Metformin weight loss

Metformin. Metformin [657-24-9] (1,1-dimethylbiguanide), mol wt 129.17, forms crystals from propanol, mp 218—220°C, and is soluble in water and 95% ethanol, but practically insoluble in ether and chloroform. Metformin, an investigational dmg in the United States, does not increase basal or meal-stimulated insulin secretion. It lowers blood glucose levels in hyperglycemic patients with Type II diabetes but has no effect on blood glucose levels in normal subjects. It does not cause hypoglycemia. Successful metformin therapy usually is associated with no or some weight loss. 

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). 

The use of metformin in polycystic ovarian syndrome, which is often accompanied by insulin resistance or other aspects of the metabolic syndrome, has been systematically reviewed (101). Metformin was therapeutically less effective than weight loss. Adverse effects were nausea, vomiting, and gastrointestinal disturbances. 

Abdominal discomfort is frequent with metformin (15-25%), and nausea, vomiting, and diarrhea occur even in the absence of lactic acidosis. Other effects include flatulence, abdominal bloating, anorexia, and a metallic taste. Anorexia and weight loss are often seen at the beginning of treatment. Phenformin can cause hemorrhagic gastritis (65). 

The administration of metformin at bedtime instead of supper time may improve diabetes control by reducing morning hyperglycaemia (Ravina and Minuchin, 1990). Metformin was not distinguished from tolbutamide in elderly diabetic patients, except in that it was associated with weight loss (Josephkutty and Potter, 1990). 

Metformin can cause adverse gastrointestinal effects with anorexia, nausea and vomiting. Patients may experience a metallic taste and there may be weight loss, which in some diabetics could be an advantage. Hypoglycaemia is less of a problem with metformin than with sulphonylureas. 

Weight loss, ciomiphene with or without metformin, aromatase inhibitors... 

The client who is obese is participating in an investigational study using metformin (Glucophage), a biguanide antidiabetic medication, for weight loss. Which data should the nurse monitor ... 

HbAlc decreased by 0.78% from the baseline value of 8.2% associated with a further weight loss of 2.8 kg. Thus, the combination of metformin with injection of Exenatide seems to be superior to the combination therapy of metformin with insulin. 

Lee A, Morley JE. Metformin decreases food consumption and induces weight loss in snbjects with obesity with type 11 non-insnlin-dependent diabetes. Obes Res 1998 6 47-53. 

Beneficial results in the glycemic profile (mean reduction of fasting glucose by about 0.8 mmol/L) have been reported with orlistat-induced weight loss in 6- to 12-month studies in obese type 2 diabetic patients. This has been found also when orlistat was given as an adjunct to antidiabetic treatment such as with metformin and sulphonylurea drugs. Smaller but significant reductions of HbAlc have also been found by orlistat treatment (placebo controlled). 

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. 

Biguanides Metformin Suppression of hepatic gluconeo-genesis by AMPK phosphorylation Low rates of hypoglycemia, weight stability/loss, better insulin sensitivity Gastrointestinal side effects and possible affection to renal or hepatic function... 

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