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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...
I received an interesting question by e-mail recently, which brought up several good points to review. The author asked: "Can a patient use metformin after a heart attack (after 12 years of using metformin) assuming the patient has good renal function? My question is if metformin should be avoided forever after an acute myocardial infarction or just temporarily withheld after the heart attack in a patient with an adequate renal and liver function (also without congestive heart failure or hypersensitivity to metformin)." I answered: "According to the USPI (the "label") for Glucophage brand of metformin, GLUCOPHAGE and GLUCOPHAGE XR are contraindicated [should not be used] in patients with: Renal disease or renal dysfunction (e.g., as suggested by serum creatinine levels =1.5 mg/dL [males], =1.4 mg/dL [females] or abnormal creatinine clearance) which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicem...
Q. I’ve just been diagnosed with lymphedema. What are the treatments like? A. Depending on the seriousness of your case, treatments can range from a simple hand massage, exercises, and instructions to keep your arm elevated for a portion of each day; to daily hours-long treatments for several weeks, followed by wearing a wrist to shoulder elastic sleeve, potentially for life. In other words: HUGE possible range of treatments. You won’t know what YOUR treatment will be like till you see the physical therapist or lymphedema therapist for the first time. However, you can hazard a guess, based on how much swelling you see and feel in your arm/chest area: the greater the swelling, the more advanced the lymphedema probably is, the longer-lasting the treatment will be. Q. So, let’s take a middle-of-the-road scenario, just as an example. What might that look like? A. At your first visit, the PT will measure both arms very carefully, taking their circumference ...
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