FROM OUR EXPERTS
The drug metformin is not recommended for people with
kidney disease. For this reason, some people think that metformin causes kidney disease. But new evidence
suggests that metformin might actually protect the kidneys.
For many people with type 2 diabetes , metformin is a very
effective drug. In everyone, the liver is a sort of "mother" organ. When blood
glucose (BG) levels go down, the liver releases some glucose into the blood to
make sure all the other organs get enough glucose energy to work properly.
When you eat and your BG levels start going up, the liver
is supposed to stop pushing all this glucose out into the bloodstream.
But for some reason, in people with type 2 diabetes, like
an oversolitous mother, the liver doesn't stop feeding the bloodstream after
meals. "Eat eat!" I can hear it say to a bloodstream already stuffed with
glucose. And this continued release of glucose into the bloodstream after
meals is one reason people with type 2 go high after me...
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 controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That's what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri. “Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.” Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease. Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant. “I treat insulin resistance with that drug even if they aren’t fully diabetic.” he says. “If th...
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