New Metformin Test (AccuType Metformin) helpful in determining effectiveness

Metformin:  Glucose Control & Weight Loss
New Metformin Test (AccuType Metformin) helpful in determining effectiveness
 

by Yusuf M. Saleeby, MD

For more than forty years the drug named Metformin (Glucophage® manufactured by Merck, but now available generic as the patent has expired) has been used to treat Type II diabetics with great success. Unlike other medications used to lower blood glucose levels, Metformin will not cause hypoglycemia because it acts quite differently than other classes of diabetic medication.

Observing the nearly 4 decades of Metformin use in overweight diabetics with cardiovascular disease, hypertension and dyslipidemia brought to light the amazing transformation this drug has on this group of patients with this insidious and life-shortening disease. Metformin happens to be one of the only drugs used to treat type II diabetes that has an impact on reduction of death by heart attach and stroke. While other agents raise the insulin levels, Metformin's mechanism of action work to make endogenous insulin levels more effective on a cellular and molecular level by up-regulating insulin receptors. What is more, the ideal anti-diabetic drug for type II should exhibit enhanced cellular sensitivity to insulin (reducing insulin resistance and glucose intolerance), inhibit excessive intestinal absorption of sugars, reduce excessive liver production of glucose (gluconeogenesis), promote weight loss and correct lipid abnormalities.  Many unfortunately raise insulin levels, a condition undesirable as type II DM has elevated insulin levels along with elevated glucose levels.

With the CDC’s predictions that one of every three children born after 2000 will develop type II diabetes, this is certainly a topic of paramount importance. Metformin answers the call today as probably the most important DM II drug on the market.

Take these well documented positive finding for glucose reduction, reduction in insulin resistance and metabolic syndrome, and apply them to the non-diabetic patient.  Several studies have done just that, and a growing number of forward thinking physicians are prescribing this drug as a part of their regiments for patients over 40, with risk factors for diabetes, obesity and syndrome X (metabolic syndrome).  It remains an FDA off-label use, but that is not unusual for drug prescribing today.  A good physician who is a patient advocate cannot wait around necessarily for the FDA to approve drugs for certain uses.  The FDA process is unbelievably slow, full of bureaucratic red tape and riddled with political interventions by Big Pharma and other interest groups.

Three placebo-controlled trials using Metformin in non-diabetics reported a reduction in fasting insulin and c-peptide levels, normalization of serum glucose and harmful low-density cholesterol (LDL-C) and apo B levels. One of the three even reported lowering of blood pressure and fasting triglyceride levels. It is shown time and again that Metformin is able to assist patients with weight loss.  Now with new biomarkers and gene making efforts, it can be determined if a patient has the “right gene” that will allow for most effective use of this drug.  A blood test called AccuType Metformin (offered by Quest Diagnostics and available online without a prescription on eStatLabs) can determine if Metformin is beneficial and effective for you.

Metformin has other uses too.  It has been used to treat women with polycystic ovary disease (Stein - Leventhal syndrome) and infertility or menstrual irregularities. There are also studies published in the medical literature showing Metformin's activity against cancer and enhancement of cellular immunity.  Metformin has been found to suppress growth of some tumors and enhance the activity of anti-cancer drugs.  In one such study it reduced the incidence of chemically induced cancer in laboratory rats.

As with all medication there are some patients who should not take this drug and there are some side effects one should be aware.  For example, people suffering from sever liver and/or kidney disease should not take this medication. Those with a history of alcohol abuse should avoid this because of an associated lactic acidosis when the two are taken together. Additionally, people who are to take an Iodine-based intravenous contrast agent for special radiological examinations need to stop the medication a couple of days prior and not resume use for up to 3 days following that type of exam. There is an associated risk of kidney damage when Metformin being taken when IV-iodine based dyes are used.  One common side effect is diarrhea, especially at the onset of use, loose stools are common and dose dependent, but with time that goes away.

Finally, continuous use of Metformin will predispose a person to vitamin B12 malabsorption. So people taking Metformin for prolonged lengths of time need to supplement with vitamin B12. By and large this is a very safe drug and the benefits attained from its use outweigh the relatively small number of untoward effects.

The multiple positive effects of this single drug (for its ability to reduce development of diabetes, cardiovascular problems, endocrine disorder, nephropathies, retinopathies, decreased immune function and cancer, as well as weight loss) make it a top disease preventing & longevity medication. There are special doses recommended for the use of this medication for prevention purposes and it is best prescribed by physicians with this as their focus of practice.  It is a regular recommendation in my practice as a “supplement” medication for continued good health and with a simple blood test, it can be determine effective in each patient on an individual basis.

===

Dr. Yusuf Saleeby is a physician with prevention and nutritional interventions as a focus.  He performs telemedicine consultations with the AtroGene Telehealth group.  He is regional medical director of eStatLabs, a DAT direct to consumer lab testing Internet site.  For more visit www.atrogene.com

References on file.

© 2011

who-will-take-care-of-32-million-new-patients

Who will take care of 32-million new patients?

Reprint from March 25th, 2010 by Dr Jon LaPook in Better Health Network

With the passage of healthcare reform, an estimated thirty two million new patients will try to find primary care doctors. That’s not going to be so easy because we already face a shortage of primary care doctors and about 13,000 more will be needed to take care of those newly eligible for insurance.

According to the American Medical Association, there are about 312,000 primary care doctors practicing in the United States. That includes family medicine, general practice (GP), internal medicine, and pediatrics. (In addition, there are 43,000 ob-gyn’s who also may serve as primary care doctors.) The estimate that another 13,000 will be needed comes from a study done by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care in partnership with the Agency for Healthcare Research and Quality.

 

Sixty five million Americans already live in areas that don’t have enough primary care doctors. And relief is not on the way anytime soon. It takes 5 to 8 years for a first year medical student to be trained as a primary care doctor. And the trend for budding doctors over the past decade has been away from primary care and towards more lucrative specialties.

 

The new legislation contains some incentives for entering into primary care. Medicare will pay a ten percent bonus to doctors spending most of their time giving primary care to the elderly. Medicaid payments will be increased by about 20 percent in 2013 and 2014 to reach 100 percent of the Medicare rate. This is important because about 16 million new patients will be eligible for Medicaid and many doctors currently don’t accept Medicaid because reimbursement is so low. In addition, primary care doctors will be paid extra for coordinating care among a team of doctors.

 

The new incentives are a good start but more is needed to increase our supply of primary care doctors. For this week’s CBS Doc Dot Com, my producer, Heather Tesoriero, and I traveled to a rural community in Indiana and discussed the shortage with an old-fashioned family practitioner named Dr. Jason Marker. When he started practice eight years ago he was $140,000 in debt from medical school loans. He works long hours and sees about 100 patients a week, but still owes $125,000. 

 

But Dr. Marker isn’t in it for the money and he’s not looking to heal only the well-healed. The day we visited him, a man walked five miles to his office from a homeless shelter. When I asked Dr. Marker what keeps him going after a rough day, he admitted that sometimes he wondered if it was all worth it. But then he added, “And then you go into the next room and you have a little old lady give you a big hug and you’re ready to go again.”