Metformin Bedtime Administration

When Do I Take Metformin For My Diet: Morning Or Night?

Metformin helps control blood sugar and increase your body's sensitivity to insulin. The drug is available only by prescription and sold under several different brand names, including Fortamet, Glumetza, Riomet, Glucophage and Glucophage XR. Your dosage will depend on your normal diet and exercise habits -- too much metformin can lead to low blood sugar and hypoglycemia. Always follow your doctor's directions for taking your medication. Video of the Day Metformin works by limiting your liver's production of glucose and stopping your body from absorbing some of the glucose in your bloodstream. Additionally, metformin increases your body's sensitivity to insulin, allowing your pancreas to produce less insulin. Keeping blood sugar levels stable can decrease hunger and food cravings, leading to weight loss. Metformin is not an appetite suppressant, nor does it boost metabolism; to lose weight, you'll still need to pay close attention to your diet and increase your physical activity. Standard vs. Extended Release Options The amount of metformin you'll take depends on why you are using the medication, how often you take the medicine, other medications you might be taking and the time between doses. The National Institutes of Health explains that metformin is available as a tablet or a liquid solution. Tablets come in an extended release dose -- Glucophage XR -- or in a standard release option. Extended release pills are designed to be taken once daily, with your evening meal. Standard tablet and liquid solutions may be taken once or multiple times daily -- with meals. Metformin should be taken with food. Always follow your doctor's orders. It's typical to start with a 500 milligram dose once daily, then increase both the amount of medication and the frequency. If you're using Continue reading >>

[bedtime Administration Of Metformin May Reduce Insulin Requirements].

Abstract The administration of metformin, as glucophage retard, at bedtime instead of supper time may improve diabetes control by reducing morning hyperglycemia. This modification of glucophage treatment was tried in 3 groups of diabetic patients: I. those with secondary failure of routine treatment with sulfonylurea (SU) and glucophage; II. those with combined SU and bedtime insulin; III. Type 1 patients with early morning hypoglycemia. The first 3 months of observation in 258 patients showed that 136 (52.7%) reacted very well to the change. In Group I the addition of insulin to SU could be postponed. In Group II, night insulin could be reduced or eliminated. In Group III, evening or night insulin could be reduced by up to 70%. There was no early morning hypoglycemia nor morning hyperglycemia. The success rate in the 2 Type 2 groups was better (72% and 60%) than in the Type 1 group (34%). 30 patients (11.6%) had to stop the treatment because of side effects of the glucophage (mainly diarrhea or nausea). So far, we have found no clinical signs that might indicate which patients might benefit from this modification of treatment. A fasting blood sugar done within 2-3 days after the change in treatment may immediately indicate whether the new treatment is effective. Continue reading >>

Metformin: Clinical Use In Type 2 Diabetes

, Volume 60, Issue9 , pp 15861593 | Cite as Metformin: clinical use in type 2 diabetes Metformin is one of the most popular oral glucose-lowering medications, widely considered to be the optimal initial therapy for patients with type 2 diabetes mellitus. Interestingly, there still remains controversy regarding the drugs precise mechanism of action, which is thought to involve a reduction in hepatic glucose production. It is now recommended as first-line treatment in various guidelines, including that of the EASD and ADA. Its favoured status lies in its efficacy, low cost, weight neutrality and good safety profile. Other benefits have also been described, including improvements in certain lipids, inflammatory markers, and a reduction in cardiovascular events, apparently independent from the drugs glucose-lowering effect. Data have emerged questioning the previous reluctance to use this agent in those with mild to moderate chronic kidney disease. Regulations guiding its use in patients with stable, modest renal dysfunction have, as a result, become more lenient in recent years. With no long-term studies comparing it against newer glucose-lowering drugs, some of which have more robust evidence for cardioprotection, metformins established role as foundation therapy in type 2 diabetes may justifiably be challenged. BiguanidesGlucose-lowering therapyMetforminReviewType 2 diabetes mellitus Diabetes Prevention Program Outcomes Study The online version of this article (doi: 10.1007/s00125-017-4336-x ) contains a slideset of the figures for download, which is available to authorised users. Metformin hydrochloride, a biguanide, is the most popular oral glucose-lowering medication in most countries, widely viewed as foundation therapy for individuals with newly diagnosed type 2 di Continue reading >>

Mealtime 50/50 Basal + Prandial Insulin Analogue Mixture With A Basal Insulin Analogue, Both Plus Metformin, In The Achievement Of Target Hba1c And Pre- And Postprandial Blood Glucose Levels In Patients With Type 2 Diabetes: A Multinational, 24-week, Randomized, Open-label, Parallel-group Comparison

Volume 29, Issue 11 , November 2007, Pages 2349-2364 Mealtime 50/50 basal + prandial insulin analogue mixture with a basal insulin analogue, both plus metformin, in the achievement of target HbA1c and pre- and postprandial blood glucose levels in patients with type 2 diabetes: A multinational, 24-week, randomized, open-label, parallel-group comparison Get rights and content Background: In people without diabetes, 50% of daily insulin secretion is basal and the remainder is postprandial. Hence, it would be expected that insulin replacement therapy in a 50/50 ratio with each meal would mimic physiologic insulin secretion better than treatment with once-daily basal insulin in patients with diabetes mellitus. Using lispro mix (LM) 50/50 before meals may be a logical approach to achieving glycemic targets (glycosylated hemoglobin [HbAlc] and pre- and postprandial blood glucose [BG] concentrations) in these patients. Objective: The aim of this study was to test the hypothesis that treatment with a premixed insulin analogue containing 50/50 basal + prandial insulins administered before each meal would achieve lower overall and mealtime glycemic control than once-daily basal insulin analogue, both plus metformin (Met), in patients with type 2 diabetes mellitus. Methods: This 24-week, randomized, open-label, parallel-group trial was conducted at 38 sites across Australia, Greece, India, The Netherlands, Poland, Puerto Rico, and the United States. Male and female patients aged 35 to 75 years with type 2 diabetes mellitus and an HbA1c level of 6.5% to 11.0%, who were receiving metformin and/or a sulfonylurea with a stable dose of 0 to 2 daily insulin injections over the previous 3 months were eligible. Patients were randomly assigned to receive LM50/50 (50% insulin lispro protami 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 >>

Lantus (insulin Glargine) Not Only For Bedtime?

Physicians are pursuing several different possibilities of dosing that deviate from the FDA-approved instructions for Lantus dosing. Lantus is approved only for bedtime dosing. That’s because the pre-approval studies were conducted only using bedtime dosing, therefore the FDA approved the drug that way. But from experience, patients can also use Lantus in the morning. Lantus is a “peakless” insulin…giving steady concentrations throughout the day. But for some patients, it doesn’t last the full 24 hours. Morning dosing might be preferred for these patients. That way, Lantus wears off at night when insulin requirements are lower. Some patients use BID dosing if Lantus doesn’t last all day. Explain that the big advantage to Lantus is once daily dosing. Lantus (insulin glargine) is a recombinant human insulin analog with a duration of action up to 24 hours.1 The microprecipitates that are formed in the subcutaneous tissue after injection slow the absorption of Lantus and provide a relatively constant level of insulin over 24 hours without a pronounced peak.1 This prolonged effect over 24 hours enables it to be administered once daily. Lantus is FDA approved for once-daily subcutaneous administration at bedtime for adults and children six years of age and older with type 1 diabetes mellitus or adults with type 2 diabetes mellitus who require basal (long-acting) insulin for the control of hyperglycemia.1 When changing a patient (child >6 years or adult) from intermediate- or long-acting insulin to Lantus, the amount of short-acting insulin or oral antidiabetic agent may need to be adjusted. In premarketing studies, for patients using once-daily NPH or Ultralente insulin, the initial dose of Lantus was not changed. For patients using twice-daily NPH insulin, the in Continue reading >>

Ch. 51 Antidiabetics

-is a pattern of undetected hypoglycemia (low blood glucose values of less than 70) followed by hyperglycemia (high blood glucose levels of more than 200) -is an early-morning (usually between 2 a.m. and 8 a.m.) increase in blood sugar (glucose) relevant to people with diabetes. Insulin administration: Nursing Interventions -Instruct patient to report hypoglycemia and hyperglycemia. -Encourage compliance with diet, insulin, exercise. -Advise patient to wear medical alert tag. -Teach patient how to check blood glucose. -Teach patient how to administer insulin. -Adjusted doses dependent on individual blood glucose -Usually done before eating and at bedtime -Usually uses rapid or short-acting insulin Remove from refrigerator 30 minutes before injection. Avoid storing insulin in direct sunlight or at high temperatures. stimulate pancreatic beta cells to secrete more insulin; this increases the insulin cell receptors, increasing the ability of the cells to bind insulin for glucose metabolism. The sulfonylureas are classified as first- and secondgeneration. First-generation sulfonylureas are divided into: short-acting, intermediate-acting, and long-acting antidiabetics. Tolbutamide (Orinase) shortactingsulfonylurea -increase the tissue response to insulin and decrease glucose production by the liver. -greater hypoglycemic potency than the firstgeneration -Effective doses are lower than for the first-generation -longer duration of action and cause fewer side effects. -less displacement potential from protein-binding sites by other highly protein-bound drugs, such as salicylates and warfarin (Coumadin), than first-generation drugs. Second-generation sulfonylureas should not be used when liver or kidney dysfunctionis present. A hypoglycemic reaction is more likely tooccur in ol Continue reading >>

Can Metformin Be Taken At Bedtime 393858

When Do I Take Metformin for My Diet: Morning orStandard tablet and liquid solutions may be taken once or multiple times daily with meals. Metformin should be taken with food. Always follow your doctor's[Bedtime administration of metformin may reduceThe administration of metformin, as glucophage retard, at bedtime instead of supper time In Group III, evening or night viagra coupon insulin could be reduced by up to 70%.Metformin (Oral Route) Proper Use Mayo ClinicAlso, exercise regularly and test for sugar in your blood or urine as directed. Metformin should be taken with meals to help reduce stomach or bowel side effectsopinions on when to take metformin er DiabetesI have been on metformin buy generic viagra er for about a month now. my fasting is about 115-135. I was wondering if I should take my metformin at night instead of.Metformin, the Liver, and Diabetes Diabetes7 Sep 2011 When should you take metformin to work with the liver? churning out glucose [day and night], even when blood sugar levels are high.Diabetes Update: Timing Your Metformin Dose24 Jun 2010 It is to take your metformin later in the day, after you have eaten a meal .. 7 pm every night. do you think I should try to take it earlier in the day.Does it matter if you take metformin at1 Answer Posted in: metformin Answer: I am on the same dosage, but I sleep poorly due to back injuries. I try What time of day do you take Metformin? Type 2 Diabetes9 Aug 2011 Thanks for any advice you can give. I've been taking Metformin earlier in the day (around 3 p.m.) and I eat snacks before bed (low carb), andSitagliptin | Diabetes Forum The Global Diabetes19 May 2012 She suggested upping the current dosage of Metformin have been on Can anyone who's taking it or has taken it give me some idea of what its like My level Continue reading >>

Proper Use

Drug information provided by: Micromedex This medicine usually comes with a patient information insert. Read the information carefully and make sure you understand it before taking this medicine. If you have any questions, ask your doctor. Carefully follow the special meal plan your doctor gave you. This is a very important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed. Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the extended-release tablet whole with a full glass of water. Do not crush, break, or chew it. While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this. Dosing The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the Continue reading >>

Ada: Evening And Bedtime Second Dose Equal For Long-acting Insulin Levemir

Patients who take Levemir (insulin detemir) twice daily can chose a convenient evening time for their second dose. There appears to be little difference between dinner time and bedtime dosing, reported Eberhard Draeger, Ph.D., a director of clinical life-cycle management at Novo Nordisk, which makes Levemir. “The time of evening administration of insulin detemir can be fitted to the needs and lifestyles of the individual patient in terms of [fasting plasma glucose] and nocturnal hypoglycemia,” said Dr. Draeger and colleagues in a poster presentation. These results are what clinicians might have expected, said endocrinologist Larry Deeb, M.D., a clinical professor of pediatrics at the University of Florida in Tallahassee, and president-elect of the American Diabetes Association. He was not involved with the study. “There’s really not a whole lot of difference between the two, certainly no clinical difference in the outcome,” said Dr. Deeb. “Is the evening better? No, and you wouldn’t expect it to be better. It’s probably easier for the patient.” Nocturnal hypoglycemia occurred in at a rate of 9.1 events per patient year with evening dosing and 6.5 per patient year with bedtime Levemir dosing. So although the overall risk of hypoglycemia was not different between the groups, the relative risk of nocturnal events was 29% lower with bedtime dosing. Dr. Deeb said it is a common practice to give this drug at morning and evening or morning and bedtime although the label initially said it should be given at bedtime. “I think the important thing for clinicians is that we are discovering a great deal of flexibility in these long acting agents,” he said. The study was a meta-analysis of two 16-week, open-label trials comparing NovoLog (insulin aspart) plus Le Continue reading >>

Type 2 Diabetes And Insulin

Getting Started When most people find out they have Type 2 diabetes, they are first instructed to make changes in their diet and lifestyle. These changes, which are likely to include routine exercise, more nutritious food choices, and often a lower calorie intake, are crucial to managing diabetes and may successfully lower blood glucose levels to an acceptable level. If they do not, a drug such as glyburide, glipizide, or metformin is often prescribed. But lifestyle changes and oral drugs for Type 2 diabetes are unlikely to be permanent solutions. This is because over time, the pancreas tends to produce less and less insulin until eventually it cannot meet the body’s needs. Ultimately, insulin (injected or infused) is the most effective treatment for Type 2 diabetes. There are many barriers to starting insulin therapy: Often they are psychological; sometimes they are physical or financial. But if insulin is begun early enough and is used appropriately, people who use it have a marked decrease in complications related to diabetes such as retinopathy (a diabetic eye disease), nephropathy (diabetic kidney disease), and neuropathy (nerve damage). The need for insulin should not be viewed as a personal failure, but rather as a largely inevitable part of the treatment of Type 2 diabetes. This article offers some practical guidance on starting insulin for people with Type 2 diabetes. When to start insulin Insulin is usually started when oral medicines (usually no more than two) and lifestyle changes (which should be maintained for life even if oral pills or insulin are later prescribed) have failed to lower a person’s HbA1c level to less than 7%. (HbA1c stands for glycosylated hemoglobin and is a measure of blood glucose control.) However, a recent consensus statement from Continue reading >>

Overview Of Current Therapeutic Options In Type 2 Diabetes

These pages are best viewed with Netscape version 3.0 or higher or Internet Explorer version 3.0 or higher. When viewed with other browsers, some characters or attributes may not be rendered correctly. ORIGINAL ARTICLE Rationale for combining oral agents with insulin therapy John B. Buse, MD, PHD The overriding goals of the treatment of type 2 diabetes are first to relieve symptoms and then to prevent acute and chronic complications of the disease. The former goal can be largely achieved by maintaining the fasting and premeal glucose levels substantially below the renal threshold for glucose, ~200 mg/dl. The latter goal is more difficult to achieve because it requires long-term patient and provider attention to the principles of self-care, a healthful lifestyle, cardiovascular risk factor management, and the more intensive glycemic goal of achieving near-normal glucose control. In most patients with diabetes, near-normal glycemia can be achieved with single oral agents, combinations of oral agents, or insulin. However, a significant proportion of patients, particularly those with more longstanding disease, do not achieve near-normal glucose levels despite large doses of insulin or combinations of oral agents. This is documented in a recent study in which maximum doses of troglitazone and micronized glyburide achieved a HbA1c level of 7% in 41% of subjects and <8% in only 60% of patients (1) and in the Veterans Affairs Cooperative Study in Type II Diabetes (VACSDM), in which some patients did not achieve a HbA1c<7% despite maximal educational intervention and large doses of insulin delivered as multiple injections (2). This inability to control diabetes in some cases despite intensive oral or injected therapy is likely due to the dual pathophysiology of type 2 diabetes� Continue reading >>

"best Time To Take Metformin": Diabetes Community - Support Group

In your case the best time to take Metformin is yesterday. Not today. Not tomorrow or beyond. cookiedog replied to Manoj_in_Bangalore 's response: Again, you are advising a poster to ignore medical advice and not take a prescribed drug. That is an irresponsible thing for you to do. You are entitled to your opinion but you should not give medical advice. Linnylcm, always check with your doctor first. I'm curious what your A1C is presently. I'm not on medicine and struggle with my numbers unless I am very strict "all" the time. My advice to you is this. Do not go off your medicine, and ask your doctor about a change in time for your medicine. If you find your numbers are doing GREAT, and you feel you can be very strict, "at some point" you might be able to get off your medicine. Some can do well this way. Some cannot,depending on your pancreas and how it's functioning. I still struggle with this, and my A1C went up this time. It's still not high, but I'm working harder to bring it down again. Since you walk for an hour every day, this is really good. It sounds like you're at a good weight, too. Discuss all these things with your doctor. Manoj_in_Bangalore replied to cookiedog 's response: Medical advise is deadly. It must be ignored at all costs. betaquartz replied to Manoj_in_Bangalore 's response: I hope you never have to depend on "medical advice" for your longevity. Heaven forbid should you get a compound fracture, AIDS, MS, or even PSP. Doctors, Chiropractors, Witch Doctors, and others are the best we have, and even they don't know, but at least they are a start. An intelligent patient does not leave it all up to the Dr, but is proactive in their own health by keeping good records, knowing their bodies, taking care of themselves, and consulting intelligently with th Continue reading >>

Nocturnal Glucose Metabolism After Bedtime Injection Of Insulin Glargine Or Neutral Protamine Hagedorn Insulin In Patients With Type 2 Diabetes

Nocturnal Glucose Metabolism after Bedtime Injection of Insulin Glargine or Neutral Protamine Hagedorn Insulin in Patients with Type 2 Diabetes 3rd Medical Clinic (T.L., B.F., N.S., M.E., R.G.B.), Justus Liebig University Giessen, 35385 Giessen, Germany Institute of Nutrition (T.L., J.E., C.K.), Justus Liebig University Giessen, 35385 Giessen, Germany Address all correspondence and requests for reprints to: Professor Thomas Linn, Clinical Research Unit, 3rd Medical Clinic and Policlinic, Rodthohl 6, 35385 Giessen, Germany. Search for other works by this author on: 3rd Medical Clinic (T.L., B.F., N.S., M.E., R.G.B.), Justus Liebig University Giessen, 35385 Giessen, Germany Search for other works by this author on: 3rd Medical Clinic (T.L., B.F., N.S., M.E., R.G.B.), Justus Liebig University Giessen, 35385 Giessen, Germany Search for other works by this author on: 3rd Medical Clinic (T.L., B.F., N.S., M.E., R.G.B.), Justus Liebig University Giessen, 35385 Giessen, Germany Search for other works by this author on: Institute of Nutrition (T.L., J.E., C.K.), Justus Liebig University Giessen, 35385 Giessen, Germany Search for other works by this author on: Institute of Nutrition (T.L., J.E., C.K.), Justus Liebig University Giessen, 35385 Giessen, Germany Search for other works by this author on: 3rd Medical Clinic (T.L., B.F., N.S., M.E., R.G.B.), Justus Liebig University Giessen, 35385 Giessen, Germany Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 10, 1 October 2008, Pages 38393846, Thomas Linn, Britta Fischer, Nedim Soydan, Michael Eckhard, Julia Ehl, Clemens Kunz, Reinhard G. Bretzel; Nocturnal Glucose Metabolism after Bedtime Injection of Insulin Glargine or Neutral Protamine Hagedorn Insulin in Patients wi Continue reading >>

When To Take My Metformin?

Hi was just wondering when is the best time to take the metformin? Before dinner or after? i have been told to take them after dinner but i think taking them an hour before i eat is better....when do you guys/gals take them (if your taking metformin)? D.D. Family preD 1971 - T2 2003 - insulin 2005 I take my morning dose(500mg) at breakfast and the evening dose(1000mg) right before bed metformin-2000mg, lisinopril-20mg, thyronorm-137mcg Originally I took mine at dinner and didn't get enough of bg reduction. I switched to first thing in the morning and last thing at night. I just added a 3rd dose in the early afternoon and now I can keep bg's stable in the low 100's all day. It seems I am much more insulin resistant in the morning and early afternoon. Taking met at those times help keep the numbers down. For some reason at dinner just the process of eating low carb is enough to keep my 2 hours numbers in the low 100's. D.D. Family T2 since 1996 and struggling to be healthy. I take 3 x 850mg of metformin. I have never had any ill effects from metformin and can take it on an empty stomach without any problems. I take it to minimize my dawn phenomena (high morning FBGs). Hi was just wondering when is the best time to take the metformin? Before dinner or after? i have been told to take them after dinner but i think taking them an hour before i eat is better....when do you guys/gals take them (if your taking metformin)? Sometimes when you take it can be very important Especially if you take time released medicines. I take Glocophage XR (time released generic metaformin) at 8:00 am and 8:00 pm. I have a PDA and it has a program that allows me to set the time for all my oral medications and my Lantus. The only med I don't take by the clock is Byetta since it is before breakfast Continue reading >>