This article is from the WebMD News Archive
Old Diabetes Drug Has Advantages
Report: Metformin Effective With Fewer Side Effects Than Newer Drugs
Reviewed by
Brunilda Nazario, MD
July 16, 2007 -- Most type 2 diabetes drugs are equally effective for lowering blood sugar, but the generic drug metformin has fewer side effects than several newer, pricier medications, a government report finds.
Metformin users are less likely to gain weight than type 2 diabetes patients who take Avandia, Actos, or other newer medications, researchers concluded, and they are more likely to show improvements in so-called "bad" cholesterol.
The report was issued by the Agency for Healthcare Research and Quality (AHRQ), a division of the Department of Health and Human Services.
Researchers from Johns Hopkins University’s Evidence-based Practices Center reviewed 216 previously published studies in their effort to compare the effectiveness, risks, and costs of older and newer diabetes pills.
The study, which was made public today, will appear in the Sept. 18 issue of the Annals of Internal Medicine.
Diabetes Drugs: Old and New
All diabetes medications help to lower blood sugar, but they work in different ways. Metformin and drugs in the class known as sulfonylureas, such as Glipizide or Glyburide, are among the least-expensive oral diabetes medications because generic versions are now available.
The newer oral medications Avandia (by GlaxoSmithKline) and Actos (by Takeda Pharmaceuticals) -- both in the drug class thiazolidinedione (TDZ) -- are now among the most widely prescribed diabetes drugs.
Among the highlights of the report:
- Metformin was one of the few diabetes drugs not associated with an increase in weight. The report noted that other widely prescribed diabetes drugs have been shown to increase body weight by an average of 2 to 11 pounds.
- Use of metformin was associated with a decrease in blood levels of low-density lipoprotein, or "bad" cholesterol, while use of the TDZ class of drugs raised levels good cholesterol and had a harmful effect on LDL "bad" cholesterol.
- Amaryl, Glucotrol, and other sulfonylurea drugs were more likely to cause unsafe drops in blood sugar (hypoglycemia) than other diabetes drugs.
- Patients on metformin or the drug acarbose complained of diarrhea and other gastrointestinal problems more than users of other drugs. Patients who took only metformin were more likely to experience these digestive problems than patients who took lower doses of metformin in combination with other diabetes drugs.
- Use of Avandia and Actos was associated with a greater risk of congestive heart failure.
Diabetes Drugs and the Heart
Concerns about heart failure risk led the FDA to announce last month that labels for Avandia and Actos will soon carry a "black box" warning to alert doctors and patients to the risk. A highly publicized study recently linked Avandia to an increased risk of death from heart attacks, but the drug's manufacturer has challenged the findings.
In testimony before a congressional committee in June, a GlaxoSmithKline spokesman said there is no evidence that Avandia carries more heart risk than other drugs of its class. And an interim report from an ongoing company-sponsored study assessing Avandia's impact on the heart found the data on heart attack risk to be inconclusive.
Is This Normal?
Get the Facts Fast!Answer:
Your level is currently NormalHigh (hyperglycemia).Low (hypoglycemia). |
If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
Your blood sugar level is slightly high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.
Congratulations on taking steps to manage your health.
However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.
Your level is currently normal. However, if you are concerned about diabetes speak with your physician. There may be other risk factors that increase your risk for diabetes.
Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.
Blood sugars consistently above 180 warrant prompt medical attention.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.
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