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How Does Metformin Work With Insulin Resistance?

Could Metformin Actually Make Insulin Resistance Worse?

Could Metformin Actually Make Insulin Resistance Worse?

Polycystic Ovarian Syndrome, or PCOS, and Insulin Resistance (IR) often occur simultaneously. While the connection between these two conditions is, as of yet, not entirely clear, researchers have determined that IR can lead to PCOS and diabetes.1 Metformin, or Glucophage, is commonly prescribed for both of these disorders, as it is assumed to reduce IR and improve the symptoms associated with it (such as high blood sugar). Understanding the Fine Print Although Metformin claims to reduce IR, current labeling laws do not require pharmaceutical companies to reveal how their products achieve results, they simply must accurately represent what kind of results can be expected from their medications.2 This pharmaceutical, in particular, lowers blood sugar using less insulin, which has been taken to mean that it reduces IR.2 This may not be the case. How Does Metformin Really Work? Diabetes Update, a blog that reviews diabetes medications and treatment options, has published some interesting findings pertaining to how Metformin actually improves diabetes and PCOS. A study conducted on mice has suggested that the drug lowers blood sugar not by reducing IR, but by activating a gene that does not function properly. This gene, which is located in the liver, stops the production of glucose.2 According to the findings of this study, this pharmaceutical works on a deeper level than simply increasing the sensitivity of the body’s cells to insulin—it actually addresses a genetic issue. While the end result remains the same, blood sugar is lowered; the cells of the body are no more sensitive to insulin than they were before. Although the desired end result is achieved, this doesn’t necessarily heal the body in the same manner as decreasing IR would. Determining Which PCOS Medicine Continue reading >>

The Multiple Benefits Of Metformin

The Multiple Benefits Of Metformin

Metformin (brand name "Glucophage") has been used in the treatment of type II diabetes for the past 40 years.1 This drug counteracts many of the underlying factors that result in the manifestation of this insidious disease. Metformin also produces helpful side benefits that can protect against the lethal complications of type II diabetes. Frequently prescribed anti-diabetic drugs fail to address the fundamental causes of type II diabetes and can induce serious side effects. Type II diabetes affects between 16 to 19 million Americans. About 75% of type II diabetics will die from a cardiovascular-related disease. Conventional doctors often prescribe drugs for the purpose of lowering blood sugar levels. These drugs do not adequately address the multiple underlying pathologies associated with the type II diabetic state. Type II diabetes is characterized by cellular insulin resistence. The result is excess accumulation of glucose in the bloodstream as cells become resistant to the effects of insulin. Type II diabetes is characterized by cellular insulin resistence. The result is excess accumulation of glucose in the bloodstream because cells become resistant to the effects of insulin and fail to take up glucose As the type II diabetic condition progresses, many people gain weight and develop more fat cells.2 Treating type II diabetes with insulin-enhancing therapy increases the risk of cardiovascular complications, induces weight gain, and fails to correct the underlying cause of the disease. Many type II diabetics produce too much insulin in a futile attempt to drive glucose into insulin-resistant cells. When doctors prescribe insulin-enhancing drugs to these type II diabetics, a temporarily reduction of serum glucose may occur, but the long-term effects of this excess insu Continue reading >>

Reducing Insulin Resistance With Metformin: The Evidence Today.

Reducing Insulin Resistance With Metformin: The Evidence Today.

Abstract Insulin resistance, defined as the inability of insulin to exert a normal biological action at the level of its target tissues, is one of the principal pathogenetic defects of type 2 diabetes. Metformin, the most widely-prescribed insulin-sensitizing agent in current clinical use, improves blood glucose control mainly by improving insulin-mediated suppression of hepatic glucose production, and by enhancing insulin-stimulated glucose disposal in skeletal muscle. Experimental studies show that metformin-mediated improvements in insulin sensitivity may be associated with several mechanisms, including increased insulin receptor tyrosine kinase activity, enhanced glycogen synthesis, and an increase in the recruitment and activity of GLUT4 glucose transporters. In adipose tissue, metformin promotes the re-esterification of free fatty acids and inhibits lipolysis, which may indirectly improve insulin sensitivity through reduced lipotoxicity. The improved glycaemia with metformin is not associated with increased circulating levels of insulin, and the risk of hypoglycaemia with metformin is minimal. The therapeutic profile of metformin supports its use for the control of blood glucose, in diabetic patients and for the prevention of diabetes in subjects with impaired glucose tolerance. Moreover, the improvement by metformin of cardiovascular risk factors associated with the dysmetabolic syndrome may account for the significant improvements in macrovascular outcomes observed in the UK Prospective Diabetes Study. Continue reading >>

Metformin (glucophage) And Weight Loss

Metformin (glucophage) And Weight Loss

Tweet Metformin, a generic diabetes treatment usually sold under the brand name Glucophage, may help people with diabetes to lose weight by lowering their appetites. Insulin makes people overweight by acting on the brain to cause hunger, making the liver manufacture fat and fill fat cells in the stomach. Avoiding obesity is a matter of avoiding foods high in blood sugar, and taking medication that prevents blood sugar levels from climbing too high. Glucophage function The function of diabetes drug Glucophage is to reduce the release levels of sugar from your liver. This stops blood glucose levels from rising too high, and means that the body does not have to produce as much insulin. Therefore, the patient is not as hungry. Type 2 diabetes drug Metformin (Glucophage) may be used successfully as a medication for type 2 diabetes. Lowers insulin levels It lowers insulin levels, helps to prevent diabetes complications, and helps people with diabetes to lose weight. Losing weight whilst taking Metformin (Glucophage) means also eating a healthy diet. Eating lots of foods that boost blood sugar levels will counteract the effects of Metformin. Most doctors prescribe 500mg of Metformin (Glucophage) before eating. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a s Continue reading >>

Insulin Resistance And The Use Of Metformin: Effects On Body Weight

Insulin Resistance And The Use Of Metformin: Effects On Body Weight

by Ruchi Mathur, MD, FRCPC Dr. Mathur is Assistant Professor of Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, California. Bariatric Times. 2011;8(1):10–12 Abstract Metformin is a widely perscribed drug for the treatment of diabetes and is often used off label for the treatment of prediabetes and insulin resistance. In addition to its primary use, metformin has often been cited as having weight loss benefits. This article reviews the concept of insulin resistance as it pertains to body weight and the effects of meformin on body weight in subgroups of patients with and without diabetes. Introduction Insulin is an anabolic storage hormone produced by the beta cells in both a basal and a pulsatile fashion in response to food intake. Insulin is fundamental in allowing cells to uptake and use glucose. Insulin also regulates gluconeogenesis along with processes, such as protein synthesis and lipogenesis. When we were evolving, the theory is that insulin was necessary because we lived a life of feast and famine. Those who could store calories had a survival benefit, thus insulin had a significant evolutionary role. So, where and when did insulin become a bad thing? Likely, at the same time our evolutionary environment took a bit of a turn. These days, it is usual to go three hours without eating, and certainly not three days! Thus, what was once adaptive is now maladaptive as we continue to store as our ancestors did. Our environment has changed faster than our genetics. Insulin resistance is an impaired response to endogenous or exogenous insulin in cells, tissues (especially skeletal muscle and adipose tissue), the liver, or the whole body.[1,2] Many investigators believe that insulin resistance is an important factor in the development of th Continue reading >>

Pcos: Insulin And Metformin

Pcos: Insulin And Metformin

Young women with PCOS often have elevated insulin levels and are more likely to develop diabetes. Metformin is a medication often prescribed for women with PCOS to help prevent diabetes. A lifestyle that includes healthy nutrition and daily exercise is the most important part of a PCOS treatment plan. What is insulin? Insulin is a hormone made by an organ in the body called the pancreas. The food you eat is broken down into simple sugar (glucose) during digestion. Glucose is absorbed into the blood after you eat. Insulin helps glucose enter the cells of the body to be used as energy. If there’s not enough insulin in the body, or if the body can’t use the insulin, sugar levels in the blood become higher. What is insulin resistance? If your body is resistant to insulin, it means you need high levels of insulin to keep your blood sugar normal. Certain medical conditions such as being overweight or having PCOS can cause insulin resistance. Insulin resistance tends to run in families. What can insulin resistance do to me? High insulin levels can cause thickening and darkening of the skin (acanthosis nigricans) on the back of the neck, axilla (under the arms), and groin area. In young women with PCOS, high insulin levels can cause the ovaries to make more androgen hormones such as testosterone. This can cause increased body hair, acne, and irregular or few periods. Having insulin resistance can increase your risk of developing diabetes. How can I lower my insulin levels? You can help lower your insulin levels naturally by eating fewer starches and sugars, and more foods that are high in fiber and low in refined carbohydrates. Low glycemic foods, on the other hand, don’t raise your blood sugar or insulin levels as much as foods that are high in sugar or refined carbohydr Continue reading >>

Insulin Resistance

Insulin Resistance

What medical conditions are associated with insulin resistance? While the metabolic syndrome links insulin resistance with abdominal obesity, elevated cholesterol, and high blood pressure; several other medical other conditions are specifically associated with insulin resistance. Insulin resistance may contribute to the following conditions: Type 2 Diabetes: Overt diabetes may be the first sign insulin resistance is present. Insulin resistance can be noted long before type 2 diabetes develops. Individuals reluctant or unable to see a health-care professional often seek medical attention when they have already developed type 2 diabetes and insulin resistance. Fatty liver: Fatty liver is strongly associated with insulin resistance. Accumulation of fat in the liver is a manifestation of the disordered control of lipids that occurs with insulin resistance. Fatty liver associated with insulin resistance may be mild or severe. Newer evidence suggests fatty liver may even lead to cirrhosis of the liver and, possibly, liver cancer. Arteriosclerosis: Arteriosclerosis (also known as atherosclerosis) is a process of progressive thickening and hardening of the walls of medium-sized and large arteries. Arteriosclerosis is responsible for: Other risk factors for arteriosclerosis include: High levels of "bad" (LDL) cholesterol Diabetes mellitus from any cause Family history of arteriosclerosis Skin Lesions: Skin lesions include increased skin tags and a condition called acanthosis nigerians (AN). Acanthosis nigricans is a darkening and thickening of the skin, especially in folds such as the neck, under the arms, and in the groin. This condition is directly related to the insulin resistance, though the exact mechanism is not clear. Acanthosis nigricans is a cosmetic condition strongly Continue reading >>

New Information On How Metformin Works

New Information On How Metformin Works

Not only has new research told us how metformin really works, but a new biomarker was found that can determine the optimal dose of metformin that should be used to get the best results for each patient. Research from the Johns Hopkins Children’s Center reveals that the drug most commonly used in Type 2 diabetics who don’t need insulin works on a much more basic level than once thought, treating persistently elevated blood sugar — the hallmark of Type 2 diabetes — by regulating the genes that control its production. investigators say they have zeroed in on a specific segment of a protein called CBP made by the genetic switches involved in overproduction of glucose by the liver that could present new targets for drug therapy of the disease. In healthy people, the liver produces glucose during fasting to maintain normal levels of cell energy production. After people eat, the pancreas releases insulin, the hormone responsible for glucose absorption. Once insulin is released, the liver should turn down or turn off its glucose production, but in people with Type 2 diabetes, the liver fails to sense insulin and continues to make glucose. The condition, known as insulin resistance, is caused by a glitch in the communication between liver and pancreas. Metformin, introduced as frontline therapy for uncomplicated Type 2 diabetes in the 1950s, up until now was believed to work by making the liver more sensitive to insulin. The Hopkins study shows, however, that metformin bypasses the stumbling block in communication and works directly in the liver cells. Senior investigator, Fred Wondisford, M.D., who heads the metabolism division at Hopkins Children’s, tells us that, "Rather than an interpreter of insulin-liver communication, metformin takes over as the messenger itself Continue reading >>

Effects Of Metformin On Insulin Secretion, Insulin Action, And Ovarian Steroidogenesis In Women With Polycystic Ovary Syndrome

Effects Of Metformin On Insulin Secretion, Insulin Action, And Ovarian Steroidogenesis In Women With Polycystic Ovary Syndrome

Hyperinsulinemia contributes to the ovarian androgen overproduction and glucose intolerance of polycystic ovary syndrome (PCOS). We sought to determine whether metformin would reduce insulin levels in obese, nondiabetic women with PCOS during a period of weight maintenance and thus attenuate the ovarian steroidogenic response to the GnRH agonist leuprolide. All subjects (n = 14) had an oral glucose tolerance test, a GnRH agonist (leuprolide) test, a frequently sampled iv glucose tolerance test, graded and oscillatory glucose infusions, and a dual energy x-ray absorptiometry scan before and after treatment with metformin (850 mg, orally, three times daily for 12 weeks). With weight maintenance (body mass index: pretreatment, 39.0 7.7 kg/m2; posttreatment, 39.1 7.9 kg/m2), oral glucose tolerance, insulin sensitivity (Si; 0.87 0.82 vs. 0.74 0.63 105 min1/pmolL), and the relationship between Si and first phase insulin secretion (AIRg vs. Si) were not improved by metformin. The insulin secretory response to glucose, administered in both graded and oscillatory fashions, was likewise unaltered in response to metformin. Free testosterone levels remained about 2-fold elevated (pretreatment, 26.6 12.7 pg/mL; posttreatment, 22.4 9.8 pg/mL). Both basal and stimulated LH and FSH levels were unaffected by metformin. The mean responses to leuprolide of 17-hydroxyprogesterone (pretreatment, 387 158 ng/dL; posttreatment, 329 116 ng/dL) as well as those of the other ovarian secretory products (androstenedione, dehydroepiandrosterone, progesterone, and estradiol) were not attenuated by metformin. We conclude that hyperinsulinemia and androgen excess in obese nondiabetic women with PCOS are not improved by the administration of metformin. HYPERINSULINEMIA appears to play a key pathogeneti Continue reading >>

6 Reasons Why Metformin Might Not Be Safe For Pcos

6 Reasons Why Metformin Might Not Be Safe For Pcos

Have you been prescribed metformin for PCOS and are wondering what the side affects are? Metformin is often described as a ‘safe’ drug, but read on to find out why this might not be the case. When I was diagnosed with PCOS, the first thing I asked my GP was what I could take to ‘fix’ it. She gently explained that there was no pill or surgery that could cure my condition. However, there was a drug that could help with the elevated insulin levels caused by it. Metformin, she claimed, was a safe drug with no major side effects that would help with insulin resistance and weight loss. Sign me up. At first, I thought metformin was the wonder drug. I lost about 5kg in 4 months, more than I had ever been able to lose previously. I was ecstatic. I had a quick look online to see whether there were any side effects and initially found that diarrhea, loose stools, fatigue, and muscle soreness were commonly experienced. But I thought that it was small price to pay for finally being able to lose some weight. However, when I investigated further I found that that there are some much more sinister side effects of metformin that aren’t so widely publicised. These include: – Depleting our bodies of essential nutrients. – Increasing the risk of having a baby with a neural tube defect by up to 9 times. – Reducing energy levels by almost 50%. – Killing beneficial gut bacteria. This article is not intended to be a case against metformin for PCOS. There is no doubt that metformin helps to reduce weight, lowers blood glucose levels, and promotes ovulation. My concern is the lack of studies about the safety of long-term use of metformin for PCOS, especially in utero. Drugs can help with the associated symptoms of a disease, but they cannot fix the root cause of it. Metformin i 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 >>

Insulin Resistance And Weight Loss With Metformin

Insulin Resistance And Weight Loss With Metformin

The cells in your body can’t absorb glucose, the body’s primary source of energy, without insulin. When glucose enters the bloodstream, the pancreas releases insulin. If cells become insulin-resistant, they no longer respond to insulin release by absorbing glucose. More glucose stays in the bloodstream, a condition known as hyperglycemia. Once this happens, a person is diagnosed with type 2 diabetes, formerly called adult-onset diabetes. Metformin is a medication that can improve the cells' sensitivity to insulin; weight loss may occur, as well. Video of the Day Insulin resistance occurs most often in people who have a family history of the disorder, overweight people and women who have polycystic ovary disease, a hormonal disorder characterized by insulin resistance and an over-production of male hormones called androgens. Inactivity also contributes to insulin resistance. Insulin resistance may have no obvious symptoms outside of weight gain. Metabolic syndrome, a disorder that includes insulin resistance and borderline high glucose levels, also includes excess weight around the waist, high blood pressure and abnormal cholesterol levels. Weight Gain and Insulin Resistance People with insulin resistance often gain weight. When blood sugar goes up, the pancreas release insulin. If cells don’t absorb glucose, the pancreas releases ever larger amounts of insulin in an effort to “force” cells to absorb the glucose. Eventually, insulin levels remain higher than normal in the bloodstream. Since high insulin levels increase hunger, people with high insulin levels often gain weight. Drugs like metformin that lower insulin can result in weight loss. Metformin attaches to the surfaces of cells and increases their ability to take in glucose. The drug also reduces glucos Continue reading >>

A Comprehensive Guide To Metformin

A Comprehensive Guide To Metformin

Metformin is the top of the line medication option for Pre-Diabetes and Type 2 Diabetes. If you must start taking medication for your newly diagnosed condition, it is then likely that your healthcare provider will prescribe this medication. Taking care of beta cells is an important thing. If you help to shield them from demise, they will keep your blood sugar down. This medication is important for your beta cell safety if you have Type 2 Diabetes. Not only does Metformin lower blood sugar and decrease resistance of insulin at the cellular level, it improves cell functioning, lipids, and how fat is distributed in our bodies. Increasing evidence in research points to Metformin’s effects on decreasing the replication of cancer cells, and providing a protective action for the neurological system. Let’s find out why Lori didn’t want to take Metformin. After learning about the benefits of going on Metformin, she changed her mind. Lori’s Story Lori came in worrying. Her doctor had placed her on Metformin, but she didn’t want to get the prescription filled. “I don’t want to go on diabetes medicine,” said Lori. “If I go on pills, next it will be shots. I don’t want to end up like my dad who took four shots a day.” “The doctor wants you on Metformin now to protect cells in your pancreas, so they can make more insulin. With diet and exercise, at your age, you can reverse the diagnosis. Would you like to talk about how we can work together to accomplish that?” “Reverse?” she asked. “What do you mean reverse? Will I not have Type 2 Diabetes anymore?” “You will always have it, but if you want to put it in remission, you are certainly young enough to do so. Your doctor wants to protect your beta cells in the pancreas. If you take the new medication, Continue reading >>

Ask The Experts - How Does Metformin Affect Insulin Resistance?

Ask The Experts - How Does Metformin Affect Insulin Resistance?

How Does Metformin Affect Insulin Resistance? What is the role of metformin in managing insulin resistance and obesity in people with diabetes? How does metformin affect the obese nondiabetic patient? Response from Mary Anne Dumas, PhD, RN, CFNP, FAANP In order to understand the role of metformin in insulin resistance and obesity, it is essential to understand the pathophysiology of both clinical problems and the pharmacologic mechanisms of metformin. Insulin resistance occurs when there is an impairment of insulin transport at either the prereceptor, receptor, or postreceptor sites. Insulin resistance occurs in obese individuals, usually at the postreceptor site, where there is an apparent failure to activate the postreceptor tyrosine kinase.[ 1 ] (Type II diabetes reportedly is related to a postreceptor abnormality.[ 1 ]) Failure of the cellular transport of insulin results in hyperglycemia, requiring greater amounts of insulin to maintain euglycemia (normal level of sugar in the blood). Euglycemia may be maintained for a long period by hyperinsulinemia; however, insulin levels are not able to sustain control glucose levels, and hyperglycemia results.[ 1 , 2 ] Metformin is a biguanide (a hypoglycemia-inducing drug) that has been demonstrated to decrease hepatic glucose production and improve peripheral insulin sensitivity. Metformin benefits individuals with diabetes by: Reducing lipid levels (eg, triglycerides); Facilitating postreceptor transport of insulin; and Continue reading >>

Metformin And Insulin Resistance

Metformin And Insulin Resistance

About a year ago, my endocrinologist determined that I was exhibiting signs of insulin resistance. In short, my body requires more than the average amount of insulin to cover carbohydrate. She suggested that I start taking metformin, noting that it would do two things for me: It would decrease the amount of insulin I need to take and it would help curb my appetite, thus resulting in weight loss. When I first got on it, I thought it was great. My blood sugar levels improved, my appetite was in fact curbed, and all seemed wonderful — until I stopped taking my metformin. As a high school senior, I had atrocious sleeping habits! That, coupled with the fact that taking metformin was really killing my appetite, was causing me to become exhausted and get some pretty severe headaches. Looking back on it now, it’s very clear that the metformin wasn’t the problem, it was me. However, as a stubborn senior in high school, I was determined to maintain my sleeping habits, as I deemed them completely normal and in accordance with the typical behavior exhibited by my peers (boy, how I’ve changed…). So, I stopped the metformin. The last three weeks or so, I’ve been back on metformin regularly. I decided to start it up again after my last appointment with my CDE. Thus far, it’s really been working wonders and my blood sugars have decreased substantially! Where my 30-day average was hovering around 190 just a few weeks ago, it has now dropped to 137! I was seriously shocked when I saw how much my average fell. For the most part, my blood sugar levels are in range, but I have had my fair share of lows as well. Managing metformin really is a science that can change on a daily basis depending on my activity level. For example, the first two weeks that I was back on metformin, I Continue reading >>

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