Sugar Matters
March 28, 2008
Common diabetes medications: Metformin

This week we start a short series discussing some of the common medications used to treat diabetes. These mini-overviews are not meant to be a thorough discussion of every piece of information available, so please do discuss medications at length with your doctor or friendly local pharmacist. I will try to go over some general points about each medication/group of medications, and include some benefits, side effects etc. As always, if you have specific questions feel free to drop me a line on my e-mail endodocs@endocrinehelp.com.{{more}}

Metformin, otherwise known as Glucophage and most recently Glumetza, is one of the most commonly prescribed medications for diabetes. It is also one of the first ones chosen out of the vast line-up of available medications. Recently it was suggested as a treatment for those with pre-diabetes and high risk of advancing to Type 2 diabetes. Why it is so popular?

First, Metformin has been around for quite some time. In the world of medications it is often good to be “old” because that means your track record is known. Metformin is one of the medications that doctors can prescribe knowing that it has been very well studied for many years.

In general Metformin works by improving what is called “insulin sensitivity”-that means it does not cause your pancreas to make more insulin, it just makes you respond better to the insulin you already make on your own. This turns out to be one of the biggest strong points about Metformin-because it does not actually make more insulin, it does not commonly lead to low blood sugars. Do some people have low blood sugars while taking Metformin? Yes, but this is uncommon and the blood sugars are not usually very low. This is why it can be used in pre-diabetes, and also why it is one of the first medications chosen to treat Type 2 diabetes.

One of the other major benefits with Metformin use is that people tend to lose weight and weight loss itself then helps with diabetes control as well.

Your stomach will let you know if you are having the most common side effects of Metformin-upset stomach, nausea and diarrhea. I know, not at all pleasant, and you are now saying, “Why on earth would I want to try that???” WAIT, I plead! While these are common side effects, they most likely last only a short while (often less than a week) and then they go away on their own even as you continue taking the medication. I have only rarely needed to stop this medication for a patient because of continued upset stomach. There are a few situations when this medication should NOT be used: when you have poor heart function, kidney failure and serious liver problems. Poor lung function and dehydration are also cautionary situations.

As an aside, Metformin is also used in Polycystic Ovarian syndrome to help regulate periods and help women get pregnant, so don’t be confused if you are in this situation.

Until next week, take care Vincies and stay healthy!

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227