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Metformin is usually the first medication chosen to help people with type 2 diabetes.
So why has metformin become the darling of diabetes?
Metformin works by helping decrease glucose production in the liver and also helps insulin that’s already in the body work better. In other words, Metformin improves how well insulin can work. This is sometimes referred to as tissues and cells in the body becoming ‘more sensitive to insulin’.
Metformin is often comparatively one of the most affordable medications for type 2 diabetes with most insurances. It is also typically tolerated well by most people.
Metformin doesn’t cause hypoglycemia or weight gain like some of the other diabetes medications. It can also be taken with many other medications for diabetes if additional control is needed.
Metformin may offer additional perks including helping to decrease the risk of heart attacks and other cardiovascular complications in people with diabetes. And it also may help the 1 last update 14 Jul 2020 with weight loss and lowering lipid profiles (LDL and triglycerides). Metformin may offer additional perks including helping to decrease the risk of heart attacks and other cardiovascular complications in people with diabetes. And it also may help with weight loss and lowering lipid profiles (LDL and triglycerides).
The most common side effects of metformin is an upset stomach. This includes nausea, vomiting and diarrhea.
Your doctor may suggest that you start on a lower dose of the medication and the 1 last update 14 Jul 2020 increase it slowly. Once your body becomes used to the medication with this more gradual adjustment these side effects often go away. Your doctor may suggest that you start on a lower dose of the medication and increase it slowly. Once your body becomes used to the medication with this more gradual adjustment these side effects often go away.
Quick Tip: Always take Metformin with food to help prevent feeling an upset stomach.
Although rare, a condition called lactic acidosis is arguably the most serious potential side effect of metformin. Unfortunately the condition is difficult to identify because the symptoms aren’t always very obvious and are nonspecific.
Lactic acidosis is most often exacerbated by metformin when there is decreased oxygen to the cells in situations such as:
Vitamin B12 deficiency can occur in some people taking metformin. Effects of Vitamin B12 deficiency can include anemia (low hemoglobin counts) and numbness or tingling in your hands or feet (called peripheral neuropathy).
The good news is that simple blood tests can identify this problem and it’s not immediately dangerous. Your doctor may have you take additional vitamins if you are found to have low vitamin B12 in order to help your deficiency.
Another very common diabetic medication class is called sulfonylureas. These can either be taken alone or in combination with metformin - and sometimes other medications.
Sulfonylureas work by stimulating insulin secretion leading to more insulin in the body.
Sulfonylureas are often tolerated very well with the most common side effect being low blood sugar.
One of the most dangerous complications of this medicine is low blood sugar. What’s more is that some of these medications can cause recurrent episodes of low blood sugar over the course of the following 24 hours. Therefore sometimes people are watched in the hospital for an extended observation period when they have low blood sugar on these medications.
A very relevant and unfortunate consequence of this class of medications is the possibility of weight gain. Because weight loss is such a critical part of diabetes treatment it is important to carefully monitor any significant weight gain on these medications.
These medications help blood glucose control by excreting excess glucose from the body into the urine.
While they are still considered a different medication class, meglitinides are very similar to sulfonylureas. While the sulfonylurea class is often tried first, meglinitides are sometimes used in people who have allergies to sulfonylureas.
Similar to sulfonylureas, meglitinides work to control blood sugar levels by stimulating the pancreas to release more insulin.
While there needs to be caution in using some diabetic medications for people with kidney disease, repalginide seems to not make kidney function worse and is therefore sometimes chosen for people with diabetes and kidney problems.
The risk of weight gain is similar to sulfonylureas and should always be carefully monitored, especially since weight loss is such an important treatment for type 2 diabetes.
Because the liver processes these medications, people with significant liver problems are probably not a good fit for this medication class. You should also always make sure to follow up with blood tests your doctor orders.
These medications work by helping insulin to work better. Similar to metformin, it makes the body cells more sensitive to insulin.
1. Weight Gain
2. Low Blood Counts (Anemia)
3. Increased Risk of Heart Failure
GLP-1 medications include GLP-1 receptor agonists which are injections and DPP-4 inhibitors (dipeptidyl peptidase 4 inhibitors) which are oral medications.
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Taking this medication with food can help symptoms of upset stomach better. It’s important to follow up with lab tests that your doctor orders to make sure your kidney function isn’t worsening.
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DPP-4’s can be relatively more expensive than other diabetic medications, depending on the insurance coverage you have. Studies showing an for 1 last update 14 Jul 2020 increased risk of hospitalizations in people with congestive heart failure (CHF) who take DDP-4 medications has led to concern and often limiting their use in people with heart problems. DPP-4’s can be relatively more expensive than other diabetic medications, depending on the insurance coverage you have. Studies showing an increased risk of hospitalizations in people with congestive heart failure (CHF) who take DDP-4 medications has led to concern and often limiting their use in people with heart problems.
If you start to have a rash while taking these medications, they may be the cause. While most of these rashes aren’t dangerous, many people stop taking the medication when this occurs.
These medications work by getting rid of glucose in the urine.
Similar to DDP-4’s. SLGT2 medications may have a positive influence on the whole picture of diabetes by helping to decrease blood pressure, assisting in weight loss and lowering the risk of heart disease.
These medications are often comparatively more expensive than some of the other diabetic medications, depending on your insurance. While these medications have of course been approved by the FDA which involves significant safety date, there isn’t yet quite as much research as some of the other diabetic medications.
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These medications may also lead to more infections and an increased risk of broken bones. Some people think the increased falls causing broken bones may be due to dizziness from low blood pressure.
Your doctor may check your kidney function regularly while on this medication to make sure there aren’t any problems. There was an increased association of bladder cancer identified in people taking this medication. More studies for 1 last update 14 Jul 2020 need to be performed to find out what this risk really is. Your doctor may check your kidney function regularly while on this medication to make sure there aren’t any problems. There was an increased association of bladder cancer identified in people taking this medication. More studies need to be performed to find out what this risk really is.
While many oral medications are usually tried first, some people with advanced type 2 diabetes will need insulin injections. And all type 1 diabetics need insulin injections.
Therefore your doctor may put you on other medication that can help decrease the risk of other comorbid conditions. A baby aspirin is often included for heart health as are other medications used to treat high blood pressure (hypertension) and high cholesterol (hypercholesterolemia).
Don’t forget that no matter what medications you’re taking, a proper diabetic diet and regular exercise are also critical for your overall health and diabetes treatment.
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