A recent report again reaffirms that metformin is the first medication to use when a patient with type 2 diabetes (T2D) needs help with lowering blood glucose levels. The 200+ page report, Oral Diabetes Medications for Adults With Type 2 Diabetes: An Update , was prepared for the Agency for Healthcare Research and Quality by the Johns Hopkins University Evidence-based Practice Center. It is loaded with tables and discussions, but the conclusion is strikingly brief: "Although the long-term benefits and harms of diabetes medications remain unclear, the evidence supports use of metformin as a firstline agent. Comparisons of two-drug combinations showed little to no difference in HbA1c reduction, but some combinations increased risk for hypoglycemia and other adverse events."
To summarize the findings from the report: An older diabetes drug, metformin, works better, and has fewer side effects than newer drugs for T2D. It's also cheaper, as it's been available as a generic for y...
Metformin as well as every other prescription drug has a "label" (in the US, called a "United States package insert" or USPI, and in Europe called the "Summary of Product Characteristics" or SPC). The label spells out what governmental agencies authorize drug companies to say about the good and bad of their prescription drugs. Labels vary from country to country depending on local laws, but the label seems always to contains a section concerning the use of the medication in pregnancy.
Drug companies and the regulators negotiate every word in a label for a new medication, as getting additional good information into the label is viewed as a marketing advantage (and vice versa for bad information). For older drugs such as metformin, which are available as generics and which are sold by several companies, there frequently is less financial incentive to update the label, and labeling may be similar or identical across all the generic versions of the drug.
Recently, the on-lin...
The drug metformin is one of the most common drugs prescribed to treat type 2 diabetes. When you’re diagnosed, most physicians prescribe metformin as well as suggesting diet and exercise changes.
But not everyone can tolerate metformin. Some people get diarrhea and nausea, sometimes so severe they stop taking the drug. Starting the drug slowly and then increasing the dosage helps. Taking metformin with meals helps.
But sometimes that’s not enough and you decide to try something else.
Metformin should also not be used if you have impaired kidney function, because the kidney is where the drug is removed, and if your kidneys are impaired, the metformin concentrations might rise too high and cause a serious, sometimes life-threatening, complication called lactic acidosis.
Now a group of researchers have found that they can give metformin in a form that has the same benefits but doesn’t have the same side effects. What they do is coat the...
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