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Why Doctors Are Not Recommending Metformin

8 Drugs Doctors Wouldn't Take

8 Drugs Doctors Wouldn't Take

Print Font: With 3,480 pages of fine print, the Physicians' Desk Reference (a.k.a. PDR) is not a quick read. That's because it contains every iota of information on more than 4,000 prescription medications. Heck, the PDR is medication — a humongous sleeping pill. More women opting for preventive mastectomy - but should they be? Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring. Doctors count on this compendium to help them make smart prescribing decisions — in other words, to choose drugs that will solve their patients' medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don't stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid. Worst case: You swallow something that has no business being inside your body. Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor. Maybe he or she will finally open that big red book with all the dust on it. Advair It's asthma medicine ... that could make your asthma deadly. Advair contains the long-acting beta-agonist (LABA) salmeterol. A 2006 analysis of 19 trials, published in the Annals of Internal Medicine, found that regular use of LABAs can increase the severity of an asthma attack. Because salmeterol is more widel 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 >>

Why Would A Doctor Prescribe Metformin To A Hypoglycemic Patient?

Why Would A Doctor Prescribe Metformin To A Hypoglycemic Patient?

Question Originally asked by Community Member slywlf Why Would A Doctor Prescribe Metformin To A Hypoglycemic Patient? A dear friend was diagnosed years ago with hypoglycemia, caused by her thyroid, while other members of her family have hyperglycemia (diabetes), and are almost all on an insulin regimen. What I do not understand is why her doctor has her on Metformin!? Isn’t that counterproductive? Her current thyroid medicine seems to be making her gain weight - it is not her diet, which is healthy and portion controlled. Since she is on Medicaid it is often hard to get meds switched. Also, she is reluctant to risk alienating one of the few local doctors who are still willing to take Medicaid, so she is worried about questioning her doctor about this. What possible purpose is served by giving a glucophage to a person with chronic low blood sugar? I am baffled and concerned! My friend has many health issues besides the thyroid and hypoglycemia, including a degenerative disk problem, a damaged ankle from a fall a few years ago, increasing eye problems since that fall, and social anxiety disorder. She also has a very low IQ, which she is very much aware of, and which makes her reluctant to confront people she perceives as smarter than herself, particularly doctors. She is 60 years old, and I worry that this doctor is not treating her condition correctly, but my own knowledge of hypoglycemia is limited to what I have found on the web - much of which seems related to overdoses of insulin in diabetics, which is not the issue here. Answer Doesn’t make any sense to me. First of all, thyroid conditions don’t cause hypoglycemia. Second, giving metformin would be worthwhile to treat either diabetes or prediabetes, especially in a family setting of diabetes, but if she’s h 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 Best For Type 2 Diabetes First Treatment

Metformin Best For Type 2 Diabetes First Treatment

HealthDay Reporter TUESDAY, Oct. 28, 2014 (HealthDay News) -- People newly diagnosed with type 2 diabetes who are initially given the drug metformin are less likely to eventually need other drugs to control their blood sugar, a new study suggests. The study found that, of those started on metformin, only about one-quarter needed another drug to control their blood sugar. However, people who were started on type 2 diabetes drugs other than metformin often needed a second drug or insulin to control their blood sugar levels, the researchers said. "This study supports the predominant practice, which is that most people are started on metformin," said lead researcher Dr. Niteesh Choudhry, an associate professor of medicine at Harvard Medical School in Boston. "Metformin might be more effective than others in controlling blood sugar," he noted. "Metformin, which is one of the oldest drugs we have and which the guidelines recommend as being the first drug to use, is associated with a lower risk of needing to add a second drug or insulin compared to any of three other commonly used classes of drugs," Choudhry said. The report was published in the Oct. 27 online edition of JAMA Internal Medicine. A hallmark of type 2 diabetes is insulin resistance, according to the American Diabetes Association (ADA). That means the body doesn't effectively use the hormone insulin. Insulin is produced by the pancreas and helps usher sugar from foods into the body's cells to be used as energy. When people have insulin resistance, too much sugar is left in the blood instead of being used. Over the long-term, high blood sugar levels can lead to serious complications, such as heart and kidney disease, according to the ADA. There are eight classes of oral type 2 diabetes medications, according to the Continue reading >>

Management Of Blood Glucose With Noninsulin Therapies In Type 2 Diabetes

Management Of Blood Glucose With Noninsulin Therapies In Type 2 Diabetes

A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes should receive individualized medical nutrition therapy, preferably from a registered dietitian, as needed to achieve treatment goals. Patients should be treated initially with metformin because it is the only medication shown in randomized controlled trials to reduce mortality and complications. Additional medications such as sulfonylureas, dipeptidyl-peptidase-4 inhibitors, thiazolidinediones, and glucagon-like peptide-1 receptor agonists should be added as needed in a patient-centered fashion. However, there is no evidence that any of these medications reduce the risk of diabetes-related complications, cardiovascular mortality, or all-cause mortality. There is insufficient evidence on which combination of hypoglycemic agents best improves health outcomes before escalating to insulin therapy. The American Diabetes Association recommends an A1C goal of less than 7% for many nonpregnant adults, with the option of a less stringent goal of less than 8% for patients with short life expectancy, cardiovascular risk factors, or long-standing diabetes. Randomized trials in middle-aged patients with cardiovascular risk factors have shown no mortality benefit and in some cases increased mortality with more stringent A1C targets. Clinical recommendation Evidence rating References Metformin should be used as first-line therapy to reduce microvascular complications, assist in weight management, reduce the risk of cardiovascular events, and reduce the risk of mortality in patients with type 2 diabetes mell 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 >>

Blood Sugar Control Tip Metformin

Blood Sugar Control Tip Metformin

Metformin is a popular medication to help Type 2 diabetes and blood sugar control. It is also used to treat other conditions such as PCOS or polycystic ovary syndrome. How Does Metformin Help in Blood Sugar Control? Metformin helps in blood sugar control by lowering the amount of sugar that the liver releases into blood. In addition, the medication also improves the way your body respond to insulin. Doctors usually prescribe Metformin under the circumstance where diet and exercise are not effective in controlling the patient’s blood sugar level. The prescription can come in tablet or liquid form. Metformin is more often being prescribed to adults. However, it can also be prescribed to kids more than ten years old on the advice of a medical specialist. While taking the medication, your doctor may ask you to monitor your blood sugar regularly. When necessary, your doses may vary. Do not take the medication without your doctor’s advice or prescription. It is best to take Metformin along with a meal in order to minimize the side effects. The common side effects of this medicine are vomiting, stomach ache and diarrhea. Your doctor may recommend you to switch to another medication if you cannot tolerate the side effects. Never start on Metformin or any other drug without consulting your doctor. It is important to note that not all diabetes patients are suitable for Metformin. Your doctor will be able to judge whether you are suitable to use the drug base on your health condition and prescribe an appropriate dosage. In general, patients with the following conditions should caution against Metformin: history of allergy to Metformin or other medications Continue reading >>

Management Of Persistent Hyperglycemia In Type 2 Diabetes Mellitus

Management Of Persistent Hyperglycemia In Type 2 Diabetes Mellitus

The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc. All topics are updated as new evidence becomes available and our peer review process is complete. INTRODUCTION — Initial treatment of patients with type 2 diabetes mellitus includes education, with emphasis on lifestyle changes including diet, exercise, and weight reduction when appropriate. Monotherapy with metformin is indicated for most patients, and insulin may be indicated for initial treatment for some [1]. Although several studies have noted remissions of type 2 diabetes mellitus that may last several years, most patients require continuous treatment in order to maintain normal or near-normal glycemia. Bariatric surgical procedures in obese patients that result in major weight loss have been shown to lead to remission in a substantial fraction of patients. Regardless of the initial response to therapy, the natural history of most patients with type 2 diabetes is for blood glucose concentrations to rise gradually with time. Treatment for hyperglycemia that fails to respond to initial monotherapy and long-term pharmacologic therapy in type 2 diabetes is reviewed here. Options for initial therapy and other therapeutic issues in diabetes management, such as the frequency of monitoring and evaluation for microvascular and macrovascular complications, are discussed separately. (See "Initial management of blood glucose in adults with type 2 diabetes mellitus" and "Overview of medical care in adults with diabetes mellitus". Continue reading >>

Glimepiride Side Effects

Glimepiride Side Effects

What Is Glimepiride (Amaryl)? Glimepiride is the generic name of the prescription drug Amaryl, used to treat patients with type 2 diabetes. Glimepiride belongs to a class of drugs known as sulfonylureas. It stimulates the pancreas to produce insulin and helps the body use insulin more efficiently. The drug can also decrease the chances that someone will develop life-threatening complications of type 2 diabetes. The drug was approved by the FDA in 1995 and is manufactured by Sanofi-Aventis. Glimepiride comes in tablet form and is usually taken once a day. It may be used alone, or in combination with insulin or another oral medication such as metformin. Your doctor will probably start you on a low dose of the medication and gradually increase your dose if needed. If you've taken glimepiride for a long period of time, the drug may not control blood sugar as well as it did when you first started the treatment. Your doctor will adjust the dosage as needed. Glimepiride Warnings Glimepiride helps control blood sugar, but it will not cure your diabetes. You should continue to take glimepiride even if you feel well. This medication should not be used to treat patients with type 1 diabetes, a disease in which the body does not produce insulin. Glimepiride will only help lower blood sugar if your body produces insulin naturally. In one study, patients who took a medication similar to glimepiride to treat diabetes were more likely to die of heart problems than those who were treated with diet changes and insulin. Talk to your doctor about the risks of this treatment. While taking glimepiride, you should tell your doctor if you: Are pregnant, plan to become pregnant, or are breastfeeding Are having surgery, including dental surgery Have ever had G6PD deficiency (a genetic blood diso Continue reading >>

Should Physicians Prescribe Metformin To Women With Polycystic Ovary Syndrome Pcos?

Should Physicians Prescribe Metformin To Women With Polycystic Ovary Syndrome Pcos?

Abstract 1. Metformin is not efficient enough in order to regulate menstrual cycles. 2.Metformin is not efficient enough in order to treat hyperandrogenism. 3. Metformin should not be used as a first-line treatment in order to treat infertility. Clomiphene citrate (CC) is the reference treatment. 4. Metformin in addition to CC is not recommended as a second line treatment, after the failure of CC alone. 5. Metformin should not be used during pregnancy in non diabetic women with PCOS, in order to prevent the risk of gestational diabetes. 6. Metformin should be prescribed to PCOS women when they are diabetic, in order to prevent their cardiovascular risk, after lifestyle modification. 7. Metformin should not be used in PCOS non diabetic women in order to lose weight. Metformin should not be used in order to treat dyslipidemia in women with PCOS. 8. In PCOS women, without diabetes, but with fasting hyperglycemia or carbohydrate intolerance, metformin should be prescribed if: BMI>35. Continue reading >>

Stopping Metformin: When Is It Ok?

Stopping Metformin: When Is It Ok?

The most common medication worldwide for treating diabetes is metformin (Glumetza, Riomet, Glucophage, Fortamet). It can help control high blood sugar in people with type 2 diabetes. It’s available in tablet form or a clear liquid you take by mouth before meals. Metformin doesn’t treat the underlying cause of diabetes. It treats the symptoms of diabetes by lowering blood sugar. It also increases the use of glucose in peripheral muscles and the liver. Metformin also helps with other things in addition to improving blood sugar. These include: lowering lipids, resulting in a decrease in blood triglyceride levels decreasing “bad” cholesterol, or low-density lipoprotein (LDL) increasing “good” cholesterol, or high-density lipoprotein (HDL) If you’re taking metformin for the treatment of type 2 diabetes, it may be possible to stop. Instead, you may be able to manage your condition by making certain lifestyle changes, like losing weight and getting more exercise. Read on to learn more about metformin and whether or not it’s possible to stop taking it. However, before you stop taking metformin consult your doctor to ensure this is the right step to take in managing your diabetes. Before you start taking metformin, your doctor will want to discuss your medical history. You won’t be able to take this medication if you have a history of any of the following: alcohol abuse liver disease kidney issues certain heart problems If you are currently taking metformin, you may have encountered some side effects. If you’ve just started treatment with this drug, it’s important to know some of the side effects you may encounter. Most common side effects The most common side effects are digestive issues and may include: diarrhea vomiting nausea heartburn abdominal cramps Continue reading >>

Stop Prescribing Benzodiazepines For Anxiety

Stop Prescribing Benzodiazepines For Anxiety

As a physician in a rural health clinic, I frequently see patients who complain of anxiety. The majority of these patients are in their 20s to 40s. Some have never been evaluated by a mental health professional, and many of these patients take benzodiazepines on a chronic basis. After current review, I wonder if we as primary care physicians are good at treating anxiety, or are we contributing to drug dependency? Benzodiazepine dependency is a growing health concern. According to the Drug Abuse Warning Network (DAWN), visits to the emergency department involving benzodiazepines increased 141% between 2004 and 2010. Benzodiazepines were involved in 28.4% of emergency department visits involving pharmaceutical related suicide attempts during that time. The arrest reports in my local newspaper attest to the problem of the illicit sell of benzodiazepine in my area. Most current guidelines recommend SSRIs and SNRIs as first line treatment for generalized anxiety disorder. Buspar and Lyrica have been shown to be effective adjuncts if needed. A number of randomized clinical trials support the use of benzodiazepines, but for short term use only (up to 6 weeks). Importantly, benzodiazepines are ineffective in treating depression, which often exists as a comorbid condition. Cognitive behavioral therapy is also often helpful in treating anxiety. We all know the physical dependency that benzodiazepines cause. The abuse of this drug is also well known. Most of us are familiar with current guidelines concerning their use. Why then, is the problem of benzodiazepine abuse getting worse? One reason is that patients are often insistent on being prescribed benzodiazepines as first-line therapy for treatment. Patients already on taking them are reluctant to try a new medication due to the Continue reading >>

Pcos And Metformin – Is This Treatment Right For You?

Pcos And Metformin – Is This Treatment Right For You?

Here at Flo Living headquarters I speak with many women suffering with PCOS who have either been offered Metformin and decided against it or have tried Metformin and it’s not worked for them. If you have a diagnosis of PCOS it’s very likely that at some point your doctor has suggested Metformin. I personally was what would be considered the “perfect” candidate for this treatment when I was in my 20s and suffering with PCOS – overweight, struggling with acne and a complete lack of periods. However, I never tried it myself – instead I created a protocol for myself that became Flo Living. I’ve since helped many women manage their PCOS successfully with this protocol, just as I did my own diagnosis. That said, I speak with women so often about the Metformin option that I want to share my perspective with you. Although I do not dismiss the option completely, I do have some caveats and concerns. What is Metformin? Metformin is a first-line medication for those suffering with type 2 diabetes. It is also presented as a treatment for PCOS sufferers who are also overweight or obese. Not all PCOS sufferers have weight gain as a symptom, it depends on the kind of PCOS. Women with the kind of PCOS that causes weight gain are usually insulin resistant. Metformin reduces overall insulin levels. Insulin resistance is when the cells of your body become resistant to the hormone insulin, preventing glucose from entering your cells to be used for energy, and instead causing soaring levels of sugar blood stream bringing about diabetes, pre-diabetes or insulin-resistant PCOS. The connection between insulin and PCOS is blood sugar regulation. We hear about this most commonly with diabetes, but it’s also very important with PCOS. An unstable, constantly spiking and crashing, bl Continue reading >>

The Multiple Benefits Of Metformin

The Multiple Benefits Of Metformin

5 Reasons you should get your metformin anti-ageing pill from our Skin /Body / Heath Renewal doctors Definition: Metformin comes from the plant world. The French Lilac plant (called Galega officinalis) was used for centuries as a folk medicine for the treatment of Diabetes. The active ingredient in the French Lilac plant, called guanidine compounds, were discovered and isolated in the 1920’s and the drug Metformin has been safely used in the treatment of Type 2 Diabetes for the last 40 years Skin /Body / Heath Renewal have been prescribing Metformin for anti- ageing to our patients for the last 5 years; we are ahead of the pack. All our Skin /Body /Health / Brain Renewal consults are holistically approached We have realized the importance of the conditions which contribute to skin conditions, ageing and a decline in Health Thus we connect the dots of chronic symptoms and formulate a comprehensive settlement plan to improve the health of all our patients A doctor’s consultation is mandatory. Every patient has to see one of our Doctors before any treatment can be prescribed , albeit a skin condition such as acne, Body Shaping or weight loss , IV infusion or brain training Frequently Asked Questions Anti-ageing Reduces Insulin levels in Type 2 Diabetes Increases peripheral glucose uptake Increases sensitivity and number of insulin receptors Cardio protective Decreases glucose absorption from GI Tract Facilitates WEIGHT LOSS Inhibits production of sugar by the liver Prevents non-alcoholic liver disease Increases fatty acid oxidation NALFD Reduces development of atherosclerosis Lowers blood cholesterol Improves cellular immunity Enhances the activity of anti-cancer drugs Suppresses the growth of some tumours Alleviates Metabolic Syndrome Continue reading >>

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