Glucophage [posted 8/4/98]
Question: Are there any studies to confirm or refute the idea that glucophage can increase fatty cell build up in the liver of overweight diabetics? I think I read something about this recently, but can't locate the article.

Answer: I'm not aware of any specific article, but you might contact the scientific department of the company, they are usually happy to locate it for you. Glucophage is made by Bristol-Myers- Squibb: 800-468-7746.

Glucophage [posted 7/21/98]
Question: If my mother has been taking insulin for over 5 years, will she be able to revert back to taking glucophage and eventually cut out the insulin? I heard that once you go on insulin, you can't go back to orals. Is this true?

Answer: There are two types of Diabetics. Type I do not produce Insulin - or in negligible quantities. There patients cannot stop taking insulin without experiencing ketosis. Type II produce insulin, but have some type of resistance to its use. These patients can be treated with insulin or with other agents. Also, losing weight may restore the insulin sensitivity so they don't need medications at all. Checking a c peptide level will establish which she is, this is the cleaved protein made by your body on its "own" insulin, not present on manufactured insulin. If high or normal she can probably be tried on oral agents (like glucophage or others) and do ok.

Glucophage for Diabetics
Question: I am a Type I Insulin dependent diabetic, and my doctor recently prescribed 500 mg twice daily of glucophage. All the info I read on this drug says it is for non-insulin dependent Type II diabetics. I mentioned this to my doctor, and she said that it was okay for me to take it because it will not cause low blood sugar reactions. The insert the pharmacist gave me also said that it should not be taken with certain drugs like beta-blockers and diuretics. I'm on 10 mg of lisinopril daily plus 25 mg of spironolactone. I think the former is a beta-blocker (I'm not sure) and that the other is a diuretic. I also take provostatin for cholesterol. The doctor and pharmacist both know that I'm on these medications, but didn't seem concerned to give me glucophage. As a matter of fact, the pharmacist handed me 6 vials of insulin at the same time he handed me the glucophage with the patient education report. I mentioned the above concerns to my doctor, but she said for me to give it a try as it had worked on others taking insulin. Is this so, and if so, what have been the results? Am I in danger of an adverse reaction of some type? Please provide more info, as I'm concerned after reading the patient education report. The doctor wanted to try this as I�m on a sliding scale insulin regiment which does not seem to be working all that well lately and my weight has increased. It's like my body is resisting the insulin. I've been diabetic for 28 years since age 15.

Answer: When this medication came out, it seemed that combination with insulin would really decrease insulin dosage. It didn't usually help and most physicians have stopped the combination, although there is no contraindication to combine them (or with your other medications). However, Rezulin a new oral medication, is used specifically to increase the sensitivity of insulin and is very effective (nationally and in my patients). So, I'm a little puzzled why he/she would start glucophage instead of Rezulin. However, there is no concern and if it works, it works.

Glucophage and Surgery
Question: I have a question concerning Glucophage and surgery. I am scheduled for a hysterectomy. How many days prior to surgery should Glucophage be discontinued? What should be given for the days prior to surgery to control blood glucose?

Answer: Prior to any IV dye, stop 3 days prior to surgery. Prior to regular surgery with no anticipated dye you could stop the morning of surgery. Other agents or insulin will have to suffice if you stop more than a day prior to surgery.

Glucophage
Question: If a person is going to have some tests run where an injection is required for tests concerning the heart, is it safe to be taking glucophage?

Answer: This drug should not be taken prior to dye injection. Other injections are usually not a problem. This drug should be stopped about 2-3 days prior to dye studies.

Glucophage
Question: My mother has been taking glucophage for the last six months and has experienced bouts with diarrhea. I have heard stories of heart attacks. Is this possible? Is there a normal/safe amount. Her dosage is 850 mg, twice per day.

Answer: Is the diarrhea constant? If it is episodic, I doubt the glucophage is involved. Patients do experience diabetic enteropathy, which is manifested by diarrhea. Clonidine usually fixes this. Heart Attacks are common in diabetics, but glucophage has not been implicated yet. Her dosage is about average.

Glucophage & Alcohol
Question:I am curently taking Glucophage 500 mg. can I have a glass of wine with my meal?

Answer:Glucophage(metformin hydrochloride) is a relatively new oral medication for the treatment of diabetes mellitus. It is a medicine that works primarily by inhibiting the glucose release from the liver-rather than at the cellular level like other oral agents(glyburide, tolinase, etc.). Metformin unlike the sulfonyureas, will not produce hypoglycaemia. It should be used with extreme caution-or not used- in patients with renal or liver dysfunction. Alcohol can potentiate the effect of glucophage so one should watch the finger stick glucose very closely after alcohol. For practical purposes, one drink shouldn't be a big deal if you monitor your glucose.

Glucophage & Porphyries
Question:Glucophage has been known to cause drug-induced porphyries. In what percentage of cases does it do this? Do you know of any cases where vitamin B12 deficiency has increased glucophage's tendency to induce porphyry? What percentage of cases?

Answer:News to me. I'd check with the company for detailed information on this adverse reaction. Bristol-Meyers-Squibb 800-468-7746.
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