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Metformin Uses

Use Of Metformin In Endocrinopathies Other Than Diabetes

Use Of Metformin In Endocrinopathies Other Than Diabetes

We would like to congratulate Jones et al on their timely reminder of the inappropriately strict contraindications to the use of metformin(1).The authors have emphasised the justification for using metformin in patients with type 2 diabetes and its proven effect in reducing cardiovascular risk in such patients. For many years Gynaecologists have also found favour with metformin and its emerging role in the treatment of polycystic ovary syndrome despite not being licensed for this. Metformin improves insulin sensitivity and decreases hyperinsulinaemia,reduces serum androgen levels,restores menstrual cyclicity and increases the ovulatory and pregnancy rates in patients with polycystic ovary syndrome who are resistant to clomiphene citrate(2).When administered during pregnancy it decreases the occurence of first trimester pregnancy loss(3),and reduces the development of gestational diabetes in women with polycystic ovary syndrome(4). Furthermore it has also been suggested as a useful treatment for obesity(5). We feel that these proven uses have to be formally recognised in addition to amending the published contraindications list,thereby eliminating ambiguity in its usage,especially considering the value of metformin in endocrinopathies like polycystic ovary syndrome. REFERENCES 1)Jones GC, Macklin JP, Alexander WD. Contraindications to the use of metformin.BMJ 2003;326:4-5 (4 January) 2)Nestler JE, Stovall D, Akhtar N, Iuorno MJ, Jakubowicz DJ. strategies for the use of insulin-sensitising drugs to treat infertility in women with polycystic ovary syndrome. Fertil Steril 2002;77(2):209-15. 3)Jakubowicz DJ,Iuorno MJ,Jakubowicz S,Roberts KA,Nestler JE Effects of metformin on early pregnancy loss in the poycystic ovary syndrome.J Clin Endocrinol Metab 2002;87(2):524-9. 4)Glue Continue reading >>

Metformin Use In Pregnancy: Promises And Uncertainties

Metformin Use In Pregnancy: Promises And Uncertainties

Metformin use in pregnancy: promises and uncertainties 1Institute of Cardiovascular and Medical Sciences, British Heart Foundation (BHF) Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, G12 8TA UK 2Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA USA Robert S. Lindsay, Email: [email protected] . Received 2017 Mar 27; Accepted 2017 May 22. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Metformin has been prescribed in pregnancy for over 40 years; for much of this time, use has been limited both in numbers and geographically, and the evidence base has been confined to observational studies. In early years, perceived safety concerns and lack of availability of the drug in many countries acted as a barrier to use. More recently, RCTs have begun to examine the role of metformin in pregnancy in much-needed detail. However, this evidence base has been interpreted differently in different countries, leading to very wide variation in its current application in pregnancy. In this short review, we will discuss the history of metformin in pregnancy and highlight some of the key clinical trials. We will then consider some of the remaining controversies associated with metformin use in pregnancy, most important of these being the potential for long-term ‘programming’ effects on the fetus as a result of metformin being able to cross the placenta. We will also consider clinical situati Continue reading >>

Use Of Metformin In Polycystic Ovary Syndrome.

Use Of Metformin In Polycystic Ovary Syndrome.

Abstract Women with polycystic ovary syndrome (PCOS) have a myriad of phenotypic and clinical features that may guide therapeutic options for metabolic protection and ovulation induction. The use of metformin may prove beneficial in a subset of the population of women with PCOS. Hyperinsulinemia, as demonstrated by elevated insulin levels on a 2-hour 75-g load glucose tolerance test, is an important parameter in deciding whether or not to initiate metformin therapy to women with PCOS with the hope of preventing or delaying the onset of type 2 diabetes mellitus (DM). Cardiovascular risk factors including markers of subclinical inflammation, and dyslipidemia may also be improved by metformin therapy. For ovulation induction, metformin is not as effective as clomiphene citrate as first-line therapy for women with PCOS. There are no clear data to suggest that metformin reduces pregnancy loss or improves pregnancy outcome in PCOS, and it is currently recommended that metformin be discontinued with the first positive pregnancy test result, unless there are other medical indications (eg, type 2 DM). This review addresses practical management guidelines for the uses of metformin in women with PCOS. Continue reading >>

Glucophage (metformin) And Diabetes

Glucophage (metformin) And Diabetes

Tweet Glucophage and Metformin are often mentioned in relation to diabetes treatment. But what exactly is Glucophage and how does Glucophage help control type 2 diabetes? The following guide to Glucophage should help you to understand more about this medication, its side effects and its value. What is Glucophage? Glucophage tablets (and Glucophage SR tablets) each have an active ingredient called Metformin hydrochloride. Metformin is widely used to aid in the control of blood glucose levels amongst people with type 2 diabetes. How does Glucophage help people with type 2 diabetes? Amongst people with type 2 diabetes, the pancreas fails to produce sufficient levels of insulin. Furthermore, the cells in the body may be resistant to any insulin that is present. Normally, insulin would instruct cells to remove sugar from the blood, but in people with diabetes blood sugar levels can climb too high. As we said before, Glucophage contains the ingredient Metformin. Metformin (Metformin hydrochloride) is a type of medicine known as a biguanide. This works to lower the amount of sugar in the blood of people with diabetes. It does this by lowering the amount of sugar produced in the liver, and also increasing the sensitivity of muscle cells to insulin. The cells are therefore more able to remove sugar from the blood. Metformin also slows the absorption of sugars from the intestines. Metformin lowers blood sugar levels between and after meals. Who is Glucophage prescribed to? Glucophage is usually prescribed as a treatment for people with type 2 diabetes who are overweight or obese. When diet and exercise fail to adequately control blood glucose levels, Glucophage is prescribed. Sometimes, this medicine is used in conjunction with other anti-diabetic medication. How often do people Continue reading >>

The Use Of Metformin And The Incidence Of Lung Cancer In Patients With Type 2 Diabetes

The Use Of Metformin And The Incidence Of Lung Cancer In Patients With Type 2 Diabetes

OBJECTIVE Observational studies have associated metformin use with a decreased risk of lung cancer incidence in patients with type 2 diabetes, but the studies had important methodological shortcomings. The objective of this study was to determine whether metformin use is associated with a decreased risk of lung cancer in patients with type 2 diabetes, while avoiding previous biases. RESEARCH DESIGN AND METHODS Using the U.K. General Practice Research Database, we assembled a cohort of patients newly treated with oral hypoglycemic agents (OHAs) between 1988 and 2009. A nested case–control analysis was conducted, where case subjects with lung cancer occurring during follow-up were matched with up to 10 control subjects for age, sex, calendar time, and duration of follow-up. Conditional logistic regression was used to estimate adjusted rate ratios of lung cancer associated with ever use of metformin, along with measures of duration and cumulative dose. Models were adjusted for potential confounders, which included smoking. RESULTS The cohort included 115,923 new users of OHAs, with 1,061 patients diagnosed with lung cancer during follow-up (rate 2.0/1,000 person-years). Metformin use was not associated with a decreased rate of lung cancer (rate ratio 0.94 [95% CI 0.76–1.17]). No dose-response was observed by number of prescriptions received, cumulative duration of use, and dose. CONCLUSIONS Metformin use is not associated with a decreased risk of lung cancer in patients with type 2 diabetes. The decreased risk reported in other observational studies is likely due to bias from methodological shortcomings. Nonetheless, greater consideration should be given to clarify inconsistencies between experimental models and population studies. Metformin, a biguanide derivative, is Continue reading >>

An Old-line Diabetes Drug May Have New Uses Against Diseases Of Aging

An Old-line Diabetes Drug May Have New Uses Against Diseases Of Aging

Just over a year ago, Catherine Price decided to start taking one of the cheapest, safest, oldest, most widely prescribed drugs for Type 2 diabetes. So much metformin is taken in the United States — some 72 million prescriptions were written for it in 2013 — that a recent study found higher trace levels of it (presumably from the urine of people taking it) in Lake Michigan than of any other drug, including caffeine. But Price, a science and medical reporter in Oakland, Calif., doesn’t have Type 2 diabetes. She has Type 1, the far less common form of the disease, which requires lifelong treatment with insulin, to compensate for her body’s failure to produce enough of the hormone. However, she had read studies indicating that metformin combined with insulin might help Type 1 diabetics, too. Moreover, the drug was being studied in clinical trials as a way to lower the risk of cancer, heart disease and dementia — not just for diabetics, but for everyone. For Price, there was yet another possible benefit — as a treatment for polycystic ovary syndrome, an endocrine disorder that doctors thought might explain the difficulty she and her husband had had conceiving. Sure enough, a month and a half after she had started taking metformin pills and even as she was enjoying the benefits of better blood-sugar control, Price became pregnant, eventually giving birth to a girl. “I’m still taking metformin along with my insulin,” said Price, 36, who was diagnosed with Type 1 diabetes 14 years ago. “I remember eating Mexican food one night, which can be a potential disaster for people with diabetes because of the carbs, but I noticed I needed only two-thirds to a half of the insulin I normally needed.” Synthesized in the 1920s, metformin was first approved for treatme Continue reading >>

Metformin: New Understandings, New Uses.

Metformin: New Understandings, New Uses.

Abstract Metformin, a biguanide, has been available in the US for the treatment of type 2 diabetes mellitus for nearly 8 years. Over this period of time, it has become the most widely prescribed antihyperglycaemic agent. Its mechanism of action involves the suppression of endogenous glucose production, primarily by the liver. Whether the drug actually has an insulin sensitising effect in peripheral tissues, such as muscle and fat, remains somewhat controversial. Nonetheless, because insulin levels decline with metformin use, it has been termed an 'insulin sensitiser'. Metformin has also been shown to have several beneficial effects on cardiovascular risk factors and it is the only oral antihyperglycaemic agent thus far associated with decreased macrovascular outcomes in patients with diabetes. Cardiovascular disease, impaired glucose tolerance and the polycystic ovary syndrome are now recognised as complications of the insulin resistance syndrome, and there is growing interest in the management of this extraordinarily common metabolic disorder. While diet and exercise remain the cornerstone of therapy for insulin resistance, pharmacological intervention is becoming an increasingly viable option. We review the role of metformin in the treatment of patients with type 2 diabetes and describe the additional benefits it provides over and above its effect on glucose levels alone. We also discuss its potential role for a variety of insulin resistant and prediabetic states, including impaired glucose tolerance, obesity, polycystic ovary syndrome and the metabolic abnormalities associated with HIV disease. Continue reading >>

Use Of Metformin In The Setting Of Mild-to-moderate Renal Insufficiency

Use Of Metformin In The Setting Of Mild-to-moderate Renal Insufficiency

ADVANTAGES OF METFORMIN There is some evidence that early treatment with metformin is associated with reduced cardiovascular morbidity and total mortality in newly diagnosed type 2 diabetic patients (4). However, the data come from a small subgroup of a much larger trial. In contrast, despite multiple trials of intensive glucose control using a variety of glucose-lowering strategies, there is a paucity of data to support specific advantages with other agents on cardiovascular outcomes (5–7). In the original UK Prospective Diabetes Study (UKPDS), 342 overweight patients with newly diagnosed diabetes were randomly assigned to metformin therapy (8). After a median period of 10 years, this subgroup experienced a 39% (P = 0.010) risk reduction for myocardial infarction and a 36% reduction for total mortality (P = 0.011) compared with conventional diet treatment. Similar benefits were not observed in those randomly assigned to sulfonylurea or insulin. In an 8.5-year posttrial monitoring study, after participants no longer were randomly assigned to their treatments, individuals originally assigned to metformin (n = 279) continued to demonstrate a reduced risk for both myocardial infarction (relative risk 33%, P = 0.005) and total mortality (relative risk 27%, P = 0.002) (9). The latter results are even more impressive when one considers that HbA1c levels in all initially randomly assigned groups had converged within 1 year of follow-up. Unlike sulfonylureas, thiazolidinediones, and insulin, metformin is weight neutral (10), which makes it an attractive choice for obese patients. Furthermore, the management of type 2 diabetes can be complicated by hypoglycemia, which can seriously limit the pursuit of glycemic control. Here, too, metformin has advantages over insulin and some 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 >>

Description And Brand Names

Description And Brand Names

Drug information provided by: Micromedex US Brand Name Fortamet Glucophage Glucophage XR Glumetza Riomet Descriptions Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral antidiabetic medicine called a sulfonylurea, or with insulin, will help to lower blood sugar when it is too high and help restore the way you use food to make energy. Many people can control type 2 diabetes with diet and exercise. Following a specially planned diet and exercise will always be important when you have diabetes, even when you are taking medicines. To work properly, the amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet or exercise, you will want to test your blood sugar to find out if it is too low. Your doctor will teach you what to do if this happens. Metformin does not help patients does not help patients who have insulin-dependent or type 1 diabetes because they cannot produce insulin from their pancreas gland. Their blood glucose is best controlled by insulin injections. This medicine is available only with your doctor's prescription. This product is available in the following dosage forms: Tablet Tablet, Extended Release Solution Copyright © 2017 Truven Health Analytics Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Continue reading >>

Non-diabetic Uses Of Metformin

Non-diabetic Uses Of Metformin

Although the U.S. Food and Drug Administration oversees the safety and effectiveness of drugs prescribed by American doctors, it does not regulate the practice of medicine. So, many medications are used “off-label,” meaning your doctor may prescribe a drug for purposes that have not yet been approved by the FDA. About 1/5 of the prescriptions for common medications are written for an off-label use, according to a 2012 review in “Mayo Clinic Proceedings.” Metformin (Glucophage), a drug licensed to treat type 2 diabetes, has a number of off-label uses. How Metformin Works Metformin is unlike other medications used to treat type 2 diabetes. Although all of its actions are not completely understood, metformin’s main mode of action is to decrease glucose production in your liver. In addition, metformin increases your cells’ sensitivity to the insulin released from your pancreas, which increases your body’s ability to metabolize glucose. Together, these actions reduce your blood glucose level without driving it too low. These same properties make the drug potentially useful in a number of situations. Drug-Induced Weight Gain Atypical antipsychotic medications, such as olanzapine (Zyprexa), are prescribed for managing schizophrenia, bipolar disorder and other conditions. But in many people, these medications cause significant weight gain, which is believed to stem from drug-induced appetite stimulation and insulin resistance. A March 2011 analysis in the “British Journal of Clinical Pharmacology” showed people who gain weight as a result of taking olanzapine may lose some of that weight by also taking metformin. This has important implications for people whose psychiatric conditions cannot be controlled without atypical antipsychotics. Metformin may not be ap Continue reading >>

Proper Use

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 >>

Metformin

Metformin

Metformin may rarely cause a serious, life-threatening condition called lactic acidosis. Tell your doctor if you have kidney disease. Your doctor will probably tell you not to take metformin. Also, tell your doctor if you are over 65 years old and if you have ever had a heart attack; stroke; diabetic ketoacidosis (blood sugar that is high enough to cause severe symptoms and requires emergency medical treatment); a coma; or heart or liver disease. Taking certain other medications with metformin may increase the risk of lactic acidosis. Tell your doctor if you are taking acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), or zonisamide (Zonegran). Tell your doctor if you have recently had any of the following conditions, or if you develop them during treatment: serious infection; severe diarrhea, vomiting, or fever; or if you drink much less fluid than usual for any reason. You may have to stop taking metformin until you recover. If you are having surgery, including dental surgery, or any major medical procedure, tell the doctor that you are taking metformin. Also, tell your doctor if you plan to have any x-ray procedure in which dye is injected, especially if you drink or have ever drunk large amounts of alcohol or have or have had liver disease or heart failure. You may need to stop taking metformin before the procedure and wait 48 hours to restart treatment. Your doctor will tell you exactly when you should stop taking metformin and when you should start taking it again. If you experience any of the following symptoms, stop taking metformin and call your doctor immediately: extreme tiredness, weakness, or discomfort; nausea; vomiting; stomach pain; decreased appetite; deep and rapid breathing or shortness of breath; dizzi Continue reading >>

What Is Metformin? - Definition, Classification & Uses

What Is Metformin? - Definition, Classification & Uses

Metformin is a medication used for type 2 diabetes and two other conditions that benefit from lowering blood sugars. You can learn more about this widely used antidiabetic drug in this lesson. What Is Metformin? Minnie just found out she has diabetes. She is upset because she believes people with diabetes cannot eat any 'white' foods. Buttery mashed potatoes with hot sausage gravy are one of Minnie's favorite indulgences. In addition, her doctor started her on a medication to help manage her type 2 diabetes. Minnie is afraid she won't be able to eat her favorite foods, and the new pill will make her gain weight. As her nurse, you try to ease some of Minnie's fears. You first tell her that she can still have her favorite foods if she eats small amounts and takes her medication called metformin. Metformin is an anti-diabetic medication that reduces the amount of blood sugar (glucose) the liver releases and helps muscles use glucose more effectively. How Does Metformin Work? You begin helping Minnie understand how metformin works by telling her about type 2 diabetes. People use sugar (glucose) for energy. Glucose travels through our bodies in the blood. The pancreas makes a hormone called insulin that allows glucose to travel from the blood into the muscles and organs. If we go a long time without eating and our blood sugar drops, our livers release stored glucose to help with our energy needs. Diabetes results when this carefully balanced system does not work well. Type 2 diabetes (non-insulin dependent) happens when we have too little insulin from our pancreas, and the insulin we have is unable to work effectively, which is called insulin resistance. This makes our blood glucose rise to harmful levels. With type 2 diabetes, our liver may release too much glucose, causing Continue reading >>

Metformin, The Anti-aging Miracle Drug

Metformin, The Anti-aging Miracle Drug

Metformin, The Anti-Aging Miracle Drug Diabetes Drugs Take A BAD RAP This article is part two of a series, for part one, click here. You probably think of Diabetes Drugs as all lumped together as “Bad Drugs”. For many years , I certainly did. Perhaps it was the Avandia story that gave Diabetes Drugs a Bad Rap and made us think poorly of ALL Diabetes Drugs. Upper Left Image: Photo of French Lilac Plant , the plant origin of Metformin, courtesy of Wikimedia Commons. Avandia, the “BAD Drug” for Diabetes Take the case of Avandia, approved in 1999, it quickly became the world’s best selling diabetes drug. However, 8 years later, the New England Journal reported that Avandia causes increased heart attack rates, and sales were suspended in Europe.(1A) In November 2011, GlaxoSmithKline admitted they withheld safety data on Avandia and agreed to pay the US government 3 billion in civil and criminal penalties related to illegal marketing. The Avandia case gave all diabetes drugs a “Bad Rap”. The reality is that there is one diabetes drug that has stood the test of time, and is in fact a “Good Drug”. This is Metformin. Perhaps the plant origin of the drug makes it a “good drug”. Metformin, the “Good Drug” Is There Anyone Who Should not Take It ? At the May 2012 Orlando A4M Meeting, Terry Grossman, M.D. from Golden Colorado gave an excellent presentation on Metformin. Credit and thanks goes to Terry Grossman MD for sharing his talk at the meeting with all of us. Much of this article comes from Grossman’s PowerPoint slides. Dr Terry Grossman is co-author of the Ray Kurzweil book, Fantastic Voyage. Upper Left Image : Photo of Terry Grossman MD, courtesy of Terry Grossman MD. Metformin by Terry Grossman MD- Metformin Discovery and Approval Discovered in the Continue reading >>

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