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Metformin Helps Liver

Diabetes: How Do I Help Protect My Liver?

Diabetes: How Do I Help Protect My Liver?

If I have diabetes, is there anything special I need to do to take care of my liver? Answers from M. Regina Castro, M.D. You're wise to wonder about steps to protect your liver. Diabetes raises your risk of nonalcoholic fatty liver disease, a condition in which excess fat builds up in your liver even if you drink little or no alcohol. This condition occurs in at least half of those with type 2 diabetes. It isn't clear whether the condition appears more often in people with type 1 diabetes than in the general population because obesity, which is a risk factor, occurs with similar frequency in both groups. Other medical conditions, such as high cholesterol and high blood pressure, also raise your risk of nonalcoholic fatty liver disease. Fatty liver disease itself usually causes no symptoms. But it raises your risk of developing liver inflammation or scarring (cirrhosis). It's also linked to an increased risk of liver cancer, heart disease and kidney disease. Fatty liver disease may even play a role in the development of type 2 diabetes. Once you have both conditions, poorly managed type 2 diabetes can make fatty liver disease worse. Your best defense against fatty liver disease includes these strategies: Work with your health care team to achieve good control of your blood sugar. Lose weight if you need to, and try to maintain a healthy weight. Take steps to reduce high blood pressure. Keep your low-density lipoprotein (LDL, or "bad") cholesterol and triglycerides — a type of blood fat — within recommended limits. Don't drink too much alcohol. If you have diabetes, your doctor may recommend an ultrasound examination of your liver when you're first diagnosed and regular follow-up blood tests to monitor your liver function. Continue reading >>

Liver Disease Affects Metformin Metabolism

Liver Disease Affects Metformin Metabolism

Increased diabetes drug exposure may increase risk of adverse reactions in type 2 patients with NASH… Obesity increases the risk of nonalcoholic steatohepatitis (NASH), which occurs when there is too much fat in the liver. NASH is often asymptomatic and because testing for it requires a liver biopsy, many cases go undiagnosed. It is estimated that between 6 and 17 percent of Americans currently have NASH. With obesity on the rise, that number will continue to grow. While it is known that NASH can affect hepatic clearance of drugs, researchers at the University of Arizona College of Pharmacy decided to study how NASH affects kidney transporters such as Oct1, Oct2, and Mate1, which are primarily responsible for the elimination of metformin. Using mouse models of obesity, diabetes, NASH, and a choline and methionine deficient diet, the researchers found that this caused decreases in Oct2 and Mate1 expression in the kidneys, leading to a 4.8-fold increase in serum metformin levels. “This study, in addition to several of our other recent studies shows that NASH, either alone or in combination with genetic differences in drug transporters, can have a profound effect on drug exposure,” said research associate John Clarke. Nathan Cherrington, professor at the university’s Department of Pharmacology and Toxicology, adds that the next step is to continue the research to demonstrate that NASH can lead to metformin retention in humans. While metformin is considered a relatively safe and effective drug, increased exposure may increase the risk of adverse reactions. “If any clinician is going to provide precision medicine, they’ll need to know the ability of the liver and kidneys to metabolize and eliminate drugs,” says Cherrington. He believes this study will lead to b Continue reading >>

Metformin Effects On The Liver

Metformin Effects On The Liver

Physicians commonly prescribe Metformin if you have Type 2 diabetes and need help controlling your blood sugar. It reduces how much glucose you absorb from food and the amount your liver produces. On rare occasions, however, Metformin causes liver dysfunction and a serious metabolic condition involving the liver. For this reason, physicians exercise caution when prescribing Metformin to patients with liver disease. Video of the Day In healthy individuals, the liver produces glucose to keep blood sugar stable when you haven't eaten for several hours. Uncontrolled glucose production in the liver may cause high blood sugar in individuals with Type 2 diabetes. Researchers discovered that Metformin blocks critical enzymes involved in signaling the liver to produce glucose, thereby decreasing blood sugar levels. Their work was reported in the February 2013 edition of the journal "Nature." Lactic Acid Production Your muscles, brain, skin and other tissues produce a substance called lactic acid. Under normal circumstances, your liver and kidneys remove lactic acid from the blood and convert some of it to glucose. If a life-threatening metabolic condition known as lactic acidosis occurs, lactic acid levels increase faster than the liver can keep up with. Though its mechanism is unclear, Metformin causes lactic acidosis in a small segment -- up to 1 percent -- of patients, according to NYU Langone Medical Center. Almost all reported cases occurred in patients with underlying metabolic issues, such as liver or kidney disease. According to LiverTox, a publication of the U.S. National Library of Science drug database, Metformin may occasionally cause mild liver toxicity, characterized by minor elevations in liver enzymes. It occurs in less than 1 percent of the patients taking Metfo Continue reading >>

Metformin

Metformin

DRUG RECORD Introduction Metformin is a first line agent for the treatment of type 2 diabetes that can be used alone or in combination with sulfonylureas, thiazolidinediones or other hypoglycemic agents. Metformin has not been linked to serum enzyme elevations during therapy and is an exceeding rare cause of idiosyncratic clinically apparent acute liver injury. Background Metformin (met for' min) is a biguanine and acts as an insulin sensitizing agent, probably through activation of adenosine monophosphate dependent (AMP) kinase in liver and muscle tissue. Metformin is often associated with weight loss making it a preferred, first line agent for management of overweight patients with type 2 diabetes. Initial concerns about the possibility that metformin (like the related biguanine phenformin) could induce lactic acidosis have been largely resolved, although the agent is contraindicated in patients with renal dysfunction because of this reason and should be used with caution in patients with significant liver disease. Metformin was approved for use in the United States in 1995 and is currently one of the most commonly used drugs for the therapy of diabetes, with more than 30 million prescriptions filled in the United States yearly. Metformin is available in many generic forms in tablets of 500, 850 or 1000 mg, the recommended regimen being to start with 500 or 850 mg once daily and increase based upon tolerance to 1000 to 2550 mg daily taken in two divided doses. Commercial formulations include Glucophage, Glumetza, Fortamet and Riomet. Metformin is also available in extended release formulations and in combinations with sulfonylureas such as glipizide (Metaglip) or glyburide (Glucovance), DDP-4 inhibitors such as alogliptin (Kazano), linagliptin (Jentadueto), saxaglipti 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 >>

The Role Of Metformin In The Management Of Nafld

The Role Of Metformin In The Management Of Nafld

Copyright © 2012 Angela Mazza et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide. Its prevalence ranges 10–24% in the general population, reaching 60–95% and 28–55% in obese and diabetic patients, respectively. Although the etiology of NAFLD is still unclear, several lines of evidences have indicated a pathogenetic role of insulin resistance in this disorder. This concept has stimulated several clinical studies where antidiabetic drugs, such as insulin sensitizers including metformin, have been evaluated in insulin-resistant, NAFLD patients. These studies indicate that metformin might be of benefit in the treatment of NAFLD, also in nondiabetic patients, when associated to hypocaloric diet and weight control. However, the heterogeneity of these studies still prevents us from reaching firm conclusions about treatment guidelines. Moreover, metformin could have beneficial tissue-specific effects in NAFLD patients irrespective of its effects as insulin sensitizer. 1. Introduction Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. It includes a broad spectrum of liver alterations, ranging from pure steatosis to cirrhosis, through nonalcoholic steatohepatitis (NASH). NAFLD is characterized by liver damage and functional impairment similar to those observed in alcoholic liver disease although occurring in patients who do not drink or drink only a moderate amount of alcohol [1]. Although the pathogenesis of the disorder is not fully clarified, insulin resistance is widel Continue reading >>

Metformin, The Liver, And Diabetes

Metformin, The Liver, And Diabetes

Most people think diabetes comes from pancreas damage, due to autoimmune problems or insulin resistance. But for many people diagnosed “Type 2,” the big problems are in the liver. What are these problems, and what can we do about them? First, some basic physiology you may already know. The liver is one of the most complicated organs in the body, and possibly the least understood. It plays a huge role in handling sugars and starches, making sure our bodies have enough fuel to function. When there’s a lot of sugar in the system, it stores some of the excess in a storage form of carbohydrate called glycogen. When blood sugar levels get low, as in times of hunger or at night, it converts some of the glycogen to glucose and makes it available for the body to use. Easy to say, but how does the liver know what to do and when to do it? Scientists have found a “molecular switch” called CRTC2 that controls this process. When the CRTC2 switch is on, the liver pours sugar into the system. When there’s enough sugar circulating, CRTC2 should be turned off. The turnoff signal is thought to be insulin. This may be an oversimplification, though. According to Salk Institute researchers quoted on RxPG news, “In many patients with type II diabetes, CRTC2 no longer responds to rising insulin levels, and as a result, the liver acts like a sugar factory on overtime, churning out glucose [day and night], even when blood sugar levels are high.” Because of this, the “average” person with Type 2 diabetes has three times the normal rate of glucose production by the liver, according to a Diabetes Care article. Diabetes Self-Management reader Jim Snell brought the whole “leaky liver” phenomenon to my attention. He has frequently posted here about his own struggles with soarin Continue reading >>

Liver And Metformin: Lessons Of A Fructose Diet In Mice - Sciencedirect

Liver And Metformin: Lessons Of A Fructose Diet In Mice - Sciencedirect

Liver and Metformin: Lessons of a fructose diet in mice Author links open overlay panel IaraKarisea Fructose increases lipogenesis and lipid peroxidation, reduces the antioxidant defenses, and mitochondrial biogenesis. Metformin mechanism of action remains partially understood and controversial. Metformin can reverse the liver injury preventing the progression to more severe states. Studies show that the continuous consumption of fructose can lead to nonalcoholic fatty liver disease (NAFLD) and steatohepatitis. We aimed to investigate the role of Metformin in an animal model of liver injury caused by fructose intake, focusing on the molecular markers of lipogenesis, beta-oxidation, and antioxidant defenses. Male three months old C57BL/6 mice were divided into control group (C) and fructose group (F, 47% fructose), maintained for ten weeks. After, the groups received Metformin or vehicle for a further eight weeks: control (C), control+Metformin (CM), fructose (F), and fructose+Metformin (FM). Fructose resulted in hepatic steatosis, insulin resistance and lower insulin sensitivity in association with higher mRNA levels of proteins linked with de novo lipogenesis and increased lipid peroxidation. Fructose diminished mRNA expression of antioxidant enzymes, and of proteins responsible for mitochondrial biogenesis. Metformin reduced de novo lipogenesis and increased the expression of proteins related to mitochondrial biogenesis, thereby increasing beta-oxidation and decreasing lipid peroxidation. Also, Metformin upregulated the expression and activity of antioxidant enzymes, providing a defense against increased reactive oxygen species generation. Therefore, a significant reduction in triglyceride accumulation in the liver, steatosis and lipid peroxidation was observed in th Continue reading >>

Metformin For The Treatment Of Nonalcoholic Fatty Liver Disease (nafld) (nafld)

Metformin For The Treatment Of Nonalcoholic Fatty Liver Disease (nafld) (nafld)

The purpose of this study is to find out if Metformin is safe and useful in the treatment of NAFLD. NAFLD is a poorly understood disease which may cause an enlarged liver, abnormal liver test results, and scarring of the liver. It may occur more often in people with obesity, high levels of cholesterol (blood fats), diabetes (high blood sugar), or the insulin resistance syndrome (where a person's body does not respond to the hormone insulin which helps keep blood sugar levels normal). Currently, no effective drug treatment for NAFLD exists. There is increasing evidence that NAFLD may be a condition due to a problem with metabolism (the way your body uses energy). Previous studies have shown that high glucose (sugar) levels may play an important role in the development of fatty liver disease. Medications that decrease your natural glucose level may reduce the amount of fat in the liver and, therefore, might be useful in the treatment of NAFLD. Metformin, a drug approved by the U.S. Food and Drug Administration (FDA) for use in patients with diabetes, has been shown to improve fatty liver in animals and in a small number of human beings. Study Type : Interventional (Clinical Trial) Actual Enrollment : 11 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Hyperinsulinemia and Insulin Resistance in Nonalcoholic Fatty Liver Disease. Metformin for the Treatment of Nonalcoholic Fatty Liver Disease: A Randomized, Double-Blinded, Placebo-Controlled Trial Study Start Date : April 2009 Primary Completion Date : December 2012 Study Completion Date : December 2012 Resource links provided by the National Library of Medicine U.S. FDA Resou Continue reading >>

Mcmaster University Researchers Discover How Metformin Drug Works On Fat In The Liver

Mcmaster University Researchers Discover How Metformin Drug Works On Fat In The Liver

How and why metformin needs to interact with insulin to be effective About 120 million people around the world with Type 2 diabetes - and two million in Canada - take the drug metformin to control their disease. While doctors know metformin needs to interact with insulin to be effective, and that it can't lower blood sugar on its own, no one has been able to explain how and why this happens. Researchers at McMaster University are the first to unlock that mystery with their discovery metformin works on fat in the liver. Their research is published in today's issue of the journal Nature Medicine. "The key is that metformin doesn't work to lower blood glucose by directly working on the glucose. It works on reducing harmful fat molecules in the liver, which then allows insulin to work better and lower blood sugar levels," said Greg Steinberg, associate professor in the Department of Medicine of the Michael G. DeGroote School of Medicine. He also holds the Canada Research Chair in Metabolism and Obesity and is a co-director of the Metabolism and Childhood (MAC)-Obesity Research Program. His research team included scientists in Alberta, Australia and Scotland. Steinberg said that most people taking metformin have a fatty liver, which is frequently caused by obesity. "Fat is likely a key trigger for pre-diabetes, causing blood sugar to start going up because insulin can't work as efficiently to stop sugar coming from the liver." In their detective work to uncover what causes fatty liver, the scientists studied mice that have a "genetic disruption" to a single amino acid in two proteins called acetyl-CoA carboxylase (ACC). These proteins, which are controlled by the metabolic sensor AMP-activated protein kinase, regulate fat production as well as the ability to burn fat. Mice w Continue reading >>

Metformin: Get The Whole Story

Metformin: Get The Whole Story

Many people look for alternatives to diabetic pharmaceutical drugs like Metformin™. At Liver Medic, we receive many inquiries regarding drug interaction of alternatives with Metformin as a common concern. Americans filled 76.9 million prescriptions for Metformin in 2016. ​ By The Numbers In the United States, approximately 26 Million people are diabetic, and of that 95% are Type II diabetics, a condition influenced by lifestyle not genetics. This is actually good news. Before one starts blaming the diabetic victims, please review articles on GMOs and addictive processed foods. Many of the health hazards of these foods are deliberately hidden from consumers and short of having a degree in chemistry it’s difficult for the individual to determine danger levels.. Metformin is the generic name, but is also found in brand names such as; Glucophage™, Glucophage XR™, Glumetza™, Fortamet™ and Riomet™. Metformin is an oral medication that lowers blood glucose (sugar) by influencing the body’s sensitivity to insulin and is used for treating Type II diabetes. Metformin and the Liver Metformin has even been used to treat liver disease. The problem with this application is that the liver is responsible for breaking down drugs. That Metformin is a drug that the body needs to detoxify makes us wonder about the effectiveness of this application as a drug versus a clearly more effective alternative. The connection physicians make with Metformin, diabetes and liver disease does have a common thread.. The liver is responsible for regulating the insulin cycles. The work of the liver is to signal the pancreas to secrete insulin, breaking down insulin and storing much of the glycogen in the body. The Root of the Problem Mainstream medicine and the drug industry have historic Continue reading >>

Metformin Affecting The Liver

Metformin Affecting The Liver

Registration is fast, simple and absolutely free so please, join our community today to contribute and support the site. This topic is now archived and is closed to further replies. I stumbled upon this board searching for my answer about Metformin 500mg. I was on 3 mets (morning, noon, night), + 4 glyburide (5mg each) per day and my sugar levels were contained. Then I had my labs done and my doc found out that my ALT levels, which measures damage to the liver, had shot up to 111. Normally it should be < 34. My doctor asked me to stop Metformin immediately and I have a liver untrasound scheduled next week to look at the damage if any. Now i am on Glyburide (20mg total) alone and its not helping my sugar levels. My fasting remains at 200+. Just wanted to make you aware of Metformin's liver effects and to seek advice if any. It does happen - sorry to hear that it actually does happen these days. Metformin does have a pretty good record - you have reason to doubt that though. With fasting numbers at 200+ why have you not considered insulin? Insulin is as natural as you can get. Yes, there are hazards there also. Just look around and you will see how people handle them - and pretty well too. I am not on insulin but if it is a question between insulin and medications I would pick insulin. Of course, with a type 2 it is more a case of insulin and medications. I give you and your doctor credit for doing the lab work .... some doctors aren't so rigorous to follow-up. More and more prescription drugs can adversly affect liver and muscle enzymes (I'm on Lipitor Gemfibrozil, and Lamisol) and routine and periodic bloodwork is a MUST. The benefits of these drugs far outweigh the risks, which as you have witnessed, need to be closely monitored. I forgot to add What DonnieD said. M Continue reading >>

The Effect Of Metformin On Liver Function Tests In The Diabetes Prevention Program

The Effect Of Metformin On Liver Function Tests In The Diabetes Prevention Program

The Effect of Metformin on Liver Function Tests in the Diabetes Prevention Program Metformin may lower aminotrans Metformin may lower aminotransferase concentrations in non-alcoholic fatty liver disease (NAFLD), which is common in people with type 2 diabetes, obesity and/or insulin resistance. In the Diabetes Prevention Program (DPP), 2153 adults with impaired glucose tolerance, an overweight group likely to be at high risk for NAFLD, were randomized to metformin (MET; n=1072) or placebo (PLAC; n=1081) between 1996 and 1999 and followed for an average of 3.2 years. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured at baseline, 3 and 6 months and every 6 months thereafter. Regression models controlling for co-variates and repeated measures were used to evaluate the effect of metformin on AST or ALT in the whole group and a sub-group reporting no alcohol use at baseline. Incidence of development of abnormal AST or ALT was calculated using sex-specific NHANES III 95th percentile for AST and ALT among participants below those cut-offs at baseline. AST and ALT were lower in the MET vs. PLAC groups (geometric means averaged over time for AST, 21.7 vs. 22.2 U/l, p=0.03; for ALT, 19.3 vs. 20.1 U/l, p=0.004) and remained so after adjustment for age, sex, BMI, fasting glucose and insulin at baseline (adjusted geometric means averaged over time (for AST, 22.1 vs. 22.6 U/l, p=0.02; for ALT, 19.7 vs. 20.7 U/l, p=0.001). ALT (but not AST) remained significantly lower in the MET group after separate adjustment for glucose and insulin at each visit, but not after separate adjustment for weight loss (19.5 vs. 20.3 U/l, p=0.2), indicating the effect on ALT is mediated via weight loss. In the sub-group with no alcohol use at baseline, ALT was significantly Continue reading >>

Can You Drink Alcohol While Taking Metformin?

Can You Drink Alcohol While Taking Metformin?

Metformin is a medication that helps manage type 2 diabetes and occasionally prediabetes. In general, drinking alcohol while taking metformin is not helpful and not recommended by doctors. The side effects of metformin can be life-threatening with excessive alcohol consumption. Metformin and alcohol both put stress on the liver, so intensifying the harmful effects and increasing the risk of liver complications. How does metformin and alcohol affect the body? Metformin is a popular, effective, and inexpensive management medication, prescribed for the treatment of type 2 diabetes. In 2014, some 14.4 million people in the United States were prescribed metformin. Metformin is also being used more and more frequently in prediabetes cases. Metformin use in overweight people with type 1 diabetes may also reduce insulin requirements and increase metabolic control. The drug works by improving insulin sensitivity, promoting the uptake of glucose into tissues and lowering sugar levels in the bloodstream. By increasing how effectively the existing glucose is used, metformin reduces the amount of glucose the liver produces and the intestines absorb. Alcohol also affects blood sugars significantly. Alcohol digestion puts stress on the liver, an organ dedicated to the removal of poisons from the body. When the liver is forced to process high amounts of alcohol, it becomes overworked and releases less glucose. Long-term alcohol use can also make cells less sensitive to insulin. This means that less glucose is absorbed from the blood and levels in the bloodstream increase. Over time, alcohol consumption damages the liver, especially when it is consumed in excess. It reduces the liver's ability to produce and regulate glucose. Conditions like alcoholic hepatitis and cirrhosis of the live Continue reading >>

Metformin-induced Hepatotoxicity

Metformin-induced Hepatotoxicity

Metformin is the first choice oral antidiabetic drug for type 2 diabetes and currently the most consumed. Although gastrointestinal intolerance is frequent, metformin-induced hepatotoxicity is rare. Fewer than 10 cases have been reported (1). In all of those cases, metformin was associated with concomitant intake of other potentially hepatotoxic drugs. We present what we feel may be the first documented case of hepatotoxicity due to metformin with no other drug interference. A 61-year-old man was admitted to the hospital with a 3-day history of painless jaundice. He had no history of liver disease or toxic habits and denied previous consumption of drugs or herbal products, but had been taking metformin (1,700 mg/day for 6 weeks) after being diagnosed with type 2 diabetes. Laboratory tests showed a mixed pattern of liver damage (total bilirubin 2.9 mg/dL, direct bilirubin 2.4 mg/dL, aspartate aminotransferase [AST] 290 units/L [≤40], alanine aminotransferase [ALT] 861 units/L [≤35], γ-glutamyltransferase [GGT] 861 units/L [≤35], and alkaline phosphatase [ALP] 622 units/L [≤120]). International normalized ratio and eosinophil counts were normal. Diagnostic work-up ruled out viral hepatitis A, B, and C, as well as autoimmune and metabolic liver disease (negative antinuclear antibodies, anti-mitochondrial antibodies, smooth muscle antibodies, anti-liver/kidney microsomal antibodies; normal ceruloplasmin, α-1 antitrypsin, copper). Abdominal ultrasound and cholangio-MRI showed no pathological findings. The patient refused a liver biopsy. After stopping metformin, the patient's clinical condition progressively improved and liver enzymes normalized in 30 days. He was discharged with only recommendations to modify his lifestyle. Six weeks after discharge, the patient a Continue reading >>

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