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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...
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...
When I was diagnosed in 1996 and my doctor suggested metformin, no one knew how it worked. I told him I was hesitant to take a drug when no one knew what it did. He agreed about the lack of knowledge but then said, “However, we do know what high blood glucose (BG) does, and it’s not a pretty picture.”
So I reluctantly decided to give the drug a try. And metformin, plus a drastic change in diet, did bring my BG levels down to close to normal ranges.
Not long after that, they discovered that metformin keeps the liver from dumping a lot of glucose into the bloodstream. And after that they decided it did so by increasing levels of a molecule called AMPK.
AMPK is known as the “energy sensor” of the cell. When your cellular energy levels are low, meaning you’re not producing a lot of ATP (known as the “energy currency” of the cell), you produce more AMPK. This hypothesis continued to be accepted as true.
But now, ne...
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