Metformin efficacy

Nagasaka S, Aiso Y, Yoshiwaza K, Ishibashi S. Comparison of pioglitazone and metformin efficacy using homeostasis model assessment. Diabetic Med 2004 21 136 1. 

Patient management Monitor long-term efficacy by measurement of HbA- c levels approximately every 3 months. When hypoglycemia occurs in patients taking a combination of repaglinide and a thiazolidinedione or repaglinide and metformin, reduce the dose of repaglinide. 

Individualize dosage on the basis of efficacy and tolerance, while not exceeding the maximum recommended daily dose of metformin IR 2,550 mg in adults and 2,000 mg in children (10 to 16 years of age) the maximum recommended daily dose of metformin ER in adults is 2,000 mg (2,500 mg with Fortamet). Give metformin IR in divided doses with meals and give metformin ER once daily with the evening meal. Start at a low dose, with gradual dose escalation, to reduce Gl side effects and... 

Chiidren Safety and efficacy of metformin IR for the treatment of type 2 diabetes have been established in children 10 to 16 years of age who demonstrated a similar response in glycemic control to that seen in adults. Adverse effects were similar to those described in adults. A maximum daily dose of 2,000 mg is recommended. Safety and efficacy of metformin ER in children have not been established. 

Charbonel B, Karasik A, Ji Liu, Mei Wu, Meininger G, for the Sitagliptin Study 020 Group. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor sitagliptin added to ongoing metformin therapy in patients with type 2 diabetes inadequately controlled with metformin alone. Diabetes Care 2006 29 2638-43. 

Hanefeld M, Bar K. Efficacy and safety of combined treatment of type 2 diabetes with acarbose and metformin. Diabetes Stoffwechsel 1998 7 186-90. 

Rosenstock J, Brown A, Fischer J, Jain A, Littlejohn T, Nadeau D, Sussman A, Taylor T, Krol A, Magner J. Efficacy and safety of acarbose in metformin-treated patients with type 2 diabetes. Diabetes Care 1998 21(12) 2050-5. 

Johansen K. Efficacy of metformin in the treatment of NIDDM. Meta-analysis. Diabetes Care 1999 22(l) 33-7. 

Gomez-Perez FJ, Fanghanel-Salmon G, Antonio Barbosa J, Montes-Villarreal J, Berry RA, Warsi G, Gould EM. Efficacy and safety of rosiglitazone plus metformin in Mexicans with type 2 diabetes. Diabetes Metab Res Rev 2002 18(2) 127-34. 

Schatz H, Schoppel K, Lehwalder D, Schandry R. Efficacy, tolerability and safety of nateglinide in combination with metformin. Results from a study under general practice conditions. Exp Clin Endocrinol Diabetes 2003 111 262-6. 

Garber AJ, Donovan Jr DS, Dandona P, Bruce S, Park J-S. Efficacy of glyburide/metformin tablets compared with initial monotherapy in type 2 diabetes. J Clin Endocrinol Metab 2003 88 3598-604. 

Insulin resistance in type 2 diabetes contributes to reduced efficacy of both endogenous and exogenous insulin. When metformin and pioglitazone were compared in patients who had not taken previous drug therapy, they were equally efficacious in glycemic control, but parameters of insulin sensitivity increased much more with pioglitazone (83). 

Barnett,A.H.,Dreyer,M.,Lange,P., and Serdarevic-Pehar, M. (2006), An open,randomized, parallel-group study to compare the efficacy and safety profile of inhaled human insulin (exubera) with glibenclamide as adjunctive therapy in patients with type 2 diabetes poorly controlled on metformin, Diabetes Care, 29,1818-1825. 

PHENYTOIN ANTIDIABETIC DRUGS- METFORMIN, SULPHONYLUREAS 1 hypoglycaemic efficacy Hydantoins are considered to 1 release of insulin Monitor capillary blood glucose closely higher doses of antidiabetic drugs needed... 

METFORMIN ISONIAZID 1 efficacy of antidiabetic drugs Isoniazid causes hyperglycaemia, the mechanism being uncertain at present Monitor capillary blood glucose closely t doses of antidiabetic drugs may be needed... 

Garber AJ, Duncan TG, Goodman AM, Mills DJ, Rohlf JL. Efficacy of metformin in type II diabetes Results of a double-blind, placebo-controlled, dose-response trial. Am J Med. 1997 102 491-7. 

The combination of metformin and insulin in Type-II diabetics increases the efficacy of insulin and reduces insulin resistance in obese patients. A considerable reduction in insulin doses has been achieved (Leblanc et al., 1987). Free serum insulin levels have been reduced from 51 to 41 units/ml 1 (Stowers, 1980). On mixed biguanide-insulin treatment, the atherogenic effect of hyperinsulinaemia and the number of hypoglycaemic reactions can be reduced. 

The therapeutic effects of acarbose and biguanides have been compared in Type-II diabetics (Pagano and Cavallo-Perin, 1990) and found to be nearly equally effective. The same was true in studies (by Schwedes et al. (1982), who compared acarbose and metformin in poorly controlled NIDDM, while Schoffling et al. (1982) reported that acarbose was even more effective than metformin. Drost et al. (1982) concluded from their studies, however, that there was no basic difference between the hypoglycaemic effects of acarbose and metformin. Petersen (1982) tested the efficacy of acarbose versus buformin in NIDDM. Acarbose was found to reduce postprandial but not fasting blood glucose levels and to be slightly less effective than buformin. 

To date, the major treatments for NAFLD have been those aimed at lowering body weight and fat content. Loss of weight is often associated with decreased ALT values in one study, a 1% decrease in weight was associated with an 8% decrease in ALT activity. The association of NAFLD with insulin resistance has suggested treatment with antidiabetic medications, particularly those that increase insulin responsiveness (such as PPAR-y receptor agonists and metformin), but there are no conclusive studies that document safety and efficacy. 

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