Metformin: Clinical Use In Type 2 Diabetes

Metformin: clinical use in type 2 diabetes

, Volume 60, Issue9 , pp 15861593 | Cite as
Metformin: clinical use in type 2 diabetes
Metformin is one of the most popular oral glucose-lowering medications, widely considered to be the optimal initial therapy for patients with type 2 diabetes mellitus. Interestingly, there still remains controversy regarding the drugs precise mechanism of action, which is thought to involve a reduction in hepatic glucose production. It is now recommended as first-line treatment in various guidelines, including that of the EASD and ADA. Its favoured status lies in its efficacy, low cost, weight neutrality and good safety profile. Other benefits have also been described, including improvements in certain lipids, inflammatory markers, and a reduction in cardiovascular events, apparently independent from the drugs glucose-lowering effect. Data have emerged questioning the previous reluctance to use this agent in those with mild to moderate chronic kidney disease. Regulations guiding its use in patients with stable, modest renal dysfunction have, as a result, become more lenient in recent years. With no long-term studies comparing it against newer glucose-lowering drugs, some of which have more robust evidence for cardioprotection, metformins established role as foundation therapy in type 2 diabetes may justifiably be challenged.
BiguanidesGlucose-lowering therapyMetforminReviewType 2 diabetes mellitus
Diabetes Prevention Program Outcomes Study
The online version of this article (doi: 10.1007/s00125-017-4336-x ) contains a slideset of the figures for download, which is available to auth Continue reading

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Diabetes Drug Can Now Be Used to Treat Obesity

Diabetes Drug Can Now Be Used to Treat Obesity
Researchers say liraglutide, which is sold as both Victoza and now Saxenda, can be used to help with weight loss as well as type 2 diabetes.
More than one-third of the United States population qualifies as obese.
That means the pursuit for a pharmaceutical weight loss drug has only become more intense.
And theres some encouraging news on this front.
A recently published study from the Mayo Clinic reports that a pharmaceutical weight loss drug already exists and has proven to be effective, even in those who are obese.
Liraglutide is a prescription medication that is self-administered via injection once per day.
It was originally created to treat type 2 diabetes under the brand name Victoza , manufactured by Novo Nordisk.
Our paper shows that liraglutide, administered for 3 months at the approved dose of 3 milligrams per day, was associated with an average weight loss of 12 pounds compared to an average 6.6-pound weight loss for patients receiving a placebo, explained Dr. Michael Camilleri, a gastroenterologist at Mayo Clinic and a senior author of the study.
In order to prescribe this medication specifically for weight loss, healthcare providers encountered an obstacle.
Insurance companies would only cover Victoza for people with an indication of diabetes or prediabetes.
Being obese does not necessarily mean a person has diabetes, so theres a hurdle to jump in order to prescribe the drug for weight loss.
Consequently, Novo Nordisk rebranded liraglutide as Saxenda and categorized it as a weight loss drug, resulting Continue reading

Diabetes: A Go-To Guide for Eating at Nearly Every Type of Restaurant

Diabetes: A Go-To Guide for Eating at Nearly Every Type of Restaurant
Diabetes: A Go-To Guide for Eating at Nearly Every Type of Restaurant
Tuesday, October 24th, 2017 by Emily Gallagher
If youre like the average American, you eat out 5 times a week. But when you have diabetes, sticking to a diabetes meal plan which includes cutting calories and keeping salt, carbs and fat to a minimum is one of the most important parts of managing your disease.
Fortunately, many restaurants now offer healthier alternatives that will allow you to still enjoy delicious meals while keeping your blood sugar in check.
Whether youre going out for Italian, Mexican, Chinese or fast food, there are ways to slim down your appetizers and main courses to fit your diabetic eating plan, said Robin Redd, a dietitian at Mon Health Medical Center. The keys are to know what to order, how its prepared, and what an appropriately sized portion looks like.
Robin offers these tips for navigating through nearly every type of popular cuisine.
Go for salad, minus the fried toppings. Ask for low-fat dressing on the side, and only use about half the packet.
Skip the cheese and ask for extra tomato, onions and lettuce.
Order unsweetened iced tea or bottled water.
Use hot sauce instead of ketchup on your fries.
Also, be sure to say no to special sauce, soda and fried chicken.
Ask the waitperson not to bring the breadbasket. Order minestrone or another broth-based soup.
If you want pasta, order a dish from the appetizer section of the menu, or share. Go with sauces based on tomatoes (marinara), vegetabl Continue reading

What Is Juvenile Diabetes?

Diabetes is one of the most common diseases affecting people around the world, although it is far ore prevalent in western countries. For example, nearly 10% of the population in America alone suffers from diabetes, either diagnosed or undiagnosed, and an estimated 2-3% of the population is undiagnosed for this condition. As many of you know, diabetes is categorized in a few different ways Type 1, Type 2 and gestational diabetes. However, many people also use the term juvenile diabetes, but what does that mean?
Short Answer: Juvenile diabetes is an older term form Type 1 diabetes, named because this diabetes variation tends to develop or appear in teenagers or children. This form of diabetes is also known as insulin-dependent diabetes and cannot be cured, only managed.
Before we get into juvenile diabetes, and the various ways that it differs from Type 2 and gestational diabetes, it is important to have a general understanding ofthis condition. Diabetes is a chronic disease in which the pancreas does not create enough insulin for the bodys needs, or when the body itself cannot use the insulin that the pancreas has created. Insulin is the critical hormone in the body that controls the level of blood sugar (glucose) in our bodies. When the balance of insulin and glucose is skewed, it can result in everything from fainting, cognitive confusion, lightheadedness and muscle weakness to higher risks of obesity and cardiovascular damage.
Diabetes is broken down into three main types, based on the specific causes and symptoms of the condition.
Type 1 Diabetes:As mentioned abo Continue reading

How Gene Editing Might Reshape Diabetes Treatment

How Gene Editing Might Reshape Diabetes Treatment
How Gene Editing Might Reshape Diabetes Treatment
The public was agog and a little nervous when the announcement came out this summer that researchers had edited the genes of human embryos, removing a mutation that causes a potentially fatal heart disease .
The embryos were created for the research and will not be implanted. But the study is intended to show that CRISPR/Cas9 technology could be used to remove disease-causing genes effectively and efficiently, not just creating a healthy embryo but allowing the edited genes to be carried into future generations, potentially eliminating the disease from the gene pool.
The number of inherited diseasesor increased risk of diseasethat might be avoided this way is staggering. But t he concerns are big ones : At what point might this lead to designer babies? Will we reach the point of thinking that genes linked to basic individual traits such as short height or curly hair are problematic? Even if such a thing should never happen, there are worries about making changes to the human germline that will be inherited from that point on. The potential consequences are unknown.
But theres a less controversial side of gene editing with CRISPR/Cas9 that has life-changing potential for people with many diseases and conditions, including diabetes. Various research projects are under way to find treatments or possibly cures by modifying peoples cells.
CRISPR stands for clustered regularly interspaced short palindromic repeats, segments of the genetic code. Cas9 is an enzyme that has Continue reading