“Why is Metformin prescribed for type 2 diabetes first (the side effects are HORRIBLE)?”
Because it is the oldest, and SAFEST type 2 medication there is. It was first used in the U.S. in the 1950s - prior to that, there were NO medications for T2 (Type 2 diabetes mellitus).
It actually does nothing to lower BG (Blood Glucose) levels - what it does is to inhibit the gluco-regulatory response that raises BG… which in T2’s is an issue due to the underlying biochemical failure of the cells to respond completely and efficiently to the action of insulin - which results in the release of the hormone glucagon which triggers a liver release of glucose into the bloodstream - raising the BG too high.
By inhibiting that last step - metformin improves BG levels. It is the most effective medication there is for this - though in the last few years, researchers are starting to re-think the efficacy of using insulin for T2s sooner rather than later.
As for side effects - the side of effects of metformin are not nearly as “horrible” as the side effects of many of the other oral T2 medications. Lets review a few.
Thiazoladinediones (Actos, Avandia) may cause liver disease, fluid retention, weight gain, and increased risk for fractures and bladder cancer (and, due to impacts on the ovulation process, increased risk for pregnancy in women).
DPP-4 inhibitors (Januvia, Onglyza, Tradjenta, Nesina) may cause hypoglycaemia, headaches, nasopharyngitis, edema, hives, urinary tract infections, and facial swelling.
Sulfonylureas (Dymelor, Diabenese, Tolinase, Orinase, Amaryl, Glucotrol, Glucotrol XL, Diabeta, Micronase) may cause skin rash, upset stomach, liver disease, and loss of red blood cells.
Meglitinides (Starlix, Prandin) may cause hypoglycaemia and weight gain.
a-glucosidase inhibitors (Precose, Glyset) may cause gas, bloating, upset stomach, and diarrhea (sound familiar?)
SGLT-2 inhibitors (Jardiance, Invokana, Farxiga) may cause yeast infections (of the vagina or penis - your preference), upper respiratory tract infections, urinary tract infections, urinary urgency, hypotension (low blood pressure), kidney impairment, dehydration, bladder cancer, hypoglycaemia, increased cholesterol.
Bile acid sequestrants (Welchol) may cause stomach pain, constipation, heartburn.
Bromocryptine mesylate may cause nausea, runny nose, headache, weakness, dizzyness, and constipation.
AND… ALL of these (like metformin) still require the patient to employ dietary restrictions on carb intake, and to maintain a regular exercise regimen, to be effective.
SO… while it ain’t perfect… metformin is not-so-bad compared to many of the other T2 medication options. But you can always ask your doc to let you try one of the others.
Learn more about managing diabetes at home
by Wayne Bottlick, Senior Manager | www.quora.com
Because it is the oldest, and SAFEST type 2 medication there is. It was first used in the U.S. in the 1950s - prior to that, there were NO medications for T2 (Type 2 diabetes mellitus).
It actually does nothing to lower BG (Blood Glucose) levels - what it does is to inhibit the gluco-regulatory response that raises BG… which in T2’s is an issue due to the underlying biochemical failure of the cells to respond completely and efficiently to the action of insulin - which results in the release of the hormone glucagon which triggers a liver release of glucose into the bloodstream - raising the BG too high.
By inhibiting that last step - metformin improves BG levels. It is the most effective medication there is for this - though in the last few years, researchers are starting to re-think the efficacy of using insulin for T2s sooner rather than later.
As for side effects - the side of effects of metformin are not nearly as “horrible” as the side effects of many of the other oral T2 medications. Lets review a few.
Thiazoladinediones (Actos, Avandia) may cause liver disease, fluid retention, weight gain, and increased risk for fractures and bladder cancer (and, due to impacts on the ovulation process, increased risk for pregnancy in women).
DPP-4 inhibitors (Januvia, Onglyza, Tradjenta, Nesina) may cause hypoglycaemia, headaches, nasopharyngitis, edema, hives, urinary tract infections, and facial swelling.
Sulfonylureas (Dymelor, Diabenese, Tolinase, Orinase, Amaryl, Glucotrol, Glucotrol XL, Diabeta, Micronase) may cause skin rash, upset stomach, liver disease, and loss of red blood cells.
Meglitinides (Starlix, Prandin) may cause hypoglycaemia and weight gain.
a-glucosidase inhibitors (Precose, Glyset) may cause gas, bloating, upset stomach, and diarrhea (sound familiar?)
SGLT-2 inhibitors (Jardiance, Invokana, Farxiga) may cause yeast infections (of the vagina or penis - your preference), upper respiratory tract infections, urinary tract infections, urinary urgency, hypotension (low blood pressure), kidney impairment, dehydration, bladder cancer, hypoglycaemia, increased cholesterol.
Bile acid sequestrants (Welchol) may cause stomach pain, constipation, heartburn.
Bromocryptine mesylate may cause nausea, runny nose, headache, weakness, dizzyness, and constipation.
AND… ALL of these (like metformin) still require the patient to employ dietary restrictions on carb intake, and to maintain a regular exercise regimen, to be effective.
SO… while it ain’t perfect… metformin is not-so-bad compared to many of the other T2 medication options. But you can always ask your doc to let you try one of the others.
Learn more about managing diabetes at home
by Wayne Bottlick, Senior Manager | www.quora.com
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