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Why Are Doctors Hesitant To Prescribe Metformin

Metastudy Confirms Metformin Appropriate Treatment For Prediabetes

Metastudy Confirms Metformin Appropriate Treatment For Prediabetes

A study that reviewed several previous studies about the impact of using metformin on the progression of prediabetes to diabetes confirms that yes, people with prediabtes who take metformin end up with better blood sugars after 3 years than those who don't and are therefore less likely to be diagnosed with full-blown diabetes. This isn't original research, it's just a look at the major studies that have examined the impact of metformin on prediabetes. But because I hear from so many people with prediabetes whose doctors won't give them any help at all, I though it worth a look. Treating prediabetes with metformin: Systematic review and meta-analysis Muriel Lilly, Can Fam Physician Vol. 55, No. 4, April 2009, pp.363 - 369 The key issue to remember here is that the concept that "prediabetes" progresses to "diabetes" which treats the two conditions as if they were separate diseases is flawed. In fact, the medical definition of "diabetes" is completely arbitrary. A committee years ago chose some blood sugar test results and defined them as "diabetes." They could have--and many argue should have--chosen different test result numbers. But they chose the ones they did mainly, their own documentation showed, to diagnose people with diabetes as late as possible, because of the severe penalties the American medical system imposes on people who have pre-existing conditions. You can read about how the diagnostic standards for diabetes were set HERE. "Prediabetes" was also defined arbitrarily at the same time as "diabetes" was defined and as has been the case with diabetes, the definition has changed over the years. But what you, the person with abnormal blood sugar, need to understand is that there's no sudden change in your health that happens when you get an official diabetes dia Continue reading >>

Why Is Metformin Considered The Drug Of Choice For Type 2 Diabetes?

Why Is Metformin Considered The Drug Of Choice For Type 2 Diabetes?

Why is Metformin Considered the Drug of Choice for Type 2 Diabetes? Metformin is a medication that I believe is underappreciated by the general public. Many people ttell me that their doctor prescribed this drug for them, but they took themselves off of it, but if they knew what I know about metformin, they would have stayed on the medication. This is what I know: metformin extends life. Its been proven in animal studies1 and in humans. A prospective observational study of nearly 20,000 people with type 2 diabetes mellitus (T2DM) and arteriosclerosis found that metformin use was associated with 24% lower all-cause mortality compared to patients who were not taking metformin.2 It is also the number one go-to medication for type 2 diabetes for several years, despite all the new designer medications coming on the market trying to replace it. How does metformin save lives? Mainly through cardioprotection. Metformin reduces cardiovascular risk in humans.3 Most people with T2DM willmost likelydie from a cardiovascular event, especially if they are not on metformin.4,5,6 Metformin has so many positive effects on the body, no one really knows for sure all the ways it preserves life. It produces modest weight loss in the near term5 and blunts weight gain when given chronically.6It normalizes hypertension,7 improves heart failure,8 preserves the kidneys,9 improves lipid levels,10 reduces the reoccurrence of colonic polyps and is being used experimentally in several different types of cancers.11 It reduces occurrence of strokes and atrial fibrillation. 12,13 It helps in neurodegenerative diseases.14 There is no end to the life-preserving effects of this drug. Why are so many people taking themselves off of metformin? Because it causes diarrhea. About 10% of metformin users get di Continue reading >>

Diabetes Medication Metformin: Why Patients Stop Taking It

Diabetes Medication Metformin: Why Patients Stop Taking It

Gretchen Becker, author of The First Year: Type 2 Diabetes: An Essential Guide for the Newly Diagnosed , has been taking metformin for more than 20 years after receiving a diagnosis of type 2 diabetes in 1996. I never had any problems with metformin until I took a pill that I thought was the extended-release version, but it wasnt, Becker told Healthline. Beckers doctor had accidentally prescribed the regular form of metformin. I had very loose bowels for several months until I figured out what the problem was, Becker said. After getting the proper prescription, it took several months for Beckers digestive system to recover. Corinna Cornejo, who received a diagnosis of type 2 diabetes in 2009, told Healthline that her digestive woes didnt start until shed been taking metformin for more than a year. At first, I thought it was a response to dairy, but my doctor eventually switched my prescription to the extended-release version, Cornejo recalled. That has helped, but the side effect has not gone away completely. For some people, however, metformins unpleasant side effect of loose stools provides a much-needed balance to the side effects that can result from other diabetes drugs theyre taking. GLP-1 drugs, like Victoza or Byetta, can cause constipation, explained Robinson. Taking metformin with a GLP-1 drug means they actually complement each other, balancing out those side effects. And for some, metformin simply isnt the right drug. No matter what you do, some patients just dont tolerate the side effects well, said Robinson. Although there are many diabetes drugs on the market today, doctors will likely push metformin first. There has never been as many diabetes treatment options available as there are now, explained Robinson. But doctors look at cost, and metformin is th 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 >>

Common Drug Has The Potential To Slow Aging, Boost Cancer Recovery

Common Drug Has The Potential To Slow Aging, Boost Cancer Recovery

Some exciting research from the University of Montreal has found that the drug metformin, commonly prescribed for diabetes and polycystic ovary syndrome (PCOS), has the potential to slow aging and fight cancer. The study, published in Aging Cell, found that metformin reduces the body's production of inflammatory cytokines, which accelerate aging. Metformin is the generic name for an oral drug that was approved by the FDA in 1994 to lower blood sugar. Brand names include Glucophage and Glucophage XR (Bristol-Myers Squibb), Fortamet (Shionogi), Glumetza and Glumetza XR (Santarus), and Riomet (Ranbaxy). Metformin was later found to stimulate ovulation, regulate periods, and increase fertility in women with PCOS and is now commonly prescribed for women whose PCOS hasn't responded to hormonal treatment alone. Found: New Potential to Slow Aging, and Slow Tumor Growth Cytokines have an important function in the body, activating the immune system to fight infection. But because they work by an inflammatory process, when they're overproduced they put the body into a state of chronic inflammation, which causes cells to age faster. Interestingly, the University of Montreal study found that the molecular pathways used to cause these anti-aging and anti-cancer benefits are not the same pathways used when metformin treats diabetes or PCOS. Previous research has suggested the anti-aging and anti-cancer possibilities of metformin, but had not gone as far as to document the mechanism that makes this happen. (Here's my previous reporting on how the inflammatory response ups the risk of stroke and other potentially fatal conditions.) Should You Ask Your Doctor About Metformin? If you're interested in Metformin's anti-aging potential in general, I doubt right now you'll get far asking your Continue reading >>

Dr Won't Prescribe Metformin

Dr Won't Prescribe Metformin

I just got in from an appointment this morning with my doctor. I had asked for a prescription for Metformin, but she said she wouldn't prescribe until my A1c is 7 or above. I have tried my best to eat low carb but after 6 months, it is becoming more and more difficult. Still in that time, I have lost 27 pounds. Even with that weight loss and exercise, 15 grams of carbs at a meal sends my bg level to 150. She said that is normal and she considers that pre-diabetes. I'll have today's lab results back next week. If my A1c isn't up, I won't get the Metformin. Is she right? Welcome to DD. Congratulations on the weight loss. You must be doing something right. Is that 150, 2 hrs after meals. I find that when I was first diagnosed I had to increase my protein. My best numbers come aftter I eat eggs and bacon or sausage or a BLT on sprouted bread. My morning numbers are still high ( 115 -150) I'm on 850 metformin 2 x day. The metformin makes the liver produce less glucose, sometimes. But I find I still get bg spikes throughout the day and when I don't eat enough. One thing I have found out about diabetes is nothing is ever the same. What works one day, does not work the next. Stress also causes bg to spike. In my case when I exercise my bg will jump 60 or 70 points. So its about balance. I don't have any problems with metformin but many people have stomach cramps . Is it because your bg is okay at 6 Do you have to starve to keep it at those levels? You want to eat more right? and metformin will let you do this? I dont really understand, sorry, My doc wants me to go on metformin cos my levels are high and I have to have a lot of insulin to try to keep them down, even tho I have cut down on food it isnt making a lot of difference to bg. I am scared to go on metformin co s folks I Continue reading >>

Why Doctors In The Know No Longer Prescribe Metformin

Why Doctors In The Know No Longer Prescribe Metformin

Until recently, diabetics looking for doctor-approved, drug-free treatment options were out of luck. But a growing number of health experts believe those days are behind us. Dr. Marlene Merritt (LAc, DOM(NM), MS Nutrition), an Austin-based doctor who used to suffer type II diabetes herself, made a recent announcement that is sending shockwaves through the medical community. After nearly dying from diabetes complications during a bike ride, Dr. Merritt began extensive research, intent on reversing her type II diabetes before succumbing to diabetic amputation, blindness, organ failure, or any of the other side effects so commonly experienced by diabetics. Dr. Merritt knew all too well that commonly-prescribed diabetes drugs like Metformin came with a host of unwanted side effects, and was determined to find a natural, drug-free solution that could actually eliminate the disease, not just treat its symptoms. After months of research and self-experimentation, Dr. Merritt developed a simple diet and exercise regimen that had a profound success rate in treating and even reversing type II diabetes. Despite reversing her own diabetes, and helping many of her patients do the same, medical journals were slow to publish her findings, perhaps due in part, some have speculated, to financial ties to the pharmaceutical industry. In response, Dr. Merritt took matters in to her own hands and shocked the medical community by partnering with independent health publisher Primal Health to make her diabetes-reversing regimen available to everyone in the form of an online presentation. Continue reading >>

Take Metformin If You Have Prediabetes

Take Metformin If You Have Prediabetes

Do you have prediabetes? You might be able to ward it off with the help of one of the diabetes drugs. Metformin might stop you from getting diabetes and could also help you in other ways. But persuading your doctor to prescribe it could be a challenge. The biggest and perhaps the best study of people who have prediabetes showed that taking metformin cuts the risk of diabetes by 31 percent. While this was less than the reduction of 58 percent that the “lifestyle intervention” provided, in real life we usually aren’t able to get that much guidance from our medical team. By “lifestyle intervention” the researchers meant being in a program that provided information, guidance, and support to help participants lose 7 percent or more of their weight and to get moderately intense physical activity — like brisk walking — for at least 150 minutes a week. But without that guidance, it typically takes a long time to help, and in fact it most people just don’t do it. Who Metformin Helps Most The study showed that metformin helped the most among younger people, and with people who had a high body mass index (BMI) or a high fasting blood glucose level. It doesn’t help seniors much. But the biggest problem with metformin is to have your doctor prescribe it. Only 3.7 percent of insured adults who had a prediabetes diagnosis were taking it between 2010 and 2012, according to a study that the Annals of Internal Medicine published last year. This very low proportion is probably because the U.S. Food and Drug Administration hasn’t approved metformin — or any other drug — for prediabetes. While doctors are free to prescribe it “off label,” some of them are hesitant to do that. Some Side Effects Like any drugs, metformin sometimes has unwanted side effects. The mos Continue reading >>

Metformin: Is It Really The Best Treatment For Pcos?

Metformin: Is It Really The Best Treatment For Pcos?

If you suffer from diabetes, or have ever had a close friend or family member who was a diabetic, you might be familiar with the name of a drug called Metformin. It is not the only medication prescribed for diabetes, but it is one of the more common ones, and in many cases it yields results. According to the National Library of Medicine, Metformin is a drug often used to treat Type 2 diabetes. And the reason for this is clear: This medication has shown results in controlling the amount of glucose in your blood, which can be effective in managing or stabilizing a diabetic condition. The problem is that Metformin is not only prescribed for diabetes. Because of its effect on blood glucose, many doctors also give it to women suffering from PCOS (Polycystic Ovarian Syndrome). This condition is closely linked to Insulin Resistance, the inability of the body to properly use glucose form the blood. But this medication was not necessarily made to be given to those who suffer with PCOS (Polycystic Ovarian Syndrome) and the side effects can far outweigh the potential efficacy. Metformin: Hazardous to Your Health? While the Mayo Clinic reports that Metformin is often administered to PCOS (Polycystic Ovarian Syndrome) patients—despite the fact that it is not approved for this use—the drug comes with a variety of potential side effects that any prospective user should know about in advance. Some of them are relatively innocuous, such as gas or stomach pain, but there is also a reported risk of liver damage and moderate to severe infections. These side effects might be easier to overlook if the drug were actually intended for use in PCOS (Polycystic Ovarian Patients), but its label gives no indication that this is its intended use. But not to worry: There is a better way to combat Continue reading >>

Ignore The Clickbait: Metformin Still Prescribed For Diabetics

Ignore The Clickbait: Metformin Still Prescribed For Diabetics

Dear Dr. Roach • I have read online and in our local newspaper that doctors are no longer recommending metformin as a treatment for Type 2 diabetes. Can you please explain why metformin is no longer being prescribed? — P.K. Answer • I, too, have seen online ads saying that doctors no longer prescribe metformin, and if you click through enough times, you find that “one weird food” cures diabetes, and that a special diet totally eliminates the need for medication for all diabetics. This is referred to as “clickbait,” and I encourage you not to pay attention to it. Metformin remains an important medication for many people with Type 2 diabetes, especially if they are overweight. For those people with diabetes who need medication despite an appropriate diet and regular exercise, metformin has been shown to be more beneficial, in terms of preventing diabetic complications and death, than most of the other medication options. It isn’t right for everyone, and people with poor kidney function may not be able to safely take it. Only your doctor, nurse practitioner or physician assistant knows what is best for you. Dear Dr. Roach • I started researching information about early dementia and also Alzheimer’s disease. I have perused numerous articles about cholinesterase inhibitors increasing acetylcholine levels that benefit the brain. Some medications are anticholinergic and might increase your risk of developing Alzheimer’s disease. Many of these medications are everyday, over-the-counter drugs. Shouldn’t the public be made aware of these drugs and their possible effect on our brain? — P.C. Answer • One type of treatment for Alzheimer’s disease is a class of drugs called cholinesterase inhibitors. These include donepezil (Aricept) and others. Pharmaco Continue reading >>

Metformin For Cancer Prevention, Longevity: Popular In Silicon Valley

Metformin For Cancer Prevention, Longevity: Popular In Silicon Valley

Metformin is not a new innovation. The drug, which is available in generic form for about 5 cents a pill, has been around for decades. But in recent years, researchers have studied the long-term effects and found that diabetics who took it for years wound up experiencing unintended health benefits, including a reduced cancer risk compared to the general population. Further studies of the drug in mice showed evidence of an improved life span. The drug is thought to mimic some of the positive effects of calorie restriction by lessening the amount of sugar the body produces and absorbs. Calorie restriction is a huge challenge for people to maintain, as it involves eating a lot less over a long period of time, but some studies have shown that it can help to extend the human life span. Poler, alongside his doctor, has reviewed the research on metformin and talked to other friends in the medical fields about the potential downsides of his $2-a-month habit. "Some people told me it was a slam dunk for its anti-aging effects," he adds, over coffee in San Francisco. "And some were skeptical, but most gave it a thumbs up that it's fairly safe." The side effects associated with prolonged metformin use include diarrhea, slow blood sugar, and abdominal pain. The most serious risk is that excessive acid accumulates in the body, causing a condition known as lactic acidosis . Poler hasn't experienced any of these side effects, so he intends to continue taking it for the long-term. Others who take metformin maintain that it's already benefiting them. "I followed the mounting evidence, then when a biotech investor friend Bob Nelsen ( Nelsen, of Arch Venture Partners, regularly takes 500mg of the diabetes drug metformin for its anti-aging effect) told me he was taking it, I had a discussi Continue reading >>

Metformin: Current Knowledge

Metformin: Current Knowledge

Go to: Abstract Diabetes mellitus is a group of metabolic disorders in which the blood glucose is higher than normal levels, due to insufficiency of insulin release or improper response of cells to insulin, resulting in high blood pressure. The resultant hyperglycemia produces sever complications. Metformin drug has been shown to prevent diabetes in people who are at high risk and decrease most of the diabetic complications. Recent reports on metformin, not only indicate some implications such as renoprotective properties have been suggested for metformin, but some reports indicate its adverse effects as well that are negligible when its benefits are brought into account. We aimed here to review the new implications of metformin and discuss about the concerns in the use of metformin, referring to the recently published papers. Keywords: Diabetes, diabetes mellitus, diabetic nephropathy, glucose, metformin, new applications, polycystic ovary syndrome, renoprotection Go to: INTRODUCTION Diabetes mellitus is a group of metabolic disorders in which the blood glucose is higher than normal levels, due to insufficiency of insulin release or improper response of cells to insulin, resulting in high blood pressure. The resultant hyperglycemia produces the classical symptoms of polyuria, polydipsia and polyphagia. It may also cause nerve problems, kidney problems, and blindness, loss of limbs, and sexual dysfunction, increase in heart attack or stroke.[1] Metformin (a biguanide derivative), by controlling blood glucose level decreases these complications. Metformin works by helping to restore the body's response to insulin. It decreases the amount of blood sugar that the liver produces and that the intestines or stomach absorb.[2] Metformin, other than hypoglycemic activity, has b Continue reading >>

Ignore The Clickbait: Metformin Still Prescribed For Diabetics

Ignore The Clickbait: Metformin Still Prescribed For Diabetics

Ignore the clickbait: Metformin still prescribed for diabetics DEAR DR. ROACH: I have read online and in our local newspaper that doctors are no longer recommending metformin as a treatment for Type 2 diabetes. Can you please explain why metformin is no longer being prescribed? P.K. ANSWER: I, too, have seen online ads saying that doctors no longer prescribe metformin, and if you click through enough times, you find that one weird food cures diabetes, and that a special diet totally eliminates the need for medication for all diabetics. This is referred to as clickbait, and I encourage you not to pay attention to it. Metformin remains an important medication for many people with Type 2 diabetes, especially if they are overweight. For those people with diabetes who need medication despite an appropriate diet and regular exercise, metformin has been shown to be more beneficial, in terms of preventing diabetic complications and death, than most of the other medication options. It isnt right for everyone, and people with poor kidney function may not be able to safely take it. Only your doctor, nurse practitioner or physician assistant knows what is best for you. DEAR DR. ROACH: I started researching information about early dementia and also Alzheimers disease. I have perused numerous articles about cholinesterase inhibitors increasing acetylcholine levels that benefit the brain. Some medications are anticholinergic and might increase your risk of developing Alzheimers disease. Many of these medications are everyday, over-the-counter drugs. Shouldnt the public be made aware of these drugs and their possible effect on our brain? P.C. ANSWER: One type of treatment for Alzheimers disease is a class of drugs called cholinesterase inhibitors. These include donepezil (Aricept) and Continue reading >>

Prescribing Attitudes, Behaviors And Opinions Regarding Metformin For Patients With Diabetes: A Focus Group Study

Prescribing Attitudes, Behaviors And Opinions Regarding Metformin For Patients With Diabetes: A Focus Group Study

Go to: Abstract The purpose of this study was to identify the reasons why metformin prescribing is suboptimal. Two semi-structured focus groups with attitudinal questionnaires and a brief educational presentation were held in two US cities. Participants included providers (physicians, pharmacists, midlevel practitioners) caring for patients with type 2 diabetes mellitus (T2DM) in an ambulatory setting. Outcome measures included provider attitudes, behaviors and opinions regarding the use of metformin. Participants identified three main themes influencing the use of metformin, including the appropriate timing of metformin initiation, known risks associated with metformin, and procedures to manage safety concerns and mitigate adverse effects associated with metformin. Participant prescribing behaviors of metformin were not consistent with the best available evidence in the settings of renal insufficiency, heart failure, hepatic dysfunction, alcohol use, and lactic acidosis. With minimal education, provider prescribing behaviors appeared to change by the end of the focus group to align more closely with the best available evidence. Provider attitudes, behaviors and opinions regarding the use of metformin for T2DM reveals the need for further education to improve appropriate use of metformin. Educational interventions should target prescribing behaviors and opinions identified to be inconsistent with the evidence. Go to: Metformin is the only recommended first-line medication for type 2 diabetes (T2DM) because it is the only oral diabetes medication that has reproducibly demonstrated reductions in both cardiovascular morbidity and mortality [Turner, 1998]. However, metformin prescribing is suboptimal. Only 65% of newly diagnosed T2DM patients [Desai et al. 2012] and 25% wit Continue reading >>

Why Isn’t Metformin Prescribed More?

Why Isn’t Metformin Prescribed More?

Since its debut in the United States in 1995, metformin has become the most popular oral drug for Type 2 diabetes in the country — and the rest of the world. Current guidelines by the American Diabetes Association state that unless there are special risks in a particular person, metformin should be the first drug prescribed to people with Type 2 diabetes. Yet perhaps due in part to its popularity, metformin isn’t free of controversy. As we’ve discussed previously here at Diabetes Flashpoints, there are concerns about prescribing metformin in people with kidney disease, and some doctors even question whether metformin deserves its status as the universally recommended first-line drug for Type 2 diabetes. In addition, there’s debate about whether metformin should be taken by more people with prediabetes. A recent study sought to explore the reasons why metformin isn’t prescribed as widely as clinical guidelines suggest it should be. Published last month in the journal Therapeutic Advances in Chronic Disease, the study notes that only roughly 65% of people with newly diagnosed Type 2 diabetes are prescribed metformin — and that over time, this number drops to just 25% of people with the condition. As noted in a Pharmacy Times article on the study, researchers from the University of Colorado put together focus groups of relevant people — doctors, pharmacists, and other medical personnel — to ask about their perceptions regarding metformin. Based on these focus groups, the researchers found that three main factors affected how doctors prescribed metformin: concerns about when to start the drug, concerns about the drug’s known risks, and whether procedures were in place to notice and deal with any adverse reactions caused by the drug. Based on the focus grou Continue reading >>

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