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Anti-diabetes And Anti-obesity Medications: Effects On Weight In People With Diabetes

Anti-diabetes And Anti-obesity Medications: Effects On Weight In People With Diabetes

Choosing medications for people with diabetes involves consideration of a number of factors, including effects on weight. Improvements in glucose control are often linked to weight gain, but this does not have to be the inevitable result of diabetes treatment. Adding a drug that either promotes weight-loss or is weight neutral to one that promotes weight gain and providing medical nutrition therapy can be considered. The current approach to the treatment of both type 1 and type 2 diabetes is to achieve the best possible glucose control. Past clinical trials have shown that glycemia plays a key role in the prevention of both macro- and microvascular complications.1–5 The current American Diabetes Association (ADA) guidelines suggest a glycemic goal of having a hemoglobin A1c (A1C) < 7%, but also state that an A1C of ≤ 6% should be a goal if it can be achieved without risk of complications.6,7 During the past 20 years, a number of new medications to control blood glucose have been introduced, and new approaches to the use of older medications have been developed. In prescribing any medication, however, one must consider benefits versus risks. In terms of the treatment of hyperglycemia, certainly toxic side effects are of concern, as is hypoglycemia. One major area of concern, however, is the effect of such drugs on weight. Weight and diabetes, especially type 2 diabetes, are closely related. Obesity is a major risk factor for the development of type 2 diabetes, and the current increase in obesity in our society has fueled a major increase in the expression of this disease.8 Not only does weight, through the mechanism of insulin resistance, aggravate hyperglycemia, it also increases the risk for hypertension, hyperlipidemia, and other conditions that lead to cardiovasc Continue reading >>

Therapeutic Use Of Metformin In Prediabetes And Diabetes Prevention

Therapeutic Use Of Metformin In Prediabetes And Diabetes Prevention

Go to: Pathophysiology and Diagnosis of Prediabetes The defects in glucose metabolism that underlie type 2 diabetes begin many years before the diagnosis of diabetes is made [6, 7]. The development of insulin resistance, in which the action of insulin on glucose metabolism is blunted, occurs early in the pathogenesis of dysglycaemia. Increased secretion of insulin initially compensates for the presence of insulin resistance; however, a simultaneous and progressive loss of β-cell mass and β-cell function limits the ability of the pancreas to maintain euglycaemia by increasing insulin secretion [8]. The early manifestations of prediabetic dysglycaemia represent one or both of [9]: impaired glucose tolerance (IGT), in which postprandial glucose control is impaired but fasting plasma glucose (FPG) is normal; impaired fasting glucose (IFG), in which a chronic elevation of FPG occurs in the absence of a deterioration in postprandial glucose control. Table 1 shows the usually accepted diagnostic criteria for the diagnosis of prediabetes based on measurements of glycaemia [4, 8–10]. A simple blood test is sufficient to diagnose IFG, while a 75 g oral glucose tolerance test (OGTT) is required for the diagnosis of IGT. The originally used cutoff level for IFG (110 mg/dL [6.1 mmol/L]) was reduced to that shown in Table 1 (100 mg/dL [5.6 mmol/L]) by an Expert Committee of the American Diabetes Association in 2003, in order to equalise the prognostic impact of diagnosis of IFG or IGT, in terms of the future risk of diabetes in a subject with either condition [11]. It should be noted that the World Health Organization (WHO) diagnostic criteria for IFG retains the 110 mg/dL (6.1 mmol/L) cutoff value for diagnosing IFG [12]. Diagnostic criteria from the American Diabetes Associatio Continue reading >>

A Complete List Of Diabetes Medications

A Complete List Of Diabetes Medications

Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. This happens when your body can’t make or use insulin like it’s supposed to. Insulin is a substance that helps your body use the sugar from the food you eat. There are two different types of diabetes: type 1 diabetes and type 2 diabetes. People with both types of diabetes need medications to help keep their blood sugar levels normal. The types of drugs that can treat you depend on the type of diabetes you have. This article gives you information about drugs that treat both types of diabetes to help give you an idea of the treatment options available to you. Insulin Insulin is the most common type of medication used in type 1 diabetes treatment. It’s also used in type 2 diabetes treatment. It’s given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include: Short-acting insulin regular insulin (Humulin and Novolin) Rapid-acting insulins Intermediate-acting insulin Long-acting insulins Combination insulins NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart) Humalog Mix 75/25 (insulin lispro protamine-insulin lispro) Humalog Mix 50/50 (insulin lispro protamine-insulin lispro) Humulin 70/30 (human insulin NPH-human insulin regular) Novolin 70/30 (human insulin NPH-human insulin regular) Ryzodeg (insulin degludec-insulin aspart) Amylinomimetic drug Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism. Most medications for type 2 diabetes are o Continue reading >>

Metformin For Prediabetes

Metformin For Prediabetes

Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it? For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl. Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%. But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for t Continue reading >>

Anti-diabetic Drugs

Anti-diabetic Drugs

Tweet Antidiabetic drugs are medicines developed to stabilise and control blood glucose levels amongst people with diabetes. Antidiabetic drugs are commonly used to manage diabetes. There are a number of different types of antidiabetic drug including: Insulin Pramlintide (Amylin) GLP-1 receptor agonists (such as Byetta and Victoza) Oral hypoglycemics (tablets) Antidiabetic drugs for type 1 diabetes For people with type 1 diabetes, daily insulin injections are essential to maintain health. Type 1 diabetics must also eat properly, keep blood glucose levels from going too low or too high, and monitor blood sugar levels. In America, pramlintide, marketed as Amylin, is used in addition to insulin by some people with type 1 diabetes to further help control their diabetes. Amylin is not currently prescribed in the UK. Antidiabetic drugs for type 2 diabetes For people with type 2 diabetes, diet and exercise may be enough to control blood glucose levels in some. However, when diet and exercise is no longer efficient, anti-diabetic drugs may be prescribed. Medication will either be taken orally in the form of tablets (oral hypoglycemics), or be injected (insulin and GLP-1 receptor agonists). Read more about oral hypoglycemics Antidiabetic treatment considerations for type 2 diabetes Biguanides, such as Metformin, are commonly prescribed as a first antidiabetic medication. If biguanides are not effective on their own you may be given alternative medication either instead of, or in addition to, biguanides. The type of medication you are offered could depend on a variety of factors as different medication have different advantages and disadvantages. Some common factors that your doctor will consider are as follows: How effective is the medication for reducing blood sugar levels? Wil Continue reading >>

Oral Antidiabetic Drugs And Regression From Prediabetes To Normoglycemia: A Meta-analysis.

Oral Antidiabetic Drugs And Regression From Prediabetes To Normoglycemia: A Meta-analysis.

Abstract BACKGROUND: Impaired glucose tolerance, impaired fasting glucose, and elevated hemoglobin A(1c) are intermediate stages, considered prediabetes, a precursor to overt type 2 diabetes mellitus. Prediabetes is associated with increased risk for cardiovascular disease, independent of diabetes development. Data have shown that various oral antidiabetic drugs can help people regress from prediabetes to normoglycemia. OBJECTIVE: To evaluate the efficacy of oral antidiabetic drugs in promoting regression from prediabetes to normoglycemia. METHODS: MEDLINE (1950-November 2011), EMBASE (1990-November 2011), and Cochrane Central Register of Controlled Trials (indexed September 2011) were systematically searched. A manual search of references from reports of clinical trials and review articles was performed to identify additional relevant studies. Randomized controlled trials 12 weeks or more in duration evaluating any of the oral antidiabetic drugs and studying regression from prediabetes to normoglycemia were included. A random-effects model was used to calculate pooled odds ratios with 95% confidence intervals. RESULTS: Thirteen studies (N = 11,600 participants) were included in the meta-analysis. Use of oral antidiabetic drugs in prediabetic patients was shown to double the odds of achieving normoglycemia compared to controls (OR 2.03, 95% CI 1.54 to 2.67). When individual classes of oral antidiabetic drugs were evaluated, use of thiazolidinediones (OR 2.33, 95% CI 1.93 to 2.81) and α-glucosidase inhibitors (OR 2.02, 95% CI 1.26 to 3.24) was associated with significantly increased odds. However, biguanides (OR 2.04) and sulfonylureas (OR 1.84) failed to reach statistical significance (p = 0.06 and p = 0.39, respectively). CONCLUSIONS: In patients with prediabetes, ora Continue reading >>

Are There Any Medications For Prediabetes?

Are There Any Medications For Prediabetes?

Yes. No. Kinda. OK, here’s the deal, the FDA hasn’t actually approved any medications for prediabetes, but doctors commonly prescribe two classes of medications “off label” to help treat the condition. The first class are thiazolidinediones, conveniently called TZDs, such as Actos. These are basically anti-insulin resistance medications. As prediabetes is a growing problem of insulin resistance, a medication to fight insulin resistance is a logical fit to try and prevent what we call conversion—that is moving from prediabetes to full-blown diabetes. The thought is that by reducing insulin resistance you can reduce overwork on the part of the pancreas (which is working overtime to try and overwhelm the insulin resistance) and thus delay the “burnout” of the pancreas that causes diabetes. The other class of drugs that seem to help are biguanides, such as Metformin. Met has a small effect on insulin resistance but for the most part attacks another part of the prediabetes equation which is the liver’s tendency to over produce hormones that raise the blood sugar level. There is also one other prescription for prediabetes that isn’t really a medication at all, but it works very well, and that is to lose some weight. Most people with prediabetes are overweight (you know who you are), and the more you weigh the more resistant your body is to the insulin you make, which means you need to make more, and so on. Hold on, hold on. Don’t stop reading yet! I can feel you tuning me out! I didn’t say you have to get skinny and svelte. Every little bit of weight you lose can lower your insulin resistance. Another way of thinking about that is that each pound you drop pushes diabetes further into the future. And that’s a prescription worth filling. Continue Learnin Continue reading >>

Metformin: Improving Insulin Sensitivity

Metformin: Improving Insulin Sensitivity

Metformin is the only medication in the biguanides category of blood glucose-lowering drugs approved by the U.S. Food and Drug Administration (FDA). Metformin has been available in the United States since the mid-1990s, when it received FDA approval. You may also know it by its brand name when it was under patent, Glucophage. Metformin is now widely available as a relatively inexpensive generic medication. Metformin’s main action is to decrease the overproduction of glucose by the liver, a common problem in prediabetes and type 2 diabetes. The action of metformin helps lower blood sugar levels particularly during the night to keep fasting glucose levels under control, but it also helps control blood glucose throughout the day. Metformin also increases the uptake of glucose by your muscles. Overall, metformin decreases insulin resistance and improves insulin sensitivity, thereby helping the insulin your body still makes work more effectively. People with prediabetes and in the early years of type 2 diabetes often continue to make some insulin, just not enough to control blood sugar levels alone. Metformin is not formally approved for use in prediabetes, and any use to treat prediabetes is considered off-label by providers. Since its approval, metformin has become the most commonly recommended blood glucose-lowering medication to treat type 2 diabetes. In recent years it has significantly replaced sulfonylureas, such as glipizide and glyburide. Today both the American Diabetes Association (ADA), the European Association for the Study of Diabetes (EASD), and the American Association of Clinical Endocrinologists (AACE) generally recommend that people with type 2 diabetes start taking metformin when they are diagnosed to help treat insulin resistance and maximize insulin s Continue reading >>

Weight Loss Drug Could Prevent Type 2 Diabetes - And Reverse High Blood Sugar

Weight Loss Drug Could Prevent Type 2 Diabetes - And Reverse High Blood Sugar

The drug - liraglutide - which increases the amount of appetite-suppressing hormones produced by the gut, was tested on overweight people with prediabetes. This is also known as ‘borderline diabetes,’ and is characterised by slightly increased blood sugar levels. The condition often leads to type 2 diabetes when untreated. Prediabetes affects one in ten people in the UK, and progresses into diabetes in five to ten per cent of patients within ten years. Prediabetes is curable with exercise and a healthier diet, but once it progresses into diabetes, it is significantly harder to treat. Both conditions are linked to poor health - causing condition such as nerve damage, blindness and even amputation. Professor Carel le Roux from Imperial College London and her team have found that a drug already used for obesity and diabetes can help to prevent progression into diabetes when combined with diet and exercise, and could even cure patients of prediabetes altogether. The researchers recruited 2,254 obese adults with prediabetes at 191 research sites in 27 countries worldwide. After splitting participants into two groups, they studied whether adding daily self-administered injections of liraglutide to diet and exercise helped to prevent progression into diabetes, compared to diet and exercise alone. After three years, the researchers found that the patients given liraglutide were 80 per cent less likely to develop diabetes than those in the placebo group. In 60 per cent of those patients, prediabetes was reversed and patients returned to healthy blood sugar levels Fri, August 19, 2016 Diabetes is a common life-long health condition. There are 3.5 million people diagnosed with diabetes in the UK and an estimated 500,000 who are living undiagnosed with the condition. Liraglutid Continue reading >>

Diagnosis

Diagnosis

Print The American Diabetes Association (ADA) recommends that blood glucose screening for adults begin at age 45, or sooner if you are overweight and have additional risk factors for prediabetes or type 2 diabetes. There are several blood tests for prediabetes. Glycated hemoglobin (A1C) test This test indicates your average blood sugar level for the past two to three months. Specifically, the test measures the percentage of blood sugar attached to the oxygen-carrying protein in red blood cells (hemoglobin). The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. In general: An A1C level below 5.7 percent is considered normal An A1C level between 5.7 and 6.4 percent is considered prediabetes An A1C level of 6.5 percent or higher on two separate tests indicates type 2 diabetes Certain conditions can make the A1C test inaccurate — such as if you are pregnant or have an uncommon form of hemoglobin (hemoglobin variant). Fasting blood sugar test A blood sample is taken after you fast for at least eight hours or overnight. In general: A fasting blood sugar level below 100 milligrams per deciliter (mg/dL) — 5.6 millimoles per liter (mmol/L) — is considered normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 7.0 mmol/L) is considered prediabetes. This result is sometimes called impaired fasting glucose. A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher indicates type 2 diabetes. Oral glucose tolerance test This test is usually used to diagnose diabetes only during pregnancy. A blood sample is taken after you fast for at least eight hours or overnight. Then you'll drink a sugary solution, and your blood sugar level will be measured again after two hours. In general: A blood sugar level less than 140 mg/dL (7.8 mmo Continue reading >>

Pre-diabetes

Pre-diabetes

What Is It? In pre-diabetes, blood sugar levels are slightly higher than normal, but still not as high as in diabetes. If diabetes is "runaway blood sugar" think of pre-diabetes as blood sugar that is "halfway out the door." People almost always develop pre-diabetes before they get type 2 diabetes. The rise in blood sugar levels that is seen in pre-diabetes starts when the body begins to develop a problem called "insulin resistance." Insulin is an important hormone that helps you to process glucose (blood sugar). If usual amounts of insulin can't trigger the body to move glucose out of the bloodstream and into your cells, then you have insulin resistance. Once insulin resistance begins, it can worsen over time. When you have pre-diabetes, you make extra insulin to keep your sugar levels near to normal. Insulin resistance can worsen as you age, and it worsens with weight gain. If your insulin resistance progresses, eventually you can't compensate well enough by making extra insulin. When this occurs, your sugar levels will increase, and you will have diabetes. Depending on what a blood sugar test finds, pre-diabetes can be more specifically called "impaired glucose (sugar) tolerance" or "impaired fasting glucose." Impaired fasting glucose means that blood sugar increase after you haven't eaten for a while – for example, in the morning, before breakfast. Impaired glucose tolerance means that blood sugar levels reach a surprisingly high level after you eat sugar. To diagnose impaired glucose tolerance, doctors usually use what is called a "glucose tolerance test." For this test you drink a sugary solution, and then you have blood drawn after a short time. Having pre-diabetes does not automatically mean you will get diabetes, but it does put you at an increased risk. Pre- Continue reading >>

Diabetes Medication - Guides And Information

Diabetes Medication - Guides And Information

Tweet Diabetes medications are a common form of treatment for people with diabetes. There are many different types of diabetes medicines, or anti-diabetic drugs, and this includes insulin, which has its own area within the site. Whilst each drug is unique in the way it works to help patients with diabetes keep their condition under control, some act similarly to one other and are grouped in the same class of drugs. The way in which they are administered can also differ, with some medicines taken orally and others injected directly into the blood. Are diabetes drugs suitable for all diabetics? Most diabetes drugs are designed for people with type 2 diabetes who are unable to control their blood sugar levels through strict diet and exercise alone. But some, such as metformin, are sometimes taken alongside insulin treatment for people with type 1 diabetes. Medication guides Explore the 18 most common medications for diabetes: Assists insulin in controlling post-meal glucose levels. Can more than one drug be taken at the same time? Depending on individual circumstances, a GP may prescribe more than one anti-diabetic drug to help treat a patient’s diabetes. Watch the video below for more information on the types of diabetes medication available. What are the side effects of anti-diabetic medicines? As with any type of medication, blood glucose-lowering drugs can have a number of side effects. These potentially harmful effects are listed in the patient information leaflet that accompanies the medication, so make sure you check this before starting your drug treatment. You may not experience any of the adverse effects listed, but if you do, consult your doctor and/or diabetes care team as they may be able to suggest another suitable medication for your condition. They will a Continue reading >>

Experts Recommend Two-pronged Approach To Treating Prediabetes

Experts Recommend Two-pronged Approach To Treating Prediabetes

According to the most recent data compiled by the CDC, 57 million U.S. adults have prediabetes, a figure that has reached pandemic levels. “In an ideal world, you want to diagnose high-risk people early in order to prevent progression to full-blown diabetes and its associated complications,” Glenn Matfin, MD, clinical associate professor at New York University and senior staff physician at the Joslin Diabetes Center, told Endocrine Today. Whether prediabetes progresses to diabetes depends on a number of variable factors, including lifestyle changes, genetics and treatment practices, which have some physicians supporting the use of medication and others vehemently against it. “We draw lines in order to differentiate between normal glucose tolerance, prediabetes and diabetes, but it is an interlinked, continuous chain,” Matfin said. “The clock is ticking, and the health risks rise significantly as prediabetes goes untreated.” To examine the current state of prediabetes treatment, Endocrine Today spoke with a number of experts to best understand how lifestyle and pharmacological approaches should be utilized to reverse glucose functions to normal levels. The issue is also examined from a financial aspect, as the ability to keep patients with prediabetes from turning into patients with diabetes translates into hundreds of millions of dollars saved in health care costs. Ralph DeFronzo, MD, and diabetes experts discuss preferred therapeutic approaches for people with prediabetes. Perhaps due to its subtle set of symptoms, the identification and diagnosis of patients with prediabetes has proved to be a challenge. Research has shown that although 30% of the U.S. population had prediabetes in 2005 to 2006, only 7.3% were aware that they had it. A consensus from diabe Continue reading >>

Get Unlimited Access On Medscape.

Get Unlimited Access On Medscape.

WARNING: RISK OF THYROID C-CELL TUMORS In rodents, semaglutide causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures. It is unknown whether Ozempic® causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined. Ozempic® is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Ozempic® and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Ozempic®. Ozempic® is not recommended as a first-line therapy for patients who have inadequate glycemic control on diet and exercise because of the uncertain relevance of rodent C-cell tumor findings to humans. Ozempic® has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Ozempic® is not a substitute for insulin. Ozempic® is not indicated for use in patients with type 1 diabetes mellitus or for the treatment of patients with diabetic ketoacidosis. Pancreatitis: Acute and chronic pancreatitis have been reported in clinical studies. Observe patients carefully for signs and symptoms of pancreatitis (persistent severe abdominal pain, sometimes radiating to the back with or without vomiting). If pancreatitis is suspected, discontinue Ozempic® promptly and if pancreatitis is confirmed, do not restart. Diabetic Ret Continue reading >>

Why All Diabetics Should Know About Turmeric

Why All Diabetics Should Know About Turmeric

By Sayer Ji • Originally published on GreenMedInfo.com Many diabetics already know about the benefits of a low-glycemic diet, but why haven’t they heard about turmeric, one of the world’s most extensively researched anti-diabetic plants? A recent literature review published in the International Journal of Endocrinology and Metabolism titled, “Anti-Hyperglycemic Effect and Insulin Sensitizing Effects of Turmeric and Its Principle Constituent Curcumin,” adds promising new support to the notion that the ancient Indian spice turmeric may provide an ideal drug alternative to treating and perhaps even preventing type 2 diabetes, which has become of the world’s most prevalent diagnoses. The study reviewed research published between 1998 to 2013 that indicates the active polyphenol in turmeric known as curcumin may provide an ideal intervention for type 2 diabetes, capable of mitigating characteristic pathophysiological hallmarks of the disease such as elevated blood sugar (hyperglycemia) and insulin resistance. Nineteen of the studies reviewed were cell (in vitro) and animal (in vivo), all which showed beneficial effects. Five of the studies were human clinical trials using turmeric or curcumin, three of which were performed in those with either diabetes or prediabetes. Amazingly, the animal and cell research literature review concluded that curcumin could improve the type 2 diabetic state through 10 distinctly different mechanisms, such as: Reduction in liver glucose production Reduction in liver glycogen production Stimulation of increased glucose uptake (by increasing GLUT4, GLUT2 and GLUT3 gene expressions) Increasing the activation of AMP kinase Promoting PPAR γ ligand- binding activity Suppressing hyperglycemia-induced inflammatory state Stimulating insulin Continue reading >>

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