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Metformin Alternatives 2017

The Pros And Cons Of Metformin For Diabetes

The Pros And Cons Of Metformin For Diabetes

Metformin is #7 on the doctors’ hit parade of top 10 prescription drugs. Each year the number of prescriptions increases substantially. Last year there were 87 million metformin prescriptions dispensed in U.S. pharmacies. That does not count combo products that include metformin in their formulation such as Glucovance, Invokamet, Janumet, Kombiglyze XR, Metaglip and Synjardy, to name just a few. Metformin is clearly the #1 drug for diabetes and because the number of people with diabetes keeps going up, prescriptions for metformin are skyrocketing. That’s why readers of our syndicated newspaper column and visitors to this website are so desperate to learn more about metformin for diabetes. How To Know If Metformin for Diabetes Is Right for You: Here is a typical letter from a reader: Q. I crossed the line a month ago from normal blood sugar to type 2 diabetes and was put on metformin. I hate taking drugs. What can you tell me about metformin? Thank the Old Wives: A. Metformin is one of the oldest and most well-studied diabetes medicines. It probably comes as a shock to most prescribers to learn that their favorite diabetes drug is available thanks to the old wives. Practitioners of folk medicine discovered that French lilac (Galega officinalis) helped control the symptoms of a condition associated with “sweet urine.” An article in the Journal of Clinical Investigation (Oct. 15, 2001) noted: “In medieval times, a prescription of Galega officinalis was said to relieve the intense urination accompanying the disease that came to have the name of diabetes mellitus [now known as type 2 diabetes].” The botanist and physician Nicholas Culpeper detailed the health benefits of French lilac in 1656. He described the ability of the plant to lower blood sugar and control Continue reading >>

After Metformin, Are Newer Drugs Better For Type 2 Diabetes?

After Metformin, Are Newer Drugs Better For Type 2 Diabetes?

After Metformin, Are Newer Drugs Better for Type 2 Diabetes? Use of a sulfonylurea as second-line therapy after metformin for type 2 diabetes is just as effective as a newer agent but far less costly, a new study based on claims data finds. The results were published online February 26 in Diabetes Care by Yuanhui Zhang, a PhD candidate at North Carolina State University, Raleigh, and colleagues. "In light of an incomplete understanding of the pros and cons of second-line medications and the high cost associated with newer medications, the decision to use newer medications should be weighed against the additional cost burden to patients and/or the health system," study coauthor Brian Denton, PhD, of the University of Michigan, Ann Arbor, told Medscape Medical News. However, the use of retrospective data means that the study is subject to both ascertainment and physician-choice bias, said Alan J. Garber, MD, PhD, of Baylor College of Medicine, Houston, Texas, when asked to comment for Medscape Medical News. Moreover, noted Dr. Garber, the study doesn't adequately account for the adverse effects of sulfonylurea-induced hypoglycemia. "Patients value things differently. If you had a hypoglycemic episode and you don't like that, you're willing to pay a lot more of your discretionary income to avoid having another one." The researchers explain that there are currently 11 classes of approved glucose-lowering medications. Metformin has a long-standing evidence base for efficacy and safety, is inexpensive, and is regarded by most as the primary first-line treatment for type 2 diabetes. When metformin fails to achieve or maintain glycemic goals, another agent needs to be added. However, there is no consensus or sufficient evidence supporting the use of one second-line agent over Continue reading >>

Towards Natural Mimetics Of Metformin And Rapamycin

Towards Natural Mimetics Of Metformin And Rapamycin

Towards natural mimetics of metformin and rapamycin We are experimenting with display styles that make it easier to read articles in PMC. The ePub format uses eBook readers, which have several "ease of reading" features already built in. The ePub format is best viewed in the iBooks reader. You may notice problems with the display of certain parts of an article in other eReaders. Generating an ePub file may take a long time, please be patient. Towards natural mimetics of metformin and rapamycin Alexander Aliper, Leslie Jellen, [...], and Alex Zhavoronkov Aging is now at the forefront of major challenges faced globally, creating an immediate need for safe, widescale interventions to reduce the burden of chronic disease and extend human healthspan. Metformin and rapamycin are two FDA-approved mTOR inhibitors proposed for this purpose, exhibiting significant anti-cancer and anti-aging properties beyond their current clinical applications. However, each faces issues with approval for off-label, prophylactic use due to adverse effects. Here, we initiate an effort to identify nutraceuticalssafer, naturally-occurring compoundsthat mimic the anti-aging effects of metformin and rapamycin without adverse effects. We applied several bioinformatic approaches and deep learning methods to the Library of Integrated Network-based Cellular Signatures (LINCS) dataset to map the gene- and pathway-level signatures of metformin and rapamycin and screen for matches among over 800 natural compounds. We then predicted the safety of each compound with an ensemble of deep neural network classifiers. The analysis revealed many novel candidate metformin and rapamycin mimetics, including allantoin and ginsenoside (metformin), epigallocatechin gallate and isoliquiritigenin (rapamycin), and withaferi Continue reading >>

Natural Alternatives To Metformin

Natural Alternatives To Metformin

Around the globe there are thousands who are diagnosed with type 2 diabetes, and the number keeps growing with each passing day. The disease limits a persons food choices and has to take medicines to keep blood sugar levels from spiking, as diabetes will lead to fatal conditions when left untreated. Metformin is an antidiabetic medication for type 2 diabetes with an efficacy thats recorded since the 50s and now is among the most prescribed drug in the entire world. The side effects associated with its use are commonly gastrointestinal (diarrhea, nausea, vomiting), headaches, and rarely sleeplessness and lethargy. Unfortunately not all patients can take metformin because of other side effects that may exacerbate their existing medical conditions. The list below enumerates some natural alternatives to metformin for those, with prior consultation from experts, who need other ways of treating their type 2 diabetes: Do not substitute this for actual advice from an expert as many cases require treatment that CAN NOT be remediedwith natural options. These natural optionsmay only be helpful in addition to treatments, again consult with a medical professional before self treating or self diagnosing. The gel found in the inner part of the plants leaf has been discovered to possess anti-diabetic properties. Its fiber, glycoprotein, and polysaccharide contents help the body in efficiently using glucose and in removing excess ones. It also decreases blood lipids and swelling, improves wound healing, and bolsters the bodys defenses and vascular health, both known for being compromised by diabetes. Fresh aloe vera can be added into salad dishes or turned into juices and smoothies but its potency may be reduced if mixed with other fruits. Antioxidants are the bodys defenses against th Continue reading >>

Will Metformin Become The First Anti-aging Drug?

Will Metformin Become The First Anti-aging Drug?

A committed group of scientists is seeking to validate metformin as the first-ever anti-aging medication.1,2 In this day of staggering drug prices, metformin is available as a low-cost generic. One mechanism by which metformin works is by activating AMPK, an enzyme inside cells that lowers blood sugar by promoting energy utilization. Activating AMPK has broad-ranging effects that extend far beyond blood sugar control. Studies show that boosting AMPK activity can prevent—and even reverse—the life-shortening effects of aging, such as cardiovascular disease, diabetes, neurodegenerative diseases, cancer, and more.3 In this article, we’ll review data that persuaded the FDA to allow metformin to be studied in humans as the first anti-aging drug.1 Broad-Spectrum Effects The most commonly prescribed antidiabetic drug is metformin. It has been in use in England since 1958 and in the United States since 1995. Derived from a compound found in the French Lilac, metformin has a track record of safety and effectiveness at routine doses of up to 2,000 mg daily.4-7 So what evidence is there for the FDA to consider this drug as an anti-aging medication? The reason is simple: Metformin can block or diminish many of the fundamental factors that accelerate aging.8-12 These include protecting against DNA damage glycation, poor mitochondrial function, and chronic inflammation. Metformin has been shown to facilitate DNA repair, which is critical for cancer prevention. By attacking these fundamental degenerative processes, metformin can prevent the development of aging’s most troubling diseases. Metformin has also been shown to increase the production of known longevity-promoting signaling molecules in cells, such as mTOR and AMPK—all of which reduce fat and sugar storage and increas Continue reading >>

What Medications Can Be Used As A Substitute For Metformin

What Medications Can Be Used As A Substitute For Metformin

Metformin is a prescription medication used for treatment of type 2 (non-insulin dependent) diabetes. Other medications may be considered if metformin does not adequately treat your type 2 diabetes. Types Types of medications for treating type 2 diabetes include dipeptidyl-peptidase 4 inhibitors such as Onglyza and Januvia, glucagon-like peptide 1 agonists such as Byetta, meglitinides such as Prandin and Starlix, sulfonylureas such as Glucotrol, Amaryl and Glynase, thiazolidinediones such as Avandia and Actos and alpha-glucosidase inhibitors such as Precose and Glyset. Function DPP-4 inhibitors, GLP-1 agonists, meglitinides and sulfonylureas increase insulin production, thiazolidinediones increases the effectiveness of insulin without increasing insulin production and alpha-glucosidase inhibitors blocks certain stomach enzymes that make the body more sensitive to insulin. Administration Byetta is available only as an injectable. The other types of medications are taken orally. Side Effects Sulfonylureas and thiazolidediones may cause weight gain. DPP-4 inhibitors increase risk of respiratory infections. Consult your pharmacist or physician for a more comprehensive list of side effects for each particular medication. Lactic Acidosis Metformin may cause lactic acidosis, which is a condition caused by excessive buildup of lactic acid in the body. Symptoms of lactic acidosis include weakness, drowsiness, decreased heart rate, cold feeling, muscle pain, shortness of breath, stomach pain, lightheadedness and fainting. Other types of type 2 diabetes medications are not associated with development of lactic acidosis. Diabetic Ketoacidosis Metformin is contraindicated in cases of diabetic ketoacidosis, a condition caused by a shortage of insulin in the body. DDP-4 inhibitors, GL Continue reading >>

Metformin, Oral Tablet

Metformin, Oral Tablet

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

Glucose-lowering Medicines For Type 2 Diabetes

Glucose-lowering Medicines For Type 2 Diabetes

Background There is an increasing array of medicines available to improve blood glucose control in type 2 diabetes. Finding the best com-bination for an individual patient requires an assessment of the patient’s characteristics and understanding the mechanism of action for each drug. Objective/s The aim of this article is to provide a rational approach for choosing between the various blood glucose-lowering medicines available for treatment of patients with type 2 diabetes mellitus. Discussion Metformin is the first choice of glucose-lowering medicines for most patients with type 2 diabetes. Sulphonylureas have proven benefits in long-term trials. Insulin is required in patients with symptoms of insulin deficiency. Glucagon-like peptide 1 agonists and sodium-glucose co-transporter 2 inhibitors provide some assistance in weight loss as well as improving blood glucose con-trol. Dipeptidyl peptidase 4 inhibitors provide an alternative to metformin and sulphonylureas, especially when side effects of those drugs limit their use. Re-assessing blood glucose control after an appropriate trial period before deciding on continuing use is appropriate. In recent years, pharmacological options for treating type 2 diabetes have expanded substantially. The place of metformin as the drug of first choice is unquestioned. Sulphonylureas have a long history and their use is supported by outcome data from the UK Prospective Diabetes Study (UKPDS).1 Choosing agents other than metformin or sulphonylureas is more difficult, apart from the use of insulin in patients who are clearly insulin-deficient. Most pharmacological options will reduce glycosylated haemoglobin (HbA1c) by 0.5–1.0%, on average, either as monotherapy, compared to placebo, or in addition to metformin and or a sulphonylure Continue reading >>

The Surprising Truth About Metformin

The Surprising Truth About Metformin

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

Understanding And Overcoming Metformin Gastrointestinal Intolerance

Understanding And Overcoming Metformin Gastrointestinal Intolerance

Department of Endocrinology, Diabetes and Nutrition, Division of Clinical Pharmacology, Center for Interdisciplinary Research on Medicines (CIRM), University of Lige, CHU, Lige, Belgium Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, University of Lige CHU, Lige, Belgium Correspondence Andr Scheen MD, PhD, Professor, Division of Clinical Pharmacology, Center for Interdisciplinary Research on Medicines (CIRM), University of Lige, CHU Sart Tilman (B35) B4000, Lige, Belgium.Email: Department of Endocrinology, Diabetes and Nutrition, Division of Clinical Pharmacology, Center for Interdisciplinary Research on Medicines (CIRM), University of Lige, CHU, Lige, Belgium Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, University of Lige CHU, Lige, Belgium Correspondence Andr Scheen MD, PhD, Professor, Division of Clinical Pharmacology, Center for Interdisciplinary Research on Medicines (CIRM), University of Lige, CHU Sart Tilman (B35) B4000, Lige, Belgium.Email: Funding information Unrestricted financial support for a medical writer for the preparation of this article was provided by Merck & Co., Inc., Kenilworth, NJ, USA. The sponsor was not involved in any aspect of the content, writing, or review of the manuscript. Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Metformin is the most widely prescribed drug for patients with type 2 diabetes mellitus and the firstline pharmacological option as supported by multiple international guidelines, yet a rather large proportion of p Continue reading >>

Understanding And Overcoming Metformin Gastrointestinal Intolerance

Understanding And Overcoming Metformin Gastrointestinal Intolerance

Abstract Metformin is the most widely prescribed drug for patients with type 2 diabetes mellitus and the first-line pharmacological option as supported by multiple international guidelines, yet a rather large proportion of patients cannot tolerate metformin in adequate amounts because of its associated gastrointestinal (GI) adverse events (AEs). GI AEs typically encountered with metformin therapy include diarrhoea, nausea, flatulence, indigestion, vomiting and abdominal discomfort, with diarrhoea and nausea being the most common. Although starting at a low dose and titrating slowly may help prevent some GI AEs associated with metformin, some patients are unable to tolerate metformin at all and it may also be difficult to convince patients to start metformin again after a bout of GI AEs. Despite this clinical importance, the underlying mechanisms of the GI intolerance associated with metformin are poorly known. In the present review, we discuss: the epidemiology of metformin-associated GI intolerance and its underlying mechanisms; genotype variability and associated factors affecting metformin GI intolerance, such as comorbidities, co-medications and bariatric surgery; clinical consequences and therapeutic strategies to overcome metformin GI intolerance. These strategies include appropriate titration of immediate-release metformin, use of extended-release metformin, the promise of delayed-release metformin and gut microbiome modulators, as well as alternative pharmacological therapies when metformin cannot be tolerated at all. Given the available data, all efforts should be made to maintain metformin before considering a shift to another drug therapy. Continue reading >>

Alternatives To Metformin

Alternatives To Metformin

What Are the Alternatives to Metformin? Metformin (Glucophage®) is a prescription medication used for the treatment of type 2 diabetes. A long-acting form, metformin ER (Glucophage XR®), is also available. For most people, metformin is effective in treating their diabetes, and most people tolerate it well. However, as with all medicines, side effects can occur. In other cases, the medicine may not completely control a person's diabetes. Fortunately, there are several alternatives to metformin. Some of the metformin alternatives include: Lifestyle Changes for Type 2 Diabetes Many lifestyle changes have been shown to be very effective for controlling type 2 diabetes (especially early type 2 diabetes). These lifestyle changes include weight loss, becoming more physically active (see Diabetes and Exercise), and changes in diet (see Diabetic Diet). In fact, these changes are important for all people with type 2 diabetes, including people taking diabetes medications. For many people, lifestyle changes alone may not be enough to adequately control type 2 diabetes. For these people, medications (including oral and injectable medications) may be necessary. Fortunately, there are many different types of oral medications available to treat type 2 diabetes, including: Sulfonylureas Sulfonylureas are medications that force the pancreas to produce more insulin. Because of this, they are very effective, but are also more likely to cause dangerously low blood sugar (hypoglycemia). These medications include: Meglitinides Meglitinides are similar to sulfonylureas, in that they force the pancreas to produce more insulin. However, they are short-acting and are less likely to cause dangerously low blood sugar. They are usually taken before every meal. Meglitinides include: Thiazolidinedio Continue reading >>

Three New Treatment Options For Type 2 Diabetes Recommended By Nice

Three New Treatment Options For Type 2 Diabetes Recommended By Nice

The drugs will help to control blood sugar in those patients who cannot take more commonly prescribed medicines meaning their condition remains stable for longer. An estimated 31,000 people may be eligible for the three recommended treatments: canagliflozin (Invokana), dapagliflozin (Forxiga) and empagliflozin (Jardiance). The three drugs can all be used on their own if a person can’t use metformin, sulfonylurea or pioglitazone, and diet and exercise alone isn’t controlling their blood glucose levels. In the UK, almost 3.5 million people who have been diagnosed with diabetes and it’s estimated that about 90% of adults with the condition have type 2 diabetes. Type 2 diabetes causes elevated blood sugar levels which damages blood vessels leading to increased risk of heart attack, stroke and limb amputation. Sugar levels rise because their body doesn’t produce enough insulin – the hormone which controls the amount of glucose in blood – or their body doesn’t use insulin effectively. Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation, said: “Type 2 diabetes is long-term condition that has a serious impact on people who live with it, and the treatments given should be tailored for the individual. “For many people whose blood glucose levels aren’t controlled by diet and exercise alone, metformin is the first drug treatment that they’ll be offered. But some people may experience nausea and diarrhoea, and they may not be able to take it if they have kidney damage. For people who can’t take a sulfonylurea or pioglitazone, then the three drugs recommended in this guidance can be considered. This is as an alternative to the separate group of drugs called dipeptidyl peptidase-4 (DPP-4) inhibitors. “The committee agreed th Continue reading >>

Can This Herb Completely Replace Drugs For Type-2 Diabetics?

Can This Herb Completely Replace Drugs For Type-2 Diabetics?

A few weeks ago, I received this email from a diabetic patient of mine. He's been working hard to control his blood sugar. He said, "Hi Frank, I have some very good news that I'm excited to tell you. I've been following your program closely and was a little discouraged. Although my A1c levels [average blood sugar levels] have been dropping, my fasting blood sugar has not. It was still at 123. About two to three weeks ago, I began taking berberine (500 mg, three times daily) and my fasting blood sugar dropped into the 90s. I'm stoked! Sincerely, Rich." So the question I had to answer for myself is, "Why did Rich fail to respond well to my usual program, and then do so well on berberine?" Berberine is a phytochemical (plant chemical) found in many different plants. When used in herbal medicine, the usual sources are barberry, goldenseal, or Oregon grape. It's the main alkaloid of Coptis chinensis, which Asian folk medicine uses to treat diabetes. You also may hear people refer to Coptis chinensis as Chinese Goldthread, Huang-Lian, and Huang-LienIt. Berberine has a lot of uses. It can treat heart disease, immune disorders, digestive problems, eye infections, and other infections. I had never heard of it being all that effective in diabetes. So as soon as Rich sent me that message, I looked into it. I found several well-written scientific articles describing an effect of berberine that I could hardly believe. It seems that you can use it as a substitute for insulin. One study, published just last year looked at the effect of berberine on how well muscle cells take in sugar. As you probably already know, except when we are actively exercising, sugar cannot get into muscle cells unless insulin is present to escort it in. That's why the blood sugar goes up when patients either Continue reading >>

Drug Treatment Of Type 2 Diabetes Mellitus In Patients For Whom Metformin Is Contraindicated

Drug Treatment Of Type 2 Diabetes Mellitus In Patients For Whom Metformin Is Contraindicated

Go to: Metformin has long been considered the initial drug therapy choice in the treatment of type 2 diabetes mellitus (T2DM). The most widely recognized clinical guidelines and consensus recommendations endorse its use when monotherapy is initially preferred to treat hyperglycemia.1–4 However, treatment with metformin is not suitable for all patients diagnosed with T2DM. Patients may initially receive metformin but not be able to tolerate common side effects, mainly its gastrointestinal adverse effects. Likewise, some practitioners may be cautious in using metformin in patients at risk for but who do not necessarily currently have specific contraindications to its use. While the specific contraindications to use of metformin have changed to an extent over the last decade, significant renal impairment or conditions that could acutely alter renal function remain a consistent theme in delineating who should not receive the medication. Some of the common sources and specific contraindications to the use of metformin based on renal function are provided in Table 1. Inconsistencies between these sources remain. Current guidelines/consensus recommendations for specific therapies to initiate in patients who cannot tolerate or have a contraindication to metformin use provide some insight on the issue but also conflict with each other. The American Diabetes Association/European Association for the Study of Diabetes recommend a sulfonylurea, meglitinide, pioglitazone, or dipeptidyl peptidase 4 (DPP-4) inhibitor when metformin cannot be used.3 They also recommend using a glucagon-like peptide-1 (GLP-1) agonist if weight loss is warranted. The American Association of Clinical Endocrinologists state GLP-1 agonists, DPP-4 inhibitors, and alpha-glucosidase inhibitors are acceptable Continue reading >>

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