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Can Metformin Help Control Diabetes?

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Posted on Mon, 15 Feb 2016
Question: Dear Doctor,
I want to ask some questions about my father's type 2 diabetes. I am from China (so is my father) and we also live in China. My father has been diagnosed with type 2 diabetes about 6 years ago and he has been taking metformin since then as his doctor in China suggested. My father is doing fine with metformin now. But we still have some questions and hope you can answer them.
1. Is metformin also commonly used to treat type 2 diabetes in the U.S. ?
2. Is there any better medication or other better treatment that are commonly used in the U.S. to treat type 2 diabetes. If there are, what are they?
3. Does injecting insulin do a better job to treat type 2 diabetes than taking medicine like metformin?
4. I heard about some injection that only need to be taken once a year or month to treat diabetes. Is it true? If it is, does it have any advantages over taking daily medicine or insulin other that its frequency ?

Thanks.
doctor
Answered by Dr. Binu Parameswaran Pillai (12 minutes later)
Brief Answer:
METFORMIN IS THE PREFERED FIRST LINE DRUG IN Type 2 Diabetes

Detailed Answer:
Good day,
Noted your concern.
Metformin is a fantastic choice in Type 2 diabetes. It treats underlying pathology and protects pancreas. It has numerous other good effects including protection against heart disease and certian cancers which are associated with diabetes.
METFORMIN remains the first and preferred drug of choice through out the world including USA and rest of the world. XXXXXXX Diabetes Asssociation strongly recommends starting metformin as first choice drug in type 2 diabetes. It even works better in Asians.

If a patient is intolerent to metformin ( mainly nausea, vomiting, bloating in stomach etc), then we may prefer another medicine like a DDP4 inhibitor or a GLP-1 anlogue, glitazones, SGLT-2 inhibitors or Sufonylureas. These are the alternatives to Metformin. Otherwise Metformin is the first line drug.

It is true that early initiation of insuin is beneficial. Insulin does have problems like weight gain, hypoglycemia etc. If a patient's diabetes is not well controlled with Metformin, then we can consider adding another pill along with Metformin or adding a basal insulin like Lantus. I prefer this second option ( adding Lantus to Metformin). Insulin just reduce glucose, but has not extra benefits like Metformin like weight reduction, prevention of certain cancers/heart disease etc.

Yes, you are right. Once weekly Exenatide and Liraglutide are new injections which are being tried. But remember that they do have higher side effects compared to Metformin.

IF A PATIENT HAS CONTRAINDICATIONS TO METFORMIN, like kidney failure, severe heart failure etc, then also, we go for an alternate pill or insulin

I hope i answered your question. Since you live in Indiana, you may have free access to XXXXXXX diabetes association website and there is a section for public. It is a resourceful website and more can be learned about Metformin.

regards
Binu




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (2 days later)
Thanks for your reply, doctor XXXXXXX
It is very helpful but I do have another question.

Do the effects/side effects vary on different brands of metformin, or on metformin manufactured in different countries.
doctor
Answered by Dr. Binu Parameswaran Pillai (14 minutes later)
Brief Answer:
Possible

Detailed Answer:
Yes, side effects and effects may vary based on brands and country of origin. It is possible In Many countries with not so strict health regulations, there are many generic manufactures who may not be using good raw materials to manufacture generic Metformin. Always buy from a registered and reputed Pharmacy . These issues are a problem in some Asian countries.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1438 Questions

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Can Metformin Help Control Diabetes?

Brief Answer: METFORMIN IS THE PREFERED FIRST LINE DRUG IN Type 2 Diabetes Detailed Answer: Good day, Noted your concern. Metformin is a fantastic choice in Type 2 diabetes. It treats underlying pathology and protects pancreas. It has numerous other good effects including protection against heart disease and certian cancers which are associated with diabetes. METFORMIN remains the first and preferred drug of choice through out the world including USA and rest of the world. XXXXXXX Diabetes Asssociation strongly recommends starting metformin as first choice drug in type 2 diabetes. It even works better in Asians. If a patient is intolerent to metformin ( mainly nausea, vomiting, bloating in stomach etc), then we may prefer another medicine like a DDP4 inhibitor or a GLP-1 anlogue, glitazones, SGLT-2 inhibitors or Sufonylureas. These are the alternatives to Metformin. Otherwise Metformin is the first line drug. It is true that early initiation of insuin is beneficial. Insulin does have problems like weight gain, hypoglycemia etc. If a patient's diabetes is not well controlled with Metformin, then we can consider adding another pill along with Metformin or adding a basal insulin like Lantus. I prefer this second option ( adding Lantus to Metformin). Insulin just reduce glucose, but has not extra benefits like Metformin like weight reduction, prevention of certain cancers/heart disease etc. Yes, you are right. Once weekly Exenatide and Liraglutide are new injections which are being tried. But remember that they do have higher side effects compared to Metformin. IF A PATIENT HAS CONTRAINDICATIONS TO METFORMIN, like kidney failure, severe heart failure etc, then also, we go for an alternate pill or insulin I hope i answered your question. Since you live in Indiana, you may have free access to XXXXXXX diabetes association website and there is a section for public. It is a resourceful website and more can be learned about Metformin. regards Binu