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Biguanides for Type 2 Diabetes
Biguanides do not cause low blood sugar (hypoglycemia) or weight gain, which are common side effects of the sulfonylurea medicines.
Metformin (Glucophage) has to be taken 2 to 3 times a day, but the extended-release form (Glucophage XR) can be taken just once a day. Both are available in generic form. Some people may have fewer gastrointestinal side effects with Glucophage XR than with Glucophage.
Although metformin may be safe to take during pregnancy, the U.S. Food and Drug Administration (FDA) has not approved it for that use. Talk with your doctor immediately if you become pregnant while taking metformin.
The effect of metformin may be increased if you also take cimetidine (Tagamet). Talk with your doctor if you are taking Tagamet.
The U.S. Food and Drug Administration (FDA) has announced a possible safety issue with the drug rosiglitazone (Avandia). A new study shows that people who take Avandia may raise their chance of having a heart attack. They may also raise their chance of death from heart disease.
Manufacturers of rosiglitazone (Avandia), pioglitazone (Actos), rosiglitazone and glimepiride (Avandaryl), rosiglitazone and metformin (Avandamet), and pioglitazone and glimepiride (Duetact) have added a warning that these drugs may cause heart failure or make heart failure worse in certain people.
Metformin is avoided in people with unstable heart failure.
If you take any of these medicines, do not stop taking them. Call your doctor to talk about which medicine is best for you.
Metformin usually keeps blood sugar levels within a target range without increasing the likelihood that you will gain weight. If after 3 to 6 months of treatment with metformin blood sugar levels are not consistently within your target range, a sulfonylurea or insulin is usually added.
Metformin should be stopped during an illness that causes vomiting or diarrhea or any condition that causes dehydration. Check with your doctor.
Children
Few studies have been done on the use of oral medicines for type 2 diabetes in children. And these medicines have not been approved by the U.S. Food and Drug Administration (FDA) for use in children. But because these oral medicines are safe for adults, most doctors use them to treat children who have type 2 diabetes.
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| By: | Healthwise Staff | Last Revised: June 9, 2010 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology | |
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