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On the basis of the evidence reviewed in this paper, ACP has found strong evidence that in most patients with type 2 diabetes in whom lifestyle modifications have failed to adequately improve hyperglycemia, oral pharmacologic therapy with metformin (unless contraindicated) is an effective management strategy.
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Not for use in patients with type 1 diabetes or diabetic ketoacidosis.
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As for the original metformin formulation, she added, current trials should help to map the way forward for its use in prevention.
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Only three trials reported severe hypoglycaemia in 24 patients (metformin and insulin, 18; placebo and insulin, six).
It can be used to induce menstruation and can be used as oral contraceptive as well.
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Bernstein recommends Glucophage, which was the original patented form of metformin prescribed before the generics came on the market.
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The reduction of renal lipotoxicity by metformin could thus be a new strategy for the prevention of diabetic nephropathy.
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While the majority of evidence supporting a role for metformin in the treatment of cancer has been derived from retrospective studies involving diabetics, some prospective clinical trials have been completed in non-diabetic patients.
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Although the influence of bias cannot be excluded, trial sequential analysis suggested evidence was sufficient for the effect, found in a random effects model, of metformin and insulin versus insulin alone on these surrogate outcomes.
Metformin may help restore regular menstrual cycles and improve metabolism, thus possibly leading to weight loss in women with PCOS.
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If only the medical establishment in the United States had looked across the border as close as Canada, they would have seen metformin being liberally prescribed with nowhere near the incidences of lactic acidosis they feared.
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Inhibition of dipeptidyl peptidase IV (DPP IV) is one of the mechanisms explaining the hypoglycemic effect of berberine.
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Identification of impaired fasting glucose, healthcare utilization and progression to diabetes in the UK using the Clinical Practice Research Datalink (CPRD).
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Moskowitz that many elderly patients with heart failure are prescribed metformin and it is possible that some of these patients benefit from treatment with metformin.
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The authors acknowledged several limitations of the trial: absence of a placebo control group, no use of hyperglycemic clamp or duodenal nutrient perfusion to eliminate differences in blood glucose and gastric emptying, and no assessment of various gut hormones that might be affected by the two therapies.
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For Diabetes, Type 2: "I have been on metformin for 6 years started at 500 mg per day.
Safety and efficacy of transferring from therapy with other oral antidiabetic agents to Actoplus Met or Actoplus Met XR not established; undertake any such change with caution and appropriate monitoring.
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