sugar in your blood. It's best to take metformin with a meal to reduce the side effects. The most common side effects are feeling sick, vomiting, diarrhoea, stomach ache and going off your food. Metformin does not cause weight gain (unlike some other diabetes medicines). Metformin may also be called by the brand names Bolamyn, Diagemet, Glucient, Glucophage, and Metabet. Who can and can't take metformin Metformin can be taken by adults. It can also be taken by children from 10 years of age on the advice of a doctor. Metformin isn't suitable for some people. Tell your doctor before starting the medicine if you: have had an allergic reaction to metformin or other medicines in the past have uncontrolled diabetes have liver or kidney problems have a severe infection are being treated for heart failure or you have recentl Continue reading >>
Metformin Dosage
Usual Adult Dose for Diabetes Type 2 Immediate-release: Initial dose: 500 mg orally twice a day or 850 mg orally once a day Dose titration: Increase in 500 mg weekly increments or 850 mg every 2 weeks as tolerated Maintenance dose: 2000 mg daily in divided doses Maximum dose: 2550 mg/day Extended-release: Initial dose: 500 to 1000 mg orally once a day Dose titration: Increase in 500 mg weekly increments as tolerated Maintenance dose: 2000 mg daily Maximum dose: 2500 mg daily Comments: -Metformin, if not contraindicated, is the preferred initial pharmacologic agent for treatment of type 2 diabetes mellitus. -Immediate-release: Take in divided doses 2 to 3 times a day with meals; titrate slowly to minimize gastrointestinal side effects. In general, significant responses are not observed with doses less than 1500 mg/day. -Extended-release: Take with the evening meal; if glycemic control is not achieved with 2000 mg once a day, may consider 1000 mg of extended-release product twice a day; if glycemic control is still not achieve, may switch to immediate-release product. Use: To improve glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise. Usual Pediatric Dose for Diabetes Type 2 10 years or older: Immediate-release: Initial dose: 500 mg orally twice a day Dose titration: Increase in 500 mg weekly increments as tolerated Maintenance dose: 2000 mg daily Maximum dose: 2000 mg daily Comments: Take in divided doses 2 to 3 times a day with meals. Titrate slowly to minimize gastrointestinal side effects. Safety and effectiveness of metformin extended-release has not been established in pediatric patients less than 18 years of age. Use: To improve glycemic control in children with type 2 diabetes mellitus as an adjunct to diet and exercise. Le Continue reading >>
'can I Take Metformin If I Want To Lose Weight?'
'Can I Take Metformin If I Want To Lose Weight?' Some doctors are now prescribing this diabetes drug for weight loss. But is it safe? 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. Im 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 didnt do much for them, others swear by iteven those that dont have Type 2 diabetes, saysFatima 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. Heres what you need to know about the drug. (Hit the reset buttonand burn fat like crazy with The Body Clock Diet !) Metformin causes a decrease in the release of glucose from a persons liver. This helps to lower a persons blood sugar when its 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 Continue reading >>
Metformin Side Effects: What You Need To Know
Metformin Side Effects: What You Need to Know Metformin is one of the most prescribed drugs on the planet with over 120 million people taking it for diabetes management, but that doesnt mean its the most popular. Unfortunately, metformin also has one of the lowest patient adherence rates, because of its side effects which can appear within hours of taking your first dose. While there are actually many positive qualities about this drug compared to other diabetes medications, metformin side effects can be remarkably uncomfortable, disrupting your daily life. In this article, well look at how metformin works, the most common side effects, how to alleviate those side-effects, and why its the most prescribed despite causing so much discomfort for patients. Metformin, also known under the brand name Glucophage, is an oral diabetes medication in the biguanide drug class , first introduced in 1957 to treat type 2 diabetes and improve blood sugar control. It works by reducing the amount of sugar your liver releases throughout the day, and it increases your bodys sensitivity to insulin. It can also reduce the amount of glucose that is absorbed from the food you eat, which in turn reduces your blood sugar levels after eating. Metformin is often considered the first line of defense for a patient newly diagnosed with type 2 diabetes, explains the American Diabetes Association. The biggest benefit of metformin is the fact that it doesnot directly cause hypoglycemia;however when paired with other diabetes medications that do lower blood sugar, metformin could result in low blood sugar until those other medication doses are reduced to compensate. Here are all of the known benefits of metformin: It reduces the amount of glucose produced by your liver It reduces the amount of glucose a 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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Apo-metformin
NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia. What is in this leaflet This leaflet answers some common questions about metformin It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist or diabetes educator. The information in this leaflet was last updated on the date listed on the last page. More recent information on this medicine may be available. You can also download the most up to date leaflet from www.apotex.com.au. All medicines have risks and benefits. Your doctor has weighed the risks of you using this medicine against the benefits they expect it will have for you. Pharmaceutical companies cannot give you medical advice or an individual diagnosis. Keep this leaflet with your medicine. You may want to read it again. What this medicine is used for The name of your medicine is APO-Metformin 500, 850 or 1000 tablets. It contains the active ingredient metformin (as metformin hydrochloride). It is used to treat type 2 diabetes (also called non-insulin dependent diabetes mellitus or maturity onset diabetes) in adults and children over 10 years of age. It is especially useful in those who are overweight, when diet and exercise are not enough to lower high blood glucose levels (hyperglycaemia). For adult patients, metformin can be used alone, or in combination with other oral diabetic medicines or in combination with insulin in insulin requiring type 2 diabetes. Ask your doctor if you have any questions about why this medicine has been prescribed for you. Your doctor may have prescribed this medicine for another reason. This medicine is available only with a doctor's prescription. How it works Metformin lowers high blood glucose by helping your body make better Continue reading >>
Stopping Metformin: Side Effects, Risks, And How To Stop Safely
Metformin is generally a safe and effective treatment for type 2 diabetes. However, it can cause side effects, and some people may want to look at other options. Type 2 diabetes occurs when the body's cells stop responding to insulin appropriately. As a result, levels of glucose, or sugar, in the blood rise too high. Certain lifestyle factors can increase the risk of type 2 diabetes, including: engaging in low levels of physical activity Metformin is an oral medication that helps manage the effects of type 2 diabetes. In people with prediabetes, the drug can also help prevent or delay the onset of the condition. Doctors prescribe metformin to nearly 120 million people worldwide. In this article, we look at the side effects of metformin and why a person with type 2 diabetes might want to stop taking it. We also look at the risk of not taking metformin and some alternative options. Metformin is an effective treatment for type 2 diabetes . It helps lower blood glucose levels by: making the body's cells more sensitive to insulin slowing the release of glucose stored in the liver slowing the absorption of glucose from food in the gut However, metformin has a number of potential side effects. Some are common, while others are rare. Common side effects of metformin include: digestive problems, such as diarrhea , vomiting, and flatulence A person should talk to a doctor before stopping metformin treatment. Taking the medication with food reduces the risk of digestive problems. Around 30 percent of people taking metformin in the long term experience vitamin B-12 deficiency. Symptoms can include: Is it safe to eat grapefruit while taking metformin? Find out more here . In some people, metformin causes blood glucose levels to drop too low, and the medical term for this is hypogly Continue reading >>
Diabetes Medication Metformin: Why Patients Stop Taking It
Gretchen Becker, author of The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed , has been taking metformin for more than 20 years after receiving a diagnosis of type 2 diabetes in 1996. I never had any problems with metformin until I took a pill that I thought was the extended-release version, but it wasnt, Becker told Healthline. Beckers doctor had accidentally prescribed the regular form of metformin. I had very loose bowels for several months until I figured out what the problem was, Becker said. After getting the proper prescription, it took several months for Beckers digestive system to recover. Corinna Cornejo, who received a diagnosis of type 2 diabetes in 2009, told Healthline that her digestive woes didnt start until shed been taking metformin for more than a year. At first, I thought it was a response to dairy, but my doctor eventually switched my prescription to the extended-release version, Cornejo recalled. That has helped, but the side effect has not gone away completely. For some people, however, metformins unpleasant side effect of loose stools provides a much-needed balance to the side effects that can result from other diabetes drugs theyre taking. GLP-1 drugs, like Victoza or Byetta, can cause constipation, explained Robinson. Taking metformin with a GLP-1 drug means they actually complement each other, balancing out those side effects. And for some, metformin simply isnt the right drug. No matter what you do, some patients just dont tolerate the side effects well, said Robinson. Although there are many diabetes drugs on the market today, doctors will likely push metformin first. There has never been as many diabetes treatment options available as there are now, explained Robinson. But doctors look at cost, and metformin is th Continue reading >>
Metformin | The Johns Hopkins Patient Guide To Diabetes
Metformin primarily reduces the liver s ability to releaseglucose from its stores. Metformin is usually taken with meals, either once or twice a day depending on the brand. Available dosage of pills include 500 mg, 850 mg, and 1000 mg. The treatment plan will differ for each patient, but a common starting regimen is listed below: To avoid stomach upset, patients usually start with a very low dose (500 mg), taken with dinner. After a few weeks, the dose may increase to 500 mg with breakfast and 500 mg with dinner. A few weeks later, the dose may increase again to 500 mg with breakfast and 1 g with dinner. If the patient has no side effects, the dose mayincrease to 1000 mg with breakfast and 1000 mg with dinner. This is usually the maximum dose. Metformin is the treatment of choice for type 2 diabetes because it works well, is inexpensive, and it has been around for decades. Patients may lose a few pounds of weighton metformin. Metformin is very effective at controlling blood glucose and lowers A1c levels by as much as 2% at maximum doses. By itself, metformin does not usually cause low blood glucose. Side effects including diarrhea. However, a slow increase in doses or extended release preparations can often prevent this. In rare cases, metformin can have a serious adverse side effectcalled lactic acidosis , where the body produces potentially dangerous levels of lactic acid. This condition is rare, and occurs more commonly in personswho are olderor havefrom heart failure , history of heavy alcohol use, or advanced kidney disease. To prevent serious kidney damage, patients generally shouldNOT take metformin for 24 hours beforeor 48 hours afterreceiving IV contrast for a CT scan . Patients with mild-to-moderate liver or kidney problems may need to take reduced doses of m Continue reading >>
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 >>
