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Can Metformin Cause A Heart Attack?

Deterring Heart Disease If You Have Diabetes

Deterring Heart Disease If You Have Diabetes

Deterring heart disease if you have diabetes Lifestyle changes are vital, but new medications may help. a_namenko; Halfpoint | Thinkstock; zaretskaya | GettyImages Two of the most prevalent health problems in this country type 2 diabetes and heart disease are closely linked. People with diabetes are more than twice as likely to die from heart disease than those without diabetes. An array of overlapping risk factors (such as being overweight and having high blood pressure and cholesterol levels) probably explains part of this association. On the plus side, a diet that emphasizes vegetables, fruits, whole grains, lean protein, and healthy fats, coupled with regular moderate exercise (at least 30 minutes daily, most days of the week) can help people dodge the dangers associated with both heart disease and type 2 diabetes. Even so, most people with type 2 diabetes must also take the drug metformin (or other medications) to help reduce their high blood sugar levels, the hallmark of the disease. For those who take metformin but still struggle to keep their blood sugar under control, doctors typically prescribe an additional drug. Two newer drugs, empagliflozin (Jardiance) and liraglutide (Victoza), have been shown to lower the risk of dying of cardiovascular disease and reduce blood sugar levels in high-risk diabetes patients. "These are promising drugs that may be good choices for people with diabetes at high risk of heart disease," says Dr. Joanna Mitri, a physician at Harvard-affiliated Joslin Diabetes Center. However, the new drugs are very expensive, costing hundreds of dollars per month, she notes. A number of older, less expensive generic drugs are still viable options to help people manage their diabetes. In addition, it's not known whether the new drugs offer heart Continue reading >>

Metformin And The Risk Of Heart Disease

Metformin And The Risk Of Heart Disease

One of the drugs used to treat type 2 diabetes is metformin. Metformin has been around for almost 50 years. In the last two decades a lot of data has been published about metformin and its role in inducing weight loss and lowering the risk of heart disease. The drug is readily available and is relatively cheap. As an oral hypoglycemic agent, it is very effective for type 2 diabetes. However, its ability to reduce the risk of heart disease is now been refuted. Researchers from France working at the Clinical Investigator Center in Lyon looked at several large studies of metformin and its effect on the heart. What the researchers found was that metformin did not lower the risk of heart disease, as had been previously reported. (1) This is a very surprising finding because metformin has been considered to be the first line drug for diabetes for more than a decade. The initial work from the UK Prospective Diabetes Study published in 1988 showed a significant reduction in mortality in obese patients with diabetes when treated with metformin. Most physicians adopted the findings from this this study and started to prescribe metformin for their patients. (2) Another surprising finding from the French analysis was that in non-obese patients with diabetes, metformin may actually increase the risk of death. However, some researchers from the United States have criticized this study because the researchers only looked at studies which had followed metformin use for a short time period. The French investigators only looked at four studies which followed patients for more three years. On the other hand, the UK study had followed patients over a period of more than 12 years. In any case, the short term analysis by the French investigators still showed that metformin did not lower the Continue reading >>

Common Diabetes Drug Metformin Could Cause Thyroid And Heart Problems, Experts Warn

Common Diabetes Drug Metformin Could Cause Thyroid And Heart Problems, Experts Warn

A drug widely prescribed to those with diabetes could cause thyroid, heart and a host of other health problems, a study has warned. Metformin is commonly used to treat type 2 diabetes. It lowers blood sugar levels by reducing glucose production in the liver. But new research, published in the Canadian Medical Association Journal, found the drug is linked to having an underactive thyroid. And the increased risk of producing low levels of the thyroid-stimulating hormone (TSH), can lead to complications, scientists have warned. The condition can cause heart disease, goitre - a lump in the throat caused by a swollen thyroid - pregnancy problems and a life-threatening condition called myxoedema coma. Both men and women can have an underactive thyroid, though the condition is more common in women. In the UK, it affects 15 in every 1,000 women and one in 1,000 men. The condition can also develop in children. The amount of metformin an individual needs to control blood sugar levels is worked out by a person's doctor or diabetes team. However, some previous research has raised concerns that the drug may lower thyroid-stimulating hormone levels. The study, published in Canadian Medical Association Journal, examined data on 74,300 patients who received metformin and sulfonylurea, another common diabetes drug, over a 25-year study period. Of these people, 5,689 were being treated for an underactive thyroid, and 59,937 had normal thyroid function. In the group with an underactive thyroid, there were 495 incidences of low thyroid-stimulating hormone (TSH) (119.7 per 1000) per year compared with 322 in the normal group (4.5 per 1000). In patients with a treated underactive thyroid, metformin was associated with a 55 per cent increased risk of low TSH levels compared with treatment wit Continue reading >>

Can A Common Diabetes Drug Help Heart Attack Recovery?

Can A Common Diabetes Drug Help Heart Attack Recovery?

Better understanding of drug’s mechanism of action can lead the way to new treatment options for heart disease in diabetes patients. Heart disease accounts for more than half of all fatalities in patients with diabetes. The diabetes drug metformin is used by patients with diabetes to help prevent heart disease; however, not all patients can take metformin. New research recently explored for the first time the mechanism by which metformin helps prevent heart disease. By better understanding the mechanism of action, the hope is that it will pave the way for new drugs. The researchers, from Newcastle University, Queen Elizabeth Hospital, Saudi Arabia, constructed a model that allowed them to simulate a heart attack in the lab, using stem cells from cord blood and cells from umbilical. They found new blood vessel formation, which is essential for heart attack recovery, and established metformin enhances the physiological process through which new blood vessels form. Their finding is that during a heart attack in patients with diabetes, there is a lack of oxygen in the presence of high glucose levels, which delays blood vessel formation. Metformin seems to reverse that process, while also affecting multiple genes, which help to promote the growth of new blood vessels. Dr. Jolanta Weaver, Senior Lecturer in Diabetes Medicine at Newcastle University, who led the study, said: “The outcome of heart disease interventions in patients with diabetes is much worse in comparison with non-diabetic individuals. As a result, there is a demand for improved treatment approaches to enhance the outcomes of those with diabetes in order to increase heart attack survival rates. “Our research is exciting as it can instantly make a difference to the treatments we are exploring, offering a n Continue reading >>

Metformin (glucophage) Side Effects & Complications

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 >>

Wrongfully Accused: Metformin Use In Heart Failure

Wrongfully Accused: Metformin Use In Heart Failure

Expert Rev Cardiovasc Ther.2011;9(2):147-150. Metformin has long been the cornerstone of therapy for glycemic control in patients with Type 2 diabetes worldwide. It is recommended as first-line therapy by all major diabetes clinical practice guidelines owing to its efficacy, favorable tolerability profile and beneficial effects in limiting weight gain. Moreover, metformin is the only oral anthyperglycemic agent shown in randomized controlled trials to reduce mortality in newly diagnosed patients with Type 2 diabetes. However, the use of metformin has not been without controversy, in particular in patients with heart failure. This article will review a recent observational study by Aguilar et al. published in Circulation Heart Failure that reported improved outcomes associated with metformin therapy in patients with diabetes and heart failure. Heart failure is a very common comorbidity present in 2540% of all adults with diabetes.[ 1 ] Diabetes also portends poorer outcomes in patients with heart failure and hyperglycemia is associated with increased risk of hospital admission.[ 2 ] Historically, the use of metformin in patients with comorbid heart failure was considered 'absolutely' contraindicated owing to the perceived increased risk of lactic acidosis. Recently, regulatory bodies in both Canada (Health Canada) and the USA (US FDA) have removed the heart failure contraindication from product labeling for metformin, although a 'black box' warning for the cautious use of metformin in this population still exists. How best to control blood glucose in patients with diabetes and heart failure still remains controversial owing to the lack of randomized controlled trial evidence. Indeed, except for one small randomized controlled trial (n = 222),[ 3 ] patients with heart fa Continue reading >>

Diabetes Drug, Metformin, Lowers Risk Of Heart Disease Deaths Better Than Sulfonylureas, New Analysis Shows

Diabetes Drug, Metformin, Lowers Risk Of Heart Disease Deaths Better Than Sulfonylureas, New Analysis Shows

Study confirms metformin should be first-line therapy for treatment of #diabetes.- Click to Tweet #Diabetes drug metformin found more effective at lowering risk of heart disease deaths than sulfonylureas.- Click to Tweet Metformin outperforms other #diabetes drugs; doesn’t cause weight gain like other drugs, study confirms. - Click to Tweet A new analysis of 204 studies involving more than 1.4 million people suggests that metformin, the most frequently prescribed stand-alone drug for type 2 diabetes, reduces the relative risk of a patient dying from heart disease by about 30 to 40 percent compared to its closest competitor drug, sulfonylurea. The study, designed to assess the comparative — not absolute or individual — benefits and risks of more than a dozen FDA-approved drugs for lowering blood sugar in type 2 diabetes, is described in the April 19 issue of the Annals of Internal Medicine. Diabetes now affects almost 10 percent of the U.S. population and poses a growing public health threat, and most people will eventually need drug treatment, the researchers say. “Metformin looks like a clear winner,” says Nisa Maruthur, M.D., M.H.S., assistant professor of medicine at the Johns Hopkins University School of Medicine. “This is likely the biggest bit of evidence to guide treatment of type 2 diabetes for the next two to three years.” Maruthur, the lead author on the meta-analysis, notes that cardiovascular fatalities — heart attacks and strokes — are major risks for people with uncontrolled blood sugar, but it has never been clear if one diabetes drug is better than another at lowering these fatalities. Other diabetes-related complications include blindness, kidney failure and limb amputations. This review, Maruthur says, provides a much-needed update to Continue reading >>

Metformin For Protection Against Alzheimer's, Cancer And Heart Disease?

Metformin For Protection Against Alzheimer's, Cancer And Heart Disease?

With commentary by Nir Barzilai, MD, director of the Institute for Aging Research, Albert Einstein College of Medicine, and Brian Kennedy, PhD, president and CEO of the Buck Institute for Research on Aging. Metformin may influence fundamental aging factors that underlie many age-related conditions, including cancer, heart disease and Alzheimer's, says Nir Barzilai, MD, director of the Institute for Aging Research at Albert Einstein College of Medicine, the Bronx. "Metformin is generic, and it's cheap," Dr. Barzilai says. And accumulating data suggests that ''it interferes with the biology of aging." Aging, he says, is a primary risk factor for not only diabetes but also most of our big killers, such as Alzheimer's, heart disease and cancer. In animal and human studies, metformin has shown promise in slowing the aging process and halting diseases. To study the potential of metformin further, Dr. Barzilai plans to launch a large-scale study, Targeting Aging with METformin (TAME), to look at the effects of metformin compared to placebo. His team has already completed the MILES study, Metformin in Longevity, and are analyzing the results. In that study, they gave some participants metformin, at 1,700 milligrams a day, and others placebo. The aim was to see if the metformin could restore the gene expression profile of an older person with blood sugar problems known as impaired glucose tolerance (but not yet diabetic), to that of a younger person. Dr. Barzilai knows he has critics of his approach. He brushed them off, saying the people who don't see the value of the research ''don't understand the biology of aging and that it can be changed." He doesn't see the research as testing an anti-aging drug. "Aging is not a disease and we don't want it to be a disease," he says. Howe Continue reading >>

Your Early Response To Metformin May Predict Future Heart Disease Risk

Your Early Response To Metformin May Predict Future Heart Disease Risk

Researchers have linked a lower risk for cardiovascular events and death in type 2 diabetes patients if within 6 months of starting metformin a patient is able to lower their HbA1c by a large degree and reach a low A1c level. According to a Medwire News release, the study authors explained that lowering A1c levels to under 7 precent “has been a recommended target in treatment guidelines for more than a decade” for many type 2 diabetes patients. However, they added that, “it remains debated whether even tighter glucose control (such as HbA1c<6.5%) may be more beneficial or harmful.” Study Results Show Low A1c May Be Beneficial In the Danish study, researchers conducted a population-based cohort study which included 24,752 patients who had just started on metformin and had HbA1c tests in Northern Denmark between 2000 and 2012. The median age for the patients was 62.5 years of age and 55 percent were males. After 6 months of metformin, 11,849 patients reached an HbA1c level under 6.5 percent. The researchers found that 6,579 patients who had A1c levels between 6.5-6.99 percent had a 1.18-fold increased risk for heart attack, stroke, or death over a median follow-up of just 2.6 years. Researchers factored for demographics, baseline HbA1c, diabetic complications, and medication use. The risk increased with A1c levels. For the 3,035 patients with A1c levels of 7.0-7.49 percent, there was a 1.23-fold increased risk for adverse outcomes compared to those getting A1c levels under 6.5 percent. By the time A1c levels got to 8 percent and above there was a 1.59-fold increased risk. The researchers also saw a link between the magnitude of HbA1c change and outcome. Those patients with an A1c reduction of 4 percentage points had a 20 percent reduced risk for all the outcomes c Continue reading >>

Does Metformin Cause Heart Attacks 620098 Jim Shaw

Does Metformin Cause Heart Attacks 620098 Jim Shaw

Diabetes drug metformin could cause heart and Mail Online A drug widely prescribed to those with diabetes could cause thyroid, heart and a host of other health problems, a study has warned. Metformin is commonly used to Does Metformin cause Heart Attack? Treato Can Metformin cause Heart Attack? Complete analysis from patient reviews and trusted online health resources, including first-hand experiences. Diabetes, Metformin And Heart Attacks Metformin Side Effects How Does Heart Attack Survivors Respond to Taking Metformin? a group of researchers aimed to discover how heart attack survivors that were diagnosed with diabetes Metformin Affects Hearts of Men and Women Differently The buy cialis oral diabetes medicine metformin affects the hearts of men and women differently, disease is the leading cause of heart. But in women, metformin had Metformin Side Effects on the Heart | LIVESTRONG.COM Metformin Side Effects on the Heart. Metformin should not be taken by those with congestive heart failure or heart disease. for metformin to cause heart Metformin and Heart Failure | Diabetes Care Metformin and Heart Failure If a benefit from metformin therapy in heart failure does NIDDM and its metabolic control predict coronary heart disease in Metformin Linked To Heart Failure In Men Real Diabetes Metformin Linked To Heart Failure In Men. leading to harmful changes that could cause heart while slashing their risks of cancer and heart disease at the Will you have cialis over the counter Heart attack with Metformin from FDA reports Could Metformin cause Heart attack? We studied 199,020 Metformin users who have side effects from FDA and eHealthme. Among them, 4,773 have Heart attack. See what we Diabetes Drug Metformin May Lower Risk of Heart Attacks and Metformin, which is a popular d Continue reading >>

Metformin And Heart Failure

Metformin And Heart Failure

Innocent until proven guilty Throughout the world and for many years, metformin has been a mainstay of therapy for patients with type 2 diabetes. This highly effective and usually well-tolerated oral agent is, to date, the only one demonstrated to reduce cardiovascular disease (CVD) complications in newly diagnosed type 2 diabetic patients (1). It's precise mechanism of action remains enigmatic, although it clearly results in a reduction of endogenous glucose production, primarily hepatic gluconeogenesis, most likely involving the stimulation of AMP-activated protein kinase activity (2). A peripheral insulin-sensitizing effect in skeletal muscle has also been demonstrated by some, but not all, investigators (3). In small studies, metformin appears to exert benefit on various other fundamental biological processes that influence atherogenesis, such as lipid metabolism, inflammation, and vascular endothelial function (4). Another insulin sensitizer category, the thiazolidinediones (TZDs), has also been proposed to reduce CVD risk, but that class carries with it concerns of weight gain and fluid retention. As a result, TZDs remain more popular in combination therapy regimens. Perhaps of greatest import to clinicians is the recognition that metformin is the only oral antidiabetic agent associated with weight loss. Accordingly, metformin remains, in the eyes of many authorities, the optimal initial drug choice in most type 2 diabetic patients if diet and exercise have not succeeded in adequately reducing blood glucose levels (5). Approval of metformin in the U.S. was delayed because of previous experience with phenformin, which was associated with lactic acidosis. Although the risk of such metabolic decompensation with metformin was known to be significantly lower than with Continue reading >>

The Best (and Worst) Diabetes Drugs—for Your Heart

The Best (and Worst) Diabetes Drugs—for Your Heart

Heart disease is the number-one killer of people with type 2 diabetes, so you would think drugs that help control diabetes would be good for the heart. But the opposite is sometimes true—some commonly prescribed diabetes drugs actually increase your risk for heart disease. There are many ways this can happen, explains Debabrata Mukherjee, MD, chief of cardiovascular medicine at Texas Tech University Health Sciences Center El Paso. “Sometimes they can cause hypoglycemia—low blood sugar—which can reduce the amount of nutrients going to the heart. Sometimes they raise bad lipids and lower good cholesterol, or increase water retention [which raises blood pressure]or reduce the ability of the coronary arteries to dilate properly. And some, we don’t understand why they raise the risk for heart disease.” How could these drugs be developed by the pharmaceutical industry and be approved by the Food and Drug Administration (FDA) yet make people with diabetes more likely to develop heart disease? Read on to find out how we got into this mess—and learn which diabetes drugs actually protect your heart. RESEARCHING DRUGS…WITH BLINDERS ON Until 2008, clinical studies needed to get diabetes drugs approved by the FDA didn’t have to even look at cardiovascular effects. They just had to show that the drugs lowered blood sugar (glucose). That’s a crucial omission, since the risk for stroke, heart disease and death from heart disease in patients with diabetes is at least twice that of patients without diabetes. So that year, the FDA made it clear to drug manufacturers that it wanted to see new drugs for type 2 diabetes undergo clinical trials to demonstrate cardiovascular safety—in addition to blood glucose effects. Now we’re seeing the results of these studies. One Continue reading >>

Metformin Affects Hearts Of Men And Women Differently

Metformin Affects Hearts Of Men And Women Differently

The oral diabetes medicine metformin affects the hearts of men and women differently, according to new research from the Washington University School of Medicine in St. Louis. Metformin is the most widely used diabetes drug in the world, with more than 61 million prescriptions being filled in the United States alone in 2012. Cardiovascular disease is the leading cause of death in people who have diabetes. To determine whether sex has an effect on the heart’s response to diabetes treatments, researchers randomly assigned 43 women and 35 men with Type 2 to one of three groups: The first group received metformin alone, the second received metformin plus rosiglitazone (brand name Avandia), and the third received metformin plus Lovaza, a type of fish oil prescribed to lower blood fats known as triglycerides. At the start of the study and at three months in, each participant had a PET scan to evaluate oxygen levels, blood flow, and glucose and fatty acid uptake in the heart; blood tests to measure glucose and free fatty acid levels; and an echocardiogram to evaluate heart function. Blood glucose levels were well controlled in all three groups. When the groups were compared without separating men and women, no differences were seen in heart metabolism. But when the participants were separated by gender, it became clear that the medicines had different, and sometimes opposite, effects on cardiac function. The biggest difference between men and women was seen in the group taking metformin alone. The drug appeared to improve heart function in women, but it caused the hearts of men to burn less sugar and more fat — a shift that can eventually cause changes in heart muscle, leading to heart failure. “Instead of making heart metabolism more normal in men, metformin alone made Continue reading >>

Metformin - Oral, Glucophage

Metformin - Oral, Glucophage

are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomiting, diarrhea, or excessive heat exposure Serious urinary tract infections (UTI), some that lead to hospitalization, occu Continue reading >>

Metformin, Heart Failure, And Lactic Acidosis: Is Metformin Absolutely Contraindicated?

Metformin, Heart Failure, And Lactic Acidosis: Is Metformin Absolutely Contraindicated?

Many patients with type 2 diabetes are denied treatment with metformin because of “contraindications” such as cardiac failure, which may not be absolute contraindications Summary points Treatment with metformin is not associated with an increased risk of lactic acidosis among patients with type 2 diabetes mellitus who have no cardiac, renal, or liver failure Despite increasing disregard of contraindications to metformin by physicians, the incidence of lactic acidosis has not increased, so metformin may be safe even in patients with “contraindications” The vast majority of case reports relating metformin to lactic acidosis report at least one other disease/illness that could result in lactic acidosis Use of metformin in patients with heart failure might be associated with lower mortality and morbidity, with no increase in hospital admissions and no documented increased risk of lactic acidosis Further studies are needed to assess the risk of lactic acidosis in patients with type 2 diabetes and traditional contraindications to metformin Metformin first became available in the United Kingdom in 1957 but was first prescribed in the United States only in 1995.w1 The mechanism of action has been extensively reviewed.w2 w3 The UK prospective diabetes study showed that metformin was associated with a lower mortality from cardiovascular disease than sulphonylureas or insulin in obese patients with type 2 diabetes mellitus.1 It was also associated with reduced all cause mortality, which was not seen in patients with equally well controlled blood glucose treated with sulphonylureas or insulin.1 Despite the evidence base for the benefits of metformin, concerns remain about its side effects and especially the perceived risk of lactic acidosis in the presence of renal, hepatic Continue reading >>

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