What is the efficacy index of T2 meds on BS level.

[raj1461]

Can one quantify the effect of 500mg Metformin on Blood Sugar level ? for eg. If one consumes say 1 glass cola and after 2 hrs the BS level is 250 so if one takes 1 tab of 500mg Metformin then by how much will the BS level come down, is there any study on this aspect of Metformin and other such T2 meds. Just curious to know how T2 meds work. TY

[Praveen55 Moderator]

Effect of any medicines including Metformin varies from person to person. On overall average basis it has been found that Metformin lowers fasting blood glucose levels by an average of 25% (17 to 37%), postprandial blood glucose up to 44.5%, and the A1c by an average of 1.5% (0.8 to 3.1%).

[raj1461 in reply to Praveen55]

Thank you for getting the gist of the question correctly, if possible can you put it in numbers that how much will BS get reduced to from 250 level and is this linear, for example if 1 tab of 500mg Metformin brings down the BS of 250 to 150(100 units) then if the BS level is 600 then will it bring it down to 500, is this reduction linear?

[Praveen55 Moderator in reply to raj1461]

Unfortunately, I did not find any report that addresses the effect of Metformin to that extent. I will put it here if I come across one that does. I believe there is no such information available because it depends on individual's conditions. Even Doctors start treatments with the lowest dose and gradually increase the dosage to bring down the BS to desirable range.

[raj1461 in reply to Praveen55]

Thank you sir.

[Hidden]

If you are diabetic and concerned enough to ask the question - it begs the question - Why are you drinking sweetened Coca Cola in the first place? Surely the practise is sheer madness and your question is surely motivated by a need of breaking rules rather than sticking to them

[raj1461 in reply to Hidden]

Nobody is drinking Cola, Cola is just an example, I wanted to know how much will BS level of 250 get reduced to by having 1 tab of 500 mg Metformin.

[Hidden in reply to raj1461]

Go see a Doctor or your diabetic clinic

[raj1461 in reply to Hidden]

As I said nobody is drinking cola, it is just an example for the question asked. TY

[Hidden in reply to raj1461]

Go see a Doctor or your diabetic clinic

[Hidden in reply to raj1461]

What is the point of the question if you do not abuse your diet? What research are you doing? Are you diabetic?

[raj1461]

Sir, 250 is just a random number, I just want to know how much will BS level of 250 get reduced to by having 1 tab of 500 mg Metformin, is there any study done on this.

[Hidden]

What a good answer - the question just makes no sense at all

[ttchari in reply to Hidden]

I don't understand. It appears to me a legitimate question. When we talk about health we should come to brass-stacks. For instance pp is 1 hr, 1.5 hr or 2 hrs?

[ttchari in reply to ttchari]

According to Dr.Bernstein 1 gm of carb increases the blood sugar by 5 points as per my understanding.

[Hidden in reply to ttchari]

What is the point of the question if you do not abuse your diet? What research are you doing? Are you diabetic?

[Praveen55 Moderator]

Average reduction in A1C = 1.5 %

Minimum reduction in A1C = 0.8%

Maximum reduction in A1C = 3.1%

Dosage: is within the recommended dosage. Will provide further information, I do not have them ready at hand.

[ttchari]

I am not able to open the web site. Error permission from owner required. Any help?

[Praveen55 Moderator in reply to ttchari]

I have copied and pasted the contents below.

Metformin

Two drugs from the biguanide class, metformin and phenformin, were developed in 1957. Unfortunately, phenformin reached the U.S. market first and resulted in several deaths from lactic acidosis. When this risk surfaced, phenformin was pulled from drugstore shelves worldwide. Metformin was eventually found to be 20 times less likely to cause lactic acidosis, but it was tainted by the history of its cousin. Metformin first became available in France in 1979 and has been widely used in Europe since then, but it was not cleared for use in Type 2 diabetes in the U.S. until 1994.

Metformin

Target Organ: Liver, secondary effects on muscle and fat.

Action: Lower glucose production by liver, increase number of insulin receptors

on muscle and fat cells

Lowers HbA1c by 1.5% to 2.0%

Time to reach maximum effect: 2-4 hrs

Taken: with meal

DrugActs OverDose RangeDoses/Day

Glucophage

(metformin)8-12 hrs500 - 2550 mg2-3

Glucophage XR

(metformin)24 hrs500 - 2250 mg1

Glucovance

(metformin

+ glyburide)12-18 hrs250/1.25 to

2000/20 mg2-3

Side Effects: bloating, fullness, nausea, cramping, diarrhea, vit B12 deficiency, headache, metallic taste, agitation, lactic acidosis

Contraindications: DKA, alcoholism, binge drinking, kidney or liver disease, congestive heart failure, pregnancy, use of contrast media, surgery, heart attack, age > 80

Metformin is a chemical kin to the French lilac plant, which was noted in the early 1900’s to lower the blood sugar. However, French lilac, like phenformin, turned out to be too toxic for use in humans. Metformin, with a much shorter action time than phenformin, has a much lower risk for severe side effects and is quite safe for use by anyone who is otherwise healthy. In fact, in the major UKPDS study, it was the only drug that reduced diabetes-related death rates, heart attacks, and strokes. It should not be used by those who use more than two ounces or two drinks of alcohol a day, who have congestive heart failure, or who have significant kidney, liver, or lung disease.

Metformin lowers fasting blood glucose levels by an average of 25% (17 to 37%), postprandial blood glucose up to 44.5%, and the A1c by an average of 1.5% (0.8 to 3.1%). Metformin reduces raised plasma insulin levels in cases of metabolic syndrome by as much as 30% and reduces the need for injected insulin in Type 2s by 15 to 32%.

Metformin is available under the trade name Glucophage, or as an extended-release tablet called Glucophage XR. It works well when combined with sulfonylureas. A combination of glyburide and metformin is available as Glucovance. Combined therapy leads to a greater reduction in blood sugar than can be attained by either class alone. Generic metformin is available at a reduced cost.

Metformin possesses some distinct advantages in treating diabetes. Excess glucose produced by the liver is the major source of high blood sugars in Type 2 diabetes and is typically the reason for high blood sugars on waking in the morning. Metformin reduces this overproduction of glucose. It helps in lowering the blood sugar, especially after eating, with no risk of hypoglycemia when used alone. Modest improvement in cholesterol levels are also seen. The 10 year UKPDS Study of over 3,000 people with Type 2 diabetes found that those who were placed on metformin had a 36% decrease in overall mortality and a 39% decrease in heart attacks.

Because metformin shuts off the liver’s excess production of glucose, it reduces the amount of injected insulin needed to control the blood sugar in both Type 1 and Type 2 diabetes. People with Type 2 diabetes who are on insulin usually are advised to lower their insulin doses prior to starting metformin. The full improvement in glycemic control and cholesterol levels may not be seen until 4 to 6 weeks of use have passed.

Side effects from metformin include a change in taste, loss of appetite, nausea or vomiting, abdominal bloating or gas, diarrhea, or skin rash. These may occur during the first few weeks of taking the medication but are seldom long-lasting. Taking the medication with food and starting out with a low dose help reduce side effects. The dosage can be gradually increased as side effects diminish.

Lactic acidosis, the serious but rare side effect originally seen with phenformin, results when a buildup of lactic acid occurs due to an inability to clear metformin from the system. Lactic acidosis occurs very rarely, only once in every 30,000 person-years of use. It almost always occurs in older people who have another major health problem, especially one that may impair breathing or circulation. Warning signs of lactic acidosis include fast and shallow breathing, diarrhea, severe muscle aches, cramping, unusual weakness or tiredness, or feeling cold. Because lactic acidosis has a mortality rate of about 40%, anyone who has significant lung disease, congestive heart failure, or kidney disease should never take this drug.

Because drinking alcohol while taking metformin may also trigger lactic acidosis when other health risks are present, be sure to ask your doctor about alcohol consumption if you are taking this drug. Be aware that Tagamet, a gastrointestinal medication, may enhance the effects of metformin. Therefore, the dose of metformin may need to be lower if you already take Tagamet.

Although not yet FDA approved, metformin is now in clinical trials for treatment of teens who have developed Type 2 diabetes. Some pediatricians also prescribe it, on occasion, to help control a strong Dawn Phenomenon seen in a growing teen with Type 1 diabetes. This use is also not approved. It also helps lower insulin resistance in women with polycystic ovary disease. One side-effect for these women, sometimes a desired outcome, is a greater likelihood of pregnancy.

[raj1461 in reply to Praveen55]

Good info, thank you.

[sandybrown in reply to raj1461]

You question is very classroom level!

One can use a home testing kit to check blood glucose number. Healthy life style says avoid and fizz drinks. Medication is necessary. How long does it take a person to go over drink drive limit? There are many drinks and quantity. Why take a drink,? have a soft drink!!!

[rnpath]

stay away from cola,since it destabilises your sugar for over 72 hours,even if it is zero calories, and avoid aspartime as sweetener.there is also a delayed rebound hyperglycemia after cola.