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Long Term Side Effects Of Metformin

60 Years Of Metformin Use: A Glance At The Past And A Look To The Future

60 Years Of Metformin Use: A Glance At The Past And A Look To The Future

, Volume 60, Issue9 , pp 15611565 | Cite as 60 years of metformin use: a glance at the past and a look to the future Diabetes Prevention Program Outcomes Study This year marks the 60th anniversary of the first clinical use of metformin for diabetes. From small beginnings (and despite a somewhat chequered history), metformin is currently recommended as the first-line oral glucose-lowering agent in most, if not all, clinical guidelines on the management of type 2 diabetes. Perhaps as a reflection of this, metformin was prescribed for 83.6% of individuals with type 2 diabetes in the UK in 2013 [ 1 ]. Meanwhile, in the USA, metformin was the eighth most commonly prescribed drug consistently from 2008 to 2012 [ 2 ], the number of prescriptions rising from 51.6 million in 2008 to 61.6 million in 2012. Metformin and gliclazide are the only two oral glucose-lowering agents on the WHO Model List of Essential Medications [ 3 ]. How did this drug reach such a commanding position and is such widespread use justified? If pharmacological therapy is really needed in addition to lifestyle measures, diabetes specialists and people with type 2 diabetes want medication that is effective at reducing blood glucose levels, easy to take, preferably has once-daily dosing, has no short- or long-term side effects, carries no risk of hypoglycaemia, does not cause weight gain and is affordable worldwide. In addition, the ideal drug would address the underlying pathophysiology of type 2 diabetes and have added value in terms of reducing non-glycaemic risk factors for, and the incidence of, micro- and macrovascular complications of diabetes. How does metformin match up to these demands? The medication is certainly an effective glucose-lowering agent, generally reducing HbA1c by approximately 1015mm Continue reading >>

Metformin: New Benefits (and Risks) For This Old Diabetes Drug

Metformin: New Benefits (and Risks) For This Old Diabetes Drug

If type 2 diabetes is part of your life—whether you have the condition or are at risk of developing it—you’ve probably heard of a drug called metformin. Perhaps your doctor has told you about it, has recently started you on it or has been prescribing it to you for years to keep your blood sugar under control. It’s no newbie. Metformin has been available by prescription in the US for more than 20 years and in Europe for more than 40 years. US doctors write nearly 60 million prescriptions a year. It’s recommended as the go-to-first prescription for people with diabetes by the American Diabetes Association, the American Association of Clinical Endocrinologists and the American College of Physicians. Yet, in many ways, metformin remains a mystery. We know broadly but still not exactly, how it works. Even more surprising, new health benefits—and side effects—keep popping up. In fact, we’ve only recently learned that metformin might protect the heart, fight cancer and even boost longevity. On the other hand, it can, rarely, lead to a potentially fatal side effect, and it can even make a common diabetes complication worse. It’s time to take a closer look at metformin. MEDIEVAL FLOWER REMEDY, MODERN DRUG In medieval times, herbalists prescribed Galega officinalis—the bloom of the French lilac, also known as goat’s rue and Italian fitch—for patients with what we now recognize as diabetes. In the 1950s, medical researchers identified a compound in the lilac, metformin, that appeared to reliably and safely reduce high blood sugar. Metformin became widely available in Europe in the 1970s and was approved by the US Food and Drug Administration in 1995 to treat type 2 diabetes. Some combination prescriptions include metformin with other prescription medication Continue reading >>

Metformin Side Effects: Prolonged Use Lead To Severe Side Effects

Metformin Side Effects: Prolonged Use Lead To Severe Side Effects

Metformin is a frontline diabetic drug prescribed by doctors to improve insulin resistance in the body. It is one of the most popular medicine for type-2 diabetes patients worldwide. However, according to a new research study, prolonged use of metformin can be a cause of side effects such as depression, loss of appetite, reduced mental ability to think clearly, fatigue and breathlessness. A recent research study initiated by the Indian government suggested that prolonged use of metformin causes vitamin B12 deficiency that triggers microvascular and neuropathy complications in the body. Additionally, if the diabetic patient doesn’t have a nutritional diet and continue taking metformin drug for long duration, it may cause him/her severe side effects. Based on this research report, doctors claimed that in India the number of people getting diagnosed with type 2 diabetes is increasing at a rapid speed, and given the fact most indians are vegetarian, they are also diagnosed with vitamin b12 deficiency that worsens when they take metformin for long period of time and end up with serious side effects. “Prolonged intake of metformin affects body’s ability to absorb Vitamin B12 and that lead to its deficiency. If a diabetic person is vitamin b12 deficient for long period of time, it causes side effects such as tingling sensation on fingers, slowness, fatigue, muscle pain, mental disabilities and forgetfulness,” said Dr. Nilesh Rajput. People who are vitamin B12 deficient can take supplements to fulfill body’s daily requirement, however if you want to avoid taking supplements than you’ll have to rely on beef, chicken, egg, fish, red meat, green leafy vegetables and beans as they are rich source of Vitamin B12. In the year 2014, there were 66.9 million people diagnosed Continue reading >>

Long-term Effect Of Metformin On Blood Glucose Control In Non-obese Patients With Type 2 Diabetes Mellitus

Long-term Effect Of Metformin On Blood Glucose Control In Non-obese Patients With Type 2 Diabetes Mellitus

Abstract We aimed to investigate the long-term effect of metformin on the blood glucose control in non-obese patients with type 2 diabetes mellitus. A retrospective study was performed in 213 patients with type 2 diabetes mellitus under the administration of metformin for more than one year. The clinical parameters were investigated for 3 years. The obese and non-obese individuals were defined as a body mass index (BMI) of 25 kg/m2 or over (n = 105) and a BMI of less than 25 kg/m2 (n = 108), respectively. HbA1c levels were significantly decreased compared with those at the baseline time. The course of HbA1c was similar between the non-obese and the obese groups, while the dose of metformin required to control blood glucose was significantly lower in the non-obese group than in the obese group. The reductions in HbA1c were 1.2% and 1.1% at 12 months, 0.9% and 0.9% at 24 months, and 0.8% and 1.0% at 36 months in the non-obese and obese groups, respectively. BMI did not change during the observation periods. Approximately half of all patients required no additional antidiabetic agents or a reduction in other treatments after the initiation of metformin in either of the two groups. The present study demonstrated the long-term beneficial effect of metformin in non-obese (BMI < 25 kg/m2) diabetic patients. This effect appears to be maintained even after the observation period of this study, because metformin was limited to a relatively low dose in the non-obese group and the observed worsening in glycemic control over time can probably be attenuated by increasing the dose of metformin. Background Metformin, one of the biguanide agents, has been recommended for the treatment of patients with type 2 diabetes mellitus according to the consensus algorithm published by the Europea Continue reading >>

How Much Do You Know About Metformin?

How Much Do You Know About Metformin?

Metformin is a drug commonly used in the treatment of Type 2 diabetes. It is sold as a generic and under several brand names, including Glucophage, Glumetza, Riomet, and Fortamet. Both the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) recommend metformin as a cornerstone of therapy for Type 2 diabetes when exercise and dietary changes aren’t enough to keep blood glucose levels in target range. The low cost of the generic forms along with a long history of use make it a good choice for many individuals with Type 2 diabetes. Although metformin has helped many people lower their blood glucose levels, it does have some potential side effects that are worth knowing about. Understanding the risks and benefits of metformin is key to using it successfully. Take this quiz to test your knowledge of this popular diabetes medicine. (You can find the answers later in the article.) Q 1. How does metformin work to lower blood glucose levels? A. It stimulates the pancreas to make more insulin. B. It decreases the amount of glucose produced by the liver and makes it easier for cells to accept glucose from the bloodstream. C. It slows the digestive system’s breakdown of carbohydrates into glucose, allowing more time for insulin to work. D. It suppresses appetite, slows stomach emptying, and inhibits the release of glucagon (a hormone that raises blood glucose levels). 2. In addition to lowering blood glucose, metformin sometimes causes moderate weight loss. TRUE FALSE 3. In research studies, metformin use was associated with which of the following benefits in people with Type 2 diabetes? A. Reduced risk of morning high blood glucose. B. Reduced neuropathy (nerve damage). C. Reduced retinopathy (damage to the retina, a membrane in Continue reading >>

Side Effects Of Metformin: What You Should Know

Side Effects Of Metformin: What You Should Know

Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range. Metformin needs to be taken long-term. This may make you wonder what side effects it can cause. Metformin can cause mild and serious side effects, which are the same in men and women. Here’s what you need to know about these side effects and when you should call your doctor. Find out: Can metformin be used to treat type 1 diabetes? » Metformin causes some common side effects. These can occur when you first start taking metformin, but usually go away over time. Tell your doctor if any of these symptoms are severe or cause a problem for you. The more common side effects of metformin include: heartburn stomach pain nausea or vomiting bloating gas diarrhea constipation weight loss headache unpleasant metallic taste in mouth Lactic acidosis The most serious side effect metformin can cause is lactic acidosis. In fact, metformin has a boxed warning about this risk. A boxed warning is the most severe warning from the Food and Drug Administration (FDA). Lactic acidosis is a rare but serious problem that can occur due to a buildup of metformin in your body. It’s a medical emergency that must be treated right away in the hospital. See Precautions for factors that raise your risk of lactic acidosis. Call your doctor right away if you have any of the following symptoms of lactic acidosis. If you have trouble breathing, call 911 right away or go to the nearest emergency room. extreme tiredness weakness decreased appetite nausea vomiting trouble breathing dizziness lighthea Continue reading >>

Long-term Metformin Use 'has No Cognitive Impact'

Long-term Metformin Use 'has No Cognitive Impact'

Long-term Metformin Use 'Has No Cognitive Impact' The long-term use of metformin in individuals at risk of developing diabetes is not associated with worsening cognitive performance, say US investigators. The findings should reassure clinicians and patients alike that the drug is safe to use for diabetes prevention. Previous studies have suggested that metformin use may be associated with worse cognitive performance and perhaps even the development of Alzheimer's disease, while other studies have conversely indicated it may even improve memory. The current analysis of the Diabetes Prevention Program Outcomes Study (DPPOS), published online May 12 in Diabetes Care, shows that, in over 2000 adults, use of metformin for more than 8 years did not lead to cognitive impairment. Lead author Jos A Luchsinger, associate professor in epidemiology and medicine at Columbia University Medical Center, New York, told Medscape Medical News that "of all studies that have looked at the relationship of metformin and cognition, I think that, arguably, this is the best, because of the design, because of the exposure to metformin in a randomized trial setting, and the follow-up." He said that their finding that long-term exposure to metformin does not have a negative effect on cognition "should be incredibly reassuring to clinicians and patients who have read reports to the contrary." Dr Luchsinger added: "I think that's enormously important because metformin is the most used diabetes medication in the world, and it's the one that most people who get diagnosed with type 2 diabetes get started on." Higher HbA1c Linked to Lower Cognition, but No Link With Metformin Use The Diabetes Prevention Program (DPP) was a randomized controlled trial involving 3234 individuals with prediabetes in which Continue reading >>

Long-term Effects Of Metformin On Metabolism And Microvascular And Macrovascular Disease In Patients With Type 2 Diabetes Mellitus

Long-term Effects Of Metformin On Metabolism And Microvascular And Macrovascular Disease In Patients With Type 2 Diabetes Mellitus

Background We investigated whether metformin hydrochloride has sustained beneficial metabolic and (cardio) vascular effects in patients with type 2 diabetes mellitus (DM2). Methods We studied 390 patients treated with insulin in the outpatient clinics of 3 hospitals in a randomized, placebo-controlled trial with a follow-up period of 4.3 years. Either metformin hydrochloride, 850 mg, or placebo (1-3 times daily) was added to insulin therapy. The primary end point was an aggregate of microvascular and macrovascular morbidity and mortality. The secondary end points were microvascular and macrovascular morbidity and mortality, as separate aggregate scores. In addition, effects on hemoglobin A1c (HbA1c), insulin requirement, lipid levels, blood pressure, body weight, and body mass index were analyzed. Results Metformin treatment prevented weight gain (mean weight gain, −3.07 kg [range, −3.85 to −2.28 kg]; P < .001), improved glycemic control (mean reduction in HbA1c level, 0.4% percentage point [95% CI, 0.55-0.25]; P < .001) (where CI indicates confidence interval), despite the aim of similar glycemic control in both groups, and reduced insulin requirements (mean reduction, 19.63 IU/d [95% CI, 24.91-14.36 IU/d]; P < .001). Metformin was not associated with an improvement in the primary end point. It was, however, associated with an improvement in the secondary, macrovascular end point (hazard ratio, 0.61 (95% CI, 0.40-0.94; P = .02), which was partly explained by the difference in weight. The number needed to treat to prevent 1 macrovascular end point was 16.1 (95% CI, 9.2-66.6). Conclusions Metformin, added to insulin in patients with DM2, improved body weight, glycemic control, and insulin requirements but did not improve the primary end point. Metformin did, howeve Continue reading >>

Metformin: Side-effects & Benefits

Metformin: Side-effects & Benefits

Editor’s Note: Metformin is considered one of the safest and most effective treatments for type 2 diabetes. Although you should be aware of the side effects below, metformin is typically safe and well-tolerated. Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body’s response to insulin, a natural substance that controls the amount of glucose in the blood. I’m also beginning to see where metformin is used in addition to insulin to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). How about the associated long term side effects of metformin? Lets take a closer look! *Be sure to read this article: Patients Share their Experience on Metformin. Metformin and Lactic Acidosis: Although rare, lactic acidosis is potentially the most serious of the metformin side effects. The uptake of lactate by the liver is effected by metformin in a negative way. If the kidneys do not process the excess lactate the blood of the patient will acidify which can lead to a whole slew of problems. Most of which are similar to the feeling one gets after an intense workout. For example: anxiety, hyperventilation, irregular heart rate nausea and in some cases vomiting. This is the reason that metformin is generally only prescribed to people with a healthy kidney function. This side e Continue reading >>

Metformin Side Effects And How To Deal With Them

Metformin Side Effects And How To Deal With Them

Metformin side effects include diabetic neuropathy, brain fog, and digestive issues. You can address them through diet, Vitamin B12, CoQ10, and exercise. Let us understand the drug Metformin in detail and study different forms of metformin, its uses and common metformin side effects along with how to deal with them. Metformin: What Is It Used For? Metformin is an old warhorse in the pharma battle against diabetes. It has been the mainstay in the treatment of Type 2 Diabetes for more than fifty years, often matching or outperforming newer drugs. In fact, many new combination drugs are often created with metformin as one of the main ingredients. Thanks to its long run in the pharmaceutical world, the side effects of Metformin are also well known. The Metformin-PCOS connection has been studied extensively since a majority of health complications associated with PCOS (polycystic ovarian syndrome) are due to hyperinsulinemia (high amounts of insulin in the blood stream). Metformin is known to reduce circulating insulin levels. The use of this drug in women with PCOS has shown highly encouraging results. RELATED: 10 Easy Breakfast Ideas For Diabetics Most Prescribed Names in Metformin Category Include: Fortamet: It is an extended-release formulation that contains metformin hydrochloride. The tablets are designed for once-a-day administration. They deliver either 500 mg or 1000 mg of metformin. The tablet is made using a patented technology called SCOTTM that delivers the active compound slowly and at a constant rate. Glucophage: Glucophage tablets contain metformin hydrochoride. They contain either 500 mg, 850 mg or 1000 mg of the active compound. Glucophage tablets do not contain any special covering and need to be taken multiple times a day until the prescribed dosage is me Continue reading >>

Any Long Term Side Effects Of Metformin Use

Any Long Term Side Effects Of Metformin Use

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Any long term side effects of metformin use Can someone advise if there are any long term adverse effects of using metformin. I was prescribed 1500mg of the medication as soon as I was diagosed last August and, in combination with some drastic diet and lifestyle changes, it has helped me to quickly bring my diabetes under control, as summarised in the info given with my signature below. My current fasting blood glucose level is around 5 mmol. Current readings taken 2 hours after a meal very rarely rise above 6 mmol. This is on a daily intake of about 150 - 180g of Carbohydrate. The reason I am asking is that I am about to see my endoctrinologist next week and would like to discuss with him the possibility of decreasing the dosage of metformin. Although I could reduce my carbohydrate intake slightly, if at all possible, I would prefer not to do it as I am happy with my current diet (I am losing weight and in addition to controlling glucose levels,my lipid problem is greatly improved) and feel that it is one I could happily maintain for the long term. ..... But it does mean that I stay on the medication, hence my question. At the moment, other than the general feeling/awareness that all medication has some unwanted side effects, I am not aware of any specific reason why I should try to get off/ reduce the metformin. Does using oral medication mean that your diabetes will progress to insulin dependence faster than with diet alone? Any other known adverse consequences of the specific medication? I do not suffer from upset stomach and show no symptoms of Acidosis. Please treat this as a request for specific information and not as an invitation for more gen Continue reading >>

What Are The Long-term Effects Of Metformin?

What Are The Long-term Effects Of Metformin?

Metformin is a prescription drug that is used to help control blood glucose levels in individuals with type 2 diabetes mellitus. It is commonly sold under the brand names Glucophage and Fortamet and is available in regular and slow-release tablets. Metformin works by acting on the liver and intestines to decrease secretion and absorption of glucose into the blood. It also increases the insulin sensitivity of muscles and tissues of the body so that they take up glucose more readily. MayoClinic.com underlines that as with any medication, metformin can cause unwanted side effects that may be common or more serious. Video of the Day Patients taking metformin, particularly women may experience general malaise, fatigue, and occasional achiness. Malaise may be caused by other effects of metformin on the liver, kidneys, stomach and intestines, as noted by Drugs.com. Vitamin B12 Malabsorption Vitamin B12 malabsorption may also occur in some patients on metformin treatment. MayoClinic.com explains that a chemical in the stomach called intrinsic factor is required for the body to absorb vitamin B12. Metformin can interfere with this chemical, causing decreased absorption of the vitamin. Over the long term, a vitamin B12 deficiency can cause significant health risks as this essential vitamin is important for synthesis of DNA, red blood cell production and other biochemical functions in the body. Decreased vitamin B12 in the blood can lead to megoblastic anemia in which the bone marrow cannot adequately manufacture red blood cells. Though this type of anemia is not common, it can occur from long-term use of metformin, causing decreased vitamin B12 levels. Long-term metformin use can cause liver or kidney problems in some individuals, according to MayoClinic.com, because the medicati Continue reading >>

Is Metformin Safe For Long Term Use?

Is Metformin Safe For Long Term Use?

Most people have mild side effects with metformin. This drug is safe for long term use; however it should be accompanied by a diet and exercise plan. In addition, this medication may not work as well over time as your body adapts to it. If you become elderly, while taking metformin, you should have regular kidney function tests. If there is decreased kidney function, taking metformin could put you at risk for lactic acidosis, which is very serious and sometimes fatal. Metformin should be temporarily discontinued in people who are having radiologic tests that require iodinated contrast materials, as this can cause problems with renal function. If you start to drink alcohol excessively, you should no longer take this medication. Continue reading >>

Long-term Safety, Tolerability, And Weight Loss Associated With Metformin In The Diabetes Prevention Program Outcomes Study

Long-term Safety, Tolerability, And Weight Loss Associated With Metformin In The Diabetes Prevention Program Outcomes Study

OBJECTIVE Metformin produced weight loss and delayed or prevented diabetes in the Diabetes Prevention Program (DPP). We examined its long-term safety and tolerability along with weight loss, and change in waist circumference during the DPP and its long-term follow-up. RESEARCH DESIGN AND METHODS The randomized double-blind clinical trial of metformin or placebo followed by a 7–8-year open-label extension and analysis of adverse events, tolerability, and the effect of adherence on change in weight and waist circumference. RESULTS No significant safety issues were identified. Gastrointestinal symptoms were more common in metformin than placebo participants and declined over time. During the DPP, average hemoglobin and hematocrit levels were slightly lower in the metformin group than in the placebo group. Decreases in hemoglobin and hematocrit in the metformin group occurred during the first year following randomization, with no further changes observed over time. During the DPP, metformin participants had reduced body weight and waist circumference compared with placebo (weight by 2.06 ± 5.65% vs. 0.02 ± 5.52%, P < 0.001, and waist circumference by 2.13 ± 7.06 cm vs. 0.79 ± 6.54 cm, P < 0.001 in metformin vs. placebo, respectively). The magnitude of weight loss during the 2-year double-blind period was directly related to adherence (P < 0.001). Throughout the unblinded follow-up, weight loss remained significantly greater in the metformin group than in the placebo group (2.0 vs. 0.2%, P < 0.001), and this was related to the degree of continuing metformin adherence (P < 0.001). CONCLUSIONS Metformin used for diabetes prevention is safe and well tolerated. Weight loss is related to adherence to metformin and is durable for at least 10 years of treatment. Metformin is Continue reading >>

Long-term Effect Of Metformin On Metabolic Parameters In The Polycystic Ovary Syndrome

Long-term Effect Of Metformin On Metabolic Parameters In The Polycystic Ovary Syndrome

Go to: Insulin resistance is a central feature of the polycystic ovary syndrome (PCOS) and may increase cardiovascular risk. Due to insulin resistance, the metabolic syndrome is more prevalent in PCOS women compared to normal women. Metformin improves the metabolic profile in PCOS in short-term studies. In this study, we evaluated the long-term effect of metformin on metabolic parameters in PCOS women during routine care without a controlled diet. We performed a retrospective medical chart review of 70 women with PCOS receiving metformin from an academic endocrine clinic. Metabolic risk factors were compared before and after metformin treatment. Time trends of these metabolic parameters were also analyzed. After a mean follow-up of 36.1 months with metformin treatment, improvements were observed for BMI (−1.09±3.48 kg/m2, p=0.0117), diastolic blood pressure (−2.69±10.35 mmHg, p=0.0378), and HDL cholesterol (+5.82±11.02 mg/dL, p<0.0001). The prevalence of metabolic syndrome decreased from 34.3% at baseline to 21.4% (p=0.0495). The course of BMI reduction during metformin treatment was significantly more pronounced in PCOS women with metabolic syndrome at baseline, compared with those without the metabolic syndrome (p=0.0369 for interaction). In conclusion, metformin improved the metabolic profile of PCOS women over 36.1 months, particularly in HDL cholesterol, diastolic blood pressure and BMI. Keywords: Polycystic ovary syndrome, metformin, metabolic syndrome, cardiovascular risk factors Continue reading >>

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