Metformin (Glucophage) This drug affects the body in several ways: Metformin increases the body’s sensitivity to insulin, increases the muscles ability to use insulin, decreases glucose production in the liver, does not promote weight gain, somewhat reduces levels of triglycerides and other fats such as LDL or “bad” cholesterol in the blood, and may decrease the absorption of glucose from the intestine. All these effects usually result in lower blood sugar. Side effects may include loss of appetite, nausea, and diarrhea. Metformin is available in 500-mg and 850-mg tablets with a maximum dosage of 2,550-mg per day. Contra indications for metformin include patients with Type 1 diabetes; those at risk for cardiovascular disease; those with kidney or liver disease; serum creatinine levels greater than 1.4 (for men) and 1.5 (for women); those who use alcohol excessively; and children and pregnant women. The use of metformin with any of these can result in serious and potentially fatal side effects such as lacticacidosis. It can be used with oral hypoglycemic agents, acarbose, troglitazone, or insulin.

Acarbose (Precose) This drug works in the small intestine to slow the breakdown of carbohydrates, particularly complex carbohydrates. Acarbose slows down the natural breakdown of starches, dextrins, maltose, and sucrose to absorbable monosaccharides. It is therefore most effective for people with high glucose levels after eating. Acarbose is taken just before meals, or with the first bite of each meal. Doses begin with one 25-mg dose with the first bite of a meal. Side effects include abdominal pain, diarrhea, and flatulence. Acarbose is not to be used with patients who have inflammatory bowel disease, colonic ulceration, or partial intestinal obstruction. It can be used alone or in combination with any of the other drugs and/or insulin.

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This entry was posted on Monday, February 25th, 2008 at 4:56 am and is filed under Diabetes Care. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.