Metabolic agents metformin

Metformin also has been shown to produce beneficial effects on serum lipid levels and thus has become a first-line agent for type 2 DM patients with metabolic syndrome. Triglyceride and low-density lipoprotein (LDL) cholesterol levels often are reduced by 8% to 15%, whereas high-density lipoprotein (HDL) cholesterol improves by approximately 2%. A modest weight loss of 2 to 3 kg (4.4—6.6 lb) also has been reported with metformin therapy. Metformin often is used in combination with a sulfonylurea or a thiazolidinedione for synergistic effects. 

Diabetic patients Weight-loss induction by orlistat may be accompanied by improved metabolic control in diabetic patients, which might require a reduction in dose of oral hypoglycemic medication (eg, sulfonylureas, metformin) or insulin. Misuse potential As with any weight-loss agent, the potential exists for misuse of orlistat in inappropriate patient populations (eg, patients with anorexia nervosa or bulimia). 

Metabolism Prickly pear cactus is a popular food among Mexicans, Mexican-Ameri-cans, and Hispanics and is commonly used to treat type 2 diabetes mellitus. The combination of prickly pear cactus with oral hypoglycemic agents, such as metformin and glipizide, in patients with type 2 diabetes mellitus may increase the risk of hypoglycemia because of additive blood glucose lowering effects [70" ]. 

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