Content for Glimepiride + Metformin

(NICE 2015). A Cochrane review article assessed 25 studies, encompassing almost 12,864 patients of published randomized controlled trials of various lengths from 12 to 52 weeks. The review highlighted that individual study sizes and lengths of study were different, renal and hepatic function patient inclusion criteria between studies was different, and therefore it was not possible to directly compare the efficacy of individual agents within this drug class. (Richter et al., 2008) It must also be noted that some of these trials were funded by pharmaceutical companies, and therefore may be prone to bias. Inzucchi SE et Al, 2015 compiled an independent comparative report using twelve peer reviewed published studies of randomized double blind trials, that indicates as an add-on to metformin therapy, the individual drugs within the class, showed between 0.5% to 0.83% reduction in HbA1c versus placebo, with Saxagliptin Linagliptin and Sitagliptin showing the greatest equal efficacy (Inzucchi SE et Al, 2015). However, episodes of hypoglycaemia were reported in significantly lower numbers of patients on Sitagliptin (1.3%) compared to Saxagliptin (5.2%), hence Sitagliptin was the prescribing choice for patient XY. It is important to bear in mind that the cost of both drugs is similar (BNF 2015), and with imminent loss of patent with

Answer: The combination of Insulin as well as oral hyperglycaemic drugs may be prescribed for Diabetes because they help in lowering the blood glucose levels. However the primary treatment doesn’t consist of these drugs. The primary treatment comprises of Diet control, Physical activity and Weight control. If after following the primary treatment strictly, no improvement in the blood glucose level is achieved then medication is suggested for the same. Insulin helps in maintaining the blood sugar levels. Note that insulin is not to be taken orally because the acids and digestive juices in the stomach destroy it. It has to be injected under the skin only. Taking insulin leads patient to experience Hyperglycaemic condition. The Hyperglycaemic drugs helps our body to react appropriately with the insulin so that the insulin hormone is able to help transfer glucose from blood to the cells successfully.

Diabetes is a growing concern and health challenge for the American people (b). Diabetes is a condition in which the body cannot react to insulin appropriately or either cannot produce insulin efficiently (w). “Without a properly functioning insulin signaling system, blood glucose levels become elevated and other metabolic abnormalities occur, leading to the development of serious, disabling complications” (w). There are numerous forms of diabetes amongst the nation, however, there are three main forms of diabetes. Most people have heard of type one diabetes, type two diabetes, and gestational diabetes because they are common. Type two diabetes deals with a resistance to insulin, while

Cynthia is a 65 year old African American female diagnosed with type 2 diabetes mellitus, diabetic peripheral neuropathy, hypertension, kidney disease, hyperlipidemia and hypothyroidism. She is on glipizide 5 mg po daily to treat her type 2 diabetes. Cynthia revisited the clinic soon after the initiation of the treatment with symptoms of shakiness, sweating, chills, clamminess, lightheadedness and moderately severe headache. In this case study, Cynthia is exhibiting the symptoms of hypoglycemia as she is on sulfonylurea therapy. Sulfonylureas, such as glipizide commonly used as a second-line of therapy in patients with Type 2 Diabetes Mellitus (T2DM), promote insulin release independent of prevailing glucose value and as a result,

If the doctor has prescribed a different dose from your friend who has type II diabetes and on the medication, take the dose as prescribed; don’t take the drug in larger or smaller quantity or for a longer time than directed. If unclear on the dosage prescribed, contact

It also decreases the amount of sugar absorbed by your intestines and stomach and lowers the level of sugar that is made by the liver as well as helps to maintain it at a normal level. Your metformin medication alone is not likely to contribute to an episode of hypoglycemia however if taken in conjunction with other diabetic medications it could increase your changes so be mindful of the combination of medications which you are taking. Some common side effects is nausea, upset stomach or vomiting and diarrhea other signs of an allergic reaction could be hives, swelling of your face, tongue, lips, and difficulty

Glyburide is another generic medication used in the management of diabetes mellitus type 2. Two trade names of this drug are DiaBeta and Glynase. The chemical name is 1-[ [p-[2-(5-chloro-o-anisamido) ethyl]phenyl]-sulfonyl]-3-cyclohexylurea. Doses up to 0.75-12 mg/day can be given as a single dose or divided doses. The circulation of the glyburide is that protein binding is extensive and half-life is 10 hours. It is excreted through the renal and biliary system. Glyburide acts as an oral blood glucose lowering drug. The drugs uses include binding and activating the sulfonylurea receptor 1, which causes depolarization. This results in an increase in intracellular calcium in the cells and stimulation of insulin release. Major drug interactions are noted between glyburide and

Diabetes is a growing but preventable health concern in the United States.1 It is a problem in the body where blood glucose levels rise higher than normal.1 According to the facts released by the American Diabetes Association in 2013, 25.8 million Americans (8.3%) have diabetes 2 and approximately 90% of all cases of diabetes worldwide are considered type 2 diabetes.3 Type 2 diabetes is a progressive disease where the body cannot use insulin properly and the patient ends up using an oral hypoglycemic agent.1 One of the many classes of medications to help manage diabetes is sulfonylureas, including glyburide and glipizide. These drugs close K-ATP channels on Beta cell membranes and cause the pancreas to release more insulin to lower blood sugar.4 Both glipizide and glyburide are metabolized in the liver5, have high protein binding5, and can decrease hemoglobin A1c (HbA1c) up to 1%-2%.6 According to the Health Insurance Association of America, health insurance is defined as "coverage that provides for the payments of benefits as a result of sickness or injury".7 Insurance companies always strive to achieve their target glycemic goal via the most effective and cost effective therapeutic strategy.8 A literature search was conducted to find data on the benefits of converting patients from glyburide to glipizide to find out why insurance prefers the switch.

Metformin is a diabetes medicine that helps control blood sugar levels in people with type II diabetes. You will take this pill two times a day in the morning and at night to improve blood sugar control. Remember to drink a full 8-ounce glass of water when taking this medication to assure proper hydration. Your kidney health will be monitored while you take this medication.

The mainstay of type 2 diabetes medication is Metformin due to the cost, safety of the medication and limitied side effects. Metformin reduces glucose levels through two pathways; it reduces hepatic glucose production and increases the insulin tissue sensitivity. Monotherapy is normal for this medication; however, it can be utilized in combination with other medications. Metformin used in conjunction with Sodium glucose cotransporter provides a greater control over the level of glucose in the body due to the reduction of glucose production, increase in sensitivity, reduction of reabsorption of glucose and the excretion of glucose through the kidneys, basically the glucose control is through 4 different pathways making it a synergetic effect on diabetes type 2. According to Inzucchi et al.(2016), the combination of these medications helped patients reduce their overall A1c (0.5-1.0), lose weight (2kg) and a reduction in their blood

Metoformin is a medication used to treat Type 2 diabetes. Metformin is classified as a biguanide and antidiabetic medication. Its therapeutic classification is an antihyperglycemic. Metformin, which is the drug’s generic name, is also known under its trade names: Fortamet, Glucophage, Glucophage XR, Glumetza and Riomet. Metformin is an oral hypoglycemic medication and has three main actions: Metofrmin increases the binding of insulin to insulin receptors in skeletal muscles and fat, which works to improve tissue sensitivity to insulin. Through this action, glucose is able to be transported into skeletal muscles and fat and the body is able to use glucose to function properly. Metformin also suppresses gluconeogenesis, which is the production of glucose from non-carbohydrate sources such as fat and protein. Metformin also prevents the liver from converting stored glycogen into glucose. All these actions work together to lower the level of blood sugar and also lower the Hemoglobin A1C value, ensuring diabetics have better control of their blood sugar.

Although gabapentin and pregabalin have few drug interactions, very common dose-dependent side effects like dizziness and sedation may be ended by patient intolerance, which can be reduced by titrating doses cautiously until reach to pain relief with reasonable side effects. Both medications also require dosage reduction in patients with renal insufficiency, and dosage adjustments can be made in relation to creatinine clearance. Gabapentin pharmacokinetics are nonlinear (due to saturable absorption), and dosing requires careful titration.

strategies are needed to prevent or reverse disease progression.7 Agents that increase beta cell mass

The change in glucagon correlates linearly with improvement in glucose tolerance. Since these drugs improve insulin secretion in response to an increase in blood glucose, it seems appropriate to pair them with drugs that have a different mechanism of action, such as insulin sensitizers or Metformin. In fact, improvements in fasting and postprandial glucose levels, improved beta-cell function, and improvement in HbA1c levels have been demonstrated in numerous clinical trials using different gliptins as monotherapy and in combination with various type 2 diabetes medications, including insulin.1

Diabetes is a systemic disease caused by a decrease in the secretion of insulin or reduced sensitivity or responsiveness to insulin by target tissue. (Beale, et al., 2011) The incidence of diabetes is growing rapidly in the United States and worldwide. An estimated 347 million people around the world are afflicted with diabetes. (Whalen, et al., 2012) According to World Health Organization (WHO), Diabetes prevalence among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. It is the major cause of blindness, kidney failure, heart attack, stroke and limbic amputation. World Health Organization (WHO) projects that diabetes will be the 7th leading cause of death in 2030. It is a complex and costly disease that can affect nearly every organ in the body and result in devastating consequences. The leading cause of non-traumatic lower extremity amputations, renal failure, and blindness in working-age adults, diabetes is also a major cause of premature mortality, stroke, cardiovascular disease, peripheral vascular disease, congenital malformations, perinatal mortality, and disability. (Cefalu, 2000) Insulin therapy and oral hypoglycemic agents have demonstrated improvement in glycaemic control. However, Insulin therapy has some disadvantages such as ineffectiveness following oral administration, short shelf life, of the need for constant refrigeration, and fatal hypoglycaemia, in the event of excess dosage.