Coping With The Side Effects Of Metformin
Metformin is prescribed for some people with diabetes to help keep their blood sugar levels under control. Metformin works by encouraging the body to burn energy, leading to lower blood glucose levels. If you take metformin it is usually more effective at lowering blood glucose levels than if you are just careful about what you eat. Nausea Metformin has a number of side effects, the most common of which are gastrointestinal. More than one in 10 people who take metformin experience side effects including nausea, vomiting, diarrhoea, stomach pain, increased flatulence or loss of appetite. More than one in 100 patients who take the medication experience changes to their sense of taste - usually a metallic taste. A number of other very rare symptoms have also been reported. Fewer than one in 10,000 people who take metformin may experience: What to do about side effects All medications take some getting used to. The NHS advises that patients can avoid the more common gastrointestinal side effects by taking the medication during or after a meal. In order to guard against vitamin B12 deficiency - which in rare cases becomes apparent in patients who have taken the medication for a long time - the charity Diabetes UK recommends eating a healthy, balanced diet including foods rich in vitamin B12 such as meat, dairy products and eggs. However, it is not recommended for those prescribed metformin to also take vitamin B12 supplements unless advised to by their doctor. Patients who feel unwell or who are concerned about a side effect should talk to their GP, pharmacist or practice nurse. Immediate medical attention should be sought in cases of breathing difficulties, muscle cramps, stomach pain, weakness or hypothermia, which can be symptoms of lactic acidosis. Continue reading >>
Metformin Side Effects And How To Deal With Them
Metformin side effects include diabetic neuropathy, brain fog, and digestive issues. You can address them through diet, Vitamin B12, CoQ10, and exercise. Let us understand the drug Metformin in detail and study different forms of metformin, its uses and common metformin side effects along with how to deal with them. Metformin: What Is It Used For? Metformin is an old warhorse in the pharma battle against diabetes. It has been the mainstay in the treatment of Type 2 Diabetes for more than fifty years, often matching or outperforming newer drugs. In fact, many new combination drugs are often created with metformin as one of the main ingredients. Thanks to its long run in the pharmaceutical world, the side effects of Metformin are also well known. The Metformin-PCOS connection has been studied extensively since a majority of health complications associated with PCOS (polycystic ovarian syndrome) are due to hyperinsulinemia (high amounts of insulin in the blood stream). Metformin is known to reduce circulating insulin levels. The use of this drug in women with PCOS has shown highly encouraging results. RELATED: 10 Easy Breakfast Ideas For Diabetics Most Prescribed Names in Metformin Category Include: Fortamet: It is an extended-release formulation that contains metformin hydrochloride. The tablets are designed for once-a-day administration. They deliver either 500 mg or 1000 mg of metformin. The tablet is made using a patented technology called SCOTTM that delivers the active compound slowly and at a constant rate. Glucophage: Glucophage tablets contain metformin hydrochoride. They contain either 500 mg, 850 mg or 1000 mg of the active compound. Glucophage tablets do not contain any special covering and need to be taken multiple times a day until the prescribed dosage is me Continue reading >>
How To Treat Diabetic Diarrhea?
I have a problem that I never see addressed. I've had type 1 diabetes for 36 years and been diagnosed as having diabetic diarrhea. Numerous tests have ruled out all other gastrointestinal problems. Is there any treatment for this problem? Continue reading >>
Does Anyone In The Rg Community Know The Mechanism Of Diarrhea Caused By Metformin?
So, apparently Metformin induced diarrhea has a complex but at the same time simple mechanism. It resembles, on a small scale, what we gastroenterologists know as "after bypass surgery dumping syndrome", in which you have a simultaneous osmotic/hipermotility condition. Would it be too much to ask you to provide me w/a reference list in which I could read up on this topic as much as possible? It would be greatly appreciated. As a researcher and clinical gastroenterologist I work w/Metmorfin tolerability, especially diarhrea, that is present between 5-10% of the cases in patients beginning Metformin treatment or in those who are increasing their daily dose. There are also some susceptible ethnic populations such as the mestizo group, which are highly prevalent in most Latin American countries, (Mexico, CA and Pacific Andean Region) who are relatively intolerant to Metformin. As clinicians we usually deal w/this problem by progressively escalating the dose on a weekly basis and in more severe cases by adding on loperamide/psyllum as rescue medication. Now, in order to provide a better and tolerable metformin, first we need to understand what we are dealing with, and second, to work on a different improved delivery system such as NERF "novel extended release fotrmulations" and/or drug combinations. Continue reading >>
Diabetes And The Gastrointestinal Tract
Gastrointestinal (GI) disorders are common among all people, including those affected by diabetes. At some point in any patient's life, the chances that he or she will develop a GI tract problem, be it peptic ulcer disease, gallstones, irritable bowel syndrome, food poisoning, or some other malady, are extremely high. As many as 75% of patients visiting diabetes clinics will report significant GI symptoms. The entire GI tract can be affected by diabetes from the oral cavity and esophagus to the large bowel and anorectal region. Thus, the symptom complex that may be experienced can vary widely. Common complaints may include dysphagia, early satiety, reflux, constipation, abdominal pain, nausea, vomiting, and diarrhea. Many patients go undiagnosed and under-treated because the GI tract has not been traditionally associated with diabetes and its complications. Both acute and chronic hyperglycemia can lead to specific GI complications. Diabetes is a systemic disease that may affect many organ systems, and the GI tract is no exception. As with other complications of diabetes, the duration of the disorder and poor glycemic control seem to be associated with more severe GI problems. Patients with a history of retinopathy, nephropathy, or neuropathy should be presumed to have GI abnormalities until proven otherwise, and this is best determined by asking a few simple questions. (See "Patient Information".) Many GI complications of diabetes seem to be related to dysfunction of the neurons supplying the enteric nervous system. Just as the nerves in the feet may be affected in peripheral neuropathy, involvement of the intestinal nerves may lead to enteric neuropathy. This is a type of autonomic or "involuntary" neuropathy and may lead to abnormalities in intestinal motility, sensat Continue reading >>
Metformin And The Gastrointestinal Tract
Go to: Introduction Metformin—dimethylbiguanide—is an oral glucose-lowering agent. Its origins can be traced to Galega officinalis, also known as French lilac or goat’s rue [1]. In the early 20th century it was noted to lower blood glucose concentrations in animals, but it was not until the 1950s that Jean Sterne studied dimethylbiguanide and subsequently developed ‘Glucophage’ [2]. Over the last 15 years, metformin has become the first-line agent for the treatment of type 2 diabetes, as noted in several international guidelines, including the ADA-EASD guidelines [3]. Metformin has had a chequered history—it was initially eclipsed by phenformin, which was withdrawn in the late 1970s after it was discovered to be associated with lactic acidosis [4]. The lower propensity of metformin for hyperlactataemia [5] and success in several large randomised controlled clinical trials, such as the UK Prospective Diabetes Study (UKPDS) [6], confirmed its clinical benefit. It is widely recognised that metformin improves glycaemic control with a good safety profile, weight neutrality or weight loss, lack of associated hypoglycaemia, reduced cardiovascular mortality and low cost [3]. However, a large proportion of patients cannot tolerate the medication in adequate amounts because of its associated side effects. Up to 25% of patients suffer metformin-associated gastrointestinal (GI) side-effects, with approximately 5% unable to tolerate metformin at all [7]. In addition to this interindividual variation in side effects, there is variability in the efficacy of metformin. There are likely to be a number of factors to account for this variability in efficacy, for example, our group (Zhou et al) recently established that the glycaemic response to metformin is moderately heritabl Continue reading >>
Gastrointestinal Tolerability Of Extended-release Metformin Tablets Compared To Immediate-release Metformin Tablets: Results Of A Retrospective Cohort Study
Objective: Metformin, a biguanide antihyperglycemic medication, lowers blood glucose in patients with type 2 diabetes with minimal risk of hypoglycemia. Most common side effects include diarrhea, nausea and vomiting. Extended-release metformin (Glucophage XR)*, a once-daily tablet using the patented GelShield Diffusion System release mechanism, may be better tolerated than immediate-release metformin (Glucophage). This retrospective chart review examined the overall gastrointestinal (GI) tolerability of both formulations. Research Design and Methods: Patient charts were reviewed and data were collected from October 2001 to May 2002. Adult patients with type 2 diabetes started on extended-release metformin (metformin-XR) or switched from immediate-release metformin to metformin-XR within the previous 2 years were eligible for inclusion in the metformin-XR cohort. Patients started on immediate-release metformin within the previous 2 years were eligible for inclusion in the immediate-release metformin cohort. Previous experience of GI side effects while taking immediate-release metformin did not prevent inclusion in either cohort, though patients with significant underlying GI disease or moderate to severe hepatic or renal impairment were excluded. GI tolerability was assessed during the first year of treatment with immediate-release metformin or metformin-XR. Primary endpoints were overall GI tolerability and frequency of diarrhea during the first year of treatment. Results: A total of 471 patients' charts were reviewed and data were collected from four diabetes clinics; 310 (metformin-XR) and 158 (immediate-release metformin) eligible patients were included. Patients were, on average, 56 years old, and overweight (mean body mass index 33 kg/m2). The majority of patients Continue reading >>
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Diagnostic accuracy of resting systolic toe pressure for diagnosis of peripheral arterial disease in people with and without diabetes: a cross-sectional retrospective case-control study
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
Diabetes Drugs: Metformin
Editor’s Note: This is the second post in our miniseries about diabetes drugs. Tune in on August 21 for the next installment. Metformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U.S. market in 1977. This situation most likely slowed the approval of metformin, which was not used in the U.S. until 1995. (By comparison, metformin has been used in Europe since the 1960’s.) The U.S. Food and Drug Administration (FDA) required large safety studies of metformin, the results of which demonstrated that the development of lactic acidosis as a result of metformin therapy is very rare. (A finding that has been confirmed in many other clinical trials to date.) Of note, the FDA officer involved in removing phenformin from the market recently wrote an article highlighting the safety of metformin. Metformin works primarily by decreasing the amount of glucose made by the liver. It does this by activating a protein known as AMP-activated protein kinase, or AMPK. This protein acts much like an “energy sensor,” setting off cellular activities that result in glucose storage, enhanced entry of glucose into cells, and decreased creation of fatty acids and cholesterol. A secondary effect of the enhanced entry of glucose into cells is improved glucose uptake and increased storage of glycogen (a form of glucose) by the muscles. Additionally, the decrease in fatty acid levels brought about by metformin may indirectly improve insulin resistance and beta cell func Continue reading >>
Folate-producing Probiotics May Help With Gastrointestinal Side Effects Of Metformin
New research suggest that specific probiotics formulated to stimulate the production of folate (also know as vitamin B9) in the colon might help alleviate metformin-associated gastrointestinal adverse effects. Gastrointestinal distress, which can manifest as stomach pain, bloating, gas, diarrhea or constipation, is one of the most common side effects of the type 2 diabetes drug metformin. It is thought that metformin can cause gastrointestinal problems by inducing an imbalance in gut bacteria. Specifically, metformin affects or reduces the limited number of bacteria able to produce folate. At the same time, metformin tends to decrease the absorption of folic acid, which is the synthetic form of folate that can be taken via pills or supplements. Therefore, metformin has not only an inhibitory effect on the production of folate in the colon but also reduces its bioavailability from other sources. Folate deficiency has been linked to inflammatory bowel disease (IBD) and the occurence of gastrointestinal symptoms, including abdominal pain and diarrhea, especially after meals. Several probiotic strains of bacteria are able to produce folate. For example, bifidobacteria and lactobacilli-containing probiotics have been extensively studied for their capacity to produce this vitamin. In this new scientific research proposal, a researcher from Istanbul Kemerburgaz University, in Turkey, chose to focus on a probiotic bacteria called Intestinibacter Bartlettii, whose count is significantly lowered with metformin treatment. The idea of biochemist Adbullah Olgun is to engineer this bacteria so that it is resistant to metformin and a greater folate producer by means of complex procedures and genetic manipulations. Then, it could be made into a probiotic for metformin users. The preven Continue reading >>
Metformin And Digestive Disorders.
1. Diabetes Metab. 2011 Apr;37(2):90-6. doi: 10.1016/j.diabet.2010.11.002. Epub 2011Jan 13. (1)Service de gastroentrologie, hpital Avicenne, AP-HP, universit Paris-V Ren-Descartes, 125, route de Stalingrad, 93009 Bobigny, France. Digestive disorders (diarrhoea, vomiting) represent the most common metforminside-effects (around 30%) with this first-line drug treatment for type 2diabetes. In healthy individuals, metformin affects glucose, vitamin B12 and the digestive uptake of bile salts. In the colon, it acts locally by modifyingglucose cell metabolism. Different pathophysiological hypotheses have beenproposed to explain the metformin-induced diarrhoea and vomiting, which cansometimes cause the patient to stop an effective treatment. These theoriesinclude stimulation of intestinal secretion of serotonin, changes in incretin andglucose metabolism, and bile-salt malabsorption. However, none of thesehypotheses can be considered an adequate pathophysiological explanation ofmetformin digestive side-effects. In addition, there is a lack of experimentaldata to explain these highly patient-dependent adverse effects.Copyright 2010 Elsevier Masson SAS. All rights reserved. Continue reading >>
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 >>
Relief For Diabetes Stomach Pain
Managing diabetes often brings changes in what we eat and the medications we take. You may also notice some changes in how your gut, or gastrointestinal (GI) tract, feels, sounds, and responds. Changes in eating You are likely making changes in eating habits, including more foods rich in fiber, such as fruits, vegetables, and beans. Fiber can be filling without adding unwanted calories, and it can help improve abnormal cholesterol levels. But there may be a few uh-ohs if you rapidly increase the amount you eat. "Gas and bloating are a side effect of fiber," says Judith Wylie-Rosett, Ed.D., R.D., professor of health promotion and nutrition research at Albert Einstein College of Medicine in Bronx, New York. "Increasing your intake gradually may help." She suggests adding legumes, such as beans and lentils, to increase dietary fiber. "Throwing out the water you soak them in and giving them an extra rinse before cooking may also help decrease the gas and bloating," she says. Glucose-lowering meds Several prescription medications used to lower blood glucose levels in type 2 diabetes can stir up your gut. Experts tend to suggest that you start with a low dose and slowly increase it based on your provider's instructions. Metformin Metformin, the typical starting medication in type 2 diabetes to bring blood glucose levels in range, can lead to heartburn, nausea, or diarrhea. Ralph DeFronzo, M.D., professor of medicine and chief of the diabetes division at the University of Texas Health Science Center at San Antonio, says, "I try to use metformin in all of my patients who have type 2 diabetes. When there is a problem, it is diarrhea and abdominal discomfort. There are 5-10 percent of people who just can't tolerate it." Typically, metformin is started at a low dose and increased Continue reading >>
Metformin And The Stomach Issues That Go Along W... | Diabetic Connect
A friend told me something that was really helpful: Metformin needs LARGE amounts of water and HATES anything buttery or greasy. That's helped me out a LOT when dealing with the fun side-effects of Met. However, I will say that I ended up having to a slow-step-up on my Met dosage (I cut the pills in half and took basically a half-dose for about 2 weeks before going to a 3/4 dose for another week then finally going to a full dose/day [2 pills]). I still have some problems, but not nearly what I was having and only when I eat certain foods. That list you're on is kind of insane, but I hope it works for your BGs. I'm starting Junuvia on Sunday with the Met. Will let ya know how it goes. They made a wholesale change in my meds yesterday. They took me off of the Invokamet and put me on Invokana and Metformin plus a once a week shot called Trulicity. And added Crestor and something for triglycerides. I find that getting adequate FIBER at least 20 grams a daymore if you candoes a great deal to mitigate the GI effects of Metfartin. I still get the fart attacks now and then, but not the explosive problem you are probably having at the moment. I am with these guys, I believe your stomach trouble will eventually calm down. I had that trouble to at first, I think most people do when they start metformin . It can frequently take a couple of weeks to adjust. If you find that it is to difficult to continue, maybe you can have your doctor temporarily lower your dose. Depends on what dosage you were started at. Stomach issues were immediate for me when I started taking it. After maybe 2 months I somewhat adjusted and switched over to the XR version. Took myself off of it in August because of the massive, massive hair loss it cursed me with. I went through the same thing you are going t Continue reading >>
Metformin (glucophage) Side Effects & Complications
The fascinating compound called metformin was discovered nearly a century ago. Scientists realized that it could lower blood sugar in an animal model (rabbits) as early as 1929, but it wasn’t until the late 1950s that a French researcher came up with the name Glucophage (roughly translated as glucose eater). The FDA gave metformin (Glucophage) the green light for the treatment of type 2 diabetes in 1994, 36 years after it had been approved for this use in Britain. Uses of Generic Metformin: Glucophage lost its patent protection in the U.S. in 2002 and now most prescriptions are filled with generic metformin. This drug is recognized as a first line treatment to control blood sugar by improving the cells’ response to insulin and reducing the amount of sugar that the liver makes. Unlike some other oral diabetes drugs, it doesn’t lead to weight gain and may even help people get their weight under control. Starting early in 2000, sales of metformin (Glucophage) were challenged by a new class of diabetes drugs. First Avandia and then Actos challenged metformin for leadership in diabetes treatment. Avandia later lost its luster because it was linked to heart attacks and strokes. Sales of this drug are now miniscule because of tight FDA regulations. Actos is coming under increasing scrutiny as well. The drug has been banned in France and Germany because of a link to bladder cancer. The FDA has also required Actos to carry its strictest black box warning about an increased risk of congestive heart failure brought on by the drug. Newer diabetes drugs like liraglutide (Victoza), saxagliptin (Onglyza) and sitagliptin (Januvia) have become very successful. But metformin remains a mainstay of diabetes treatment. It is prescribed on its own or sometimes combined with the newer d Continue reading >>
Metformin And Digestive Disorders
Digestive disorders (diarrhoea, vomiting) represent the most common metformin side-effects (around 30%) with this first-line drug treatment for type 2 diabetes. In healthy individuals, metformin affects glucose, vitamin B12 and the digestive uptake of bile salts. In the colon, it acts locally by modifying glucose cell metabolism. Different pathophysiological hypotheses have been proposed to explain the metformin-induced diarrhoea and vomiting, which can sometimes cause the patient to stop an effective treatment. These theories include stimulation of intestinal secretion of serotonin, changes in incretin and glucose metabolism, and bile-salt malabsorption. However, none of these hypotheses can be considered an adequate pathophysiological explanation of metformin digestive side-effects. In addition, there is a lack of experimental data to explain these highly patient-dependent adverse effects. The full text of this article is available in PDF format. Les troubles digestifs (diarrhée, vomissements) sous metformine représentent l’effet indésirable le plus fréquent (environ 30 %) pour le médicament de référence du diabète de type 2. Chez l’individu non diabétique, la metformine agit sur l’absorption digestive du glucose, de la vitamine B12 et des sels biliaires. Pour le côlon, elle agit localement en modifiant le métabolisme cellulaire. Différentes hypothèses physiopathologiques peuvent expliquer les diarrhées et vomissements qui peuvent obliger le patient à cesser un traitement efficace: stimulation de la sécrétion intestinale de sérotonine, modification des incrétines et du métabolisme du glucose ou malabsorption des sels biliaires. Aucune de ces hypothèses ne peut être considérée comme l’explication physiopathologique des effets secondaires Continue reading >>
