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Review: Metformin a Top Diabetes Drug

Researchers Say Metformin Is Best Early Treatment for Overweight People With Type 2 Diabetes
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July 20, 2005 -- One of the many medications used to treat type 2 diabetes may stand out above the rest.

Metformin used alone is still the best for lowering blood sugar and preventing complications of type 2 diabetes in people who are overweight or obese, according to a new review.

Researchers analyzed 29 major trials of metformin (brand name Glucophage).

"Our review of the literature suggests that metformin is a good first-line therapy for overweight or obese people with type 2 diabetes," researcher Antonio Saenz, MD, concludes.

Best for Weight Loss

There are now more than a dozen blood sugar-lowering or insulin-sensitizing medications approved for the treatment of type 2 diabetes. Metformin won FDA approval as a medication to treat type 2 diabetes in the mid-1990s, but it has been widely used in Europe for decades.

The newly published analysis did not compare metformin head-to-head with many of the newer drugs. But it is widely recognized to have weight loss benefits for overweight people with diabetes that the newer drugs may not have.

Though many of the newer drugs may promote weight gain, metformin has been associated with modest weight losses in people with type 2 diabetes.

"Metformin is generally considered to be the first-line treatment for overweight diabetics, but the main message is that these people should do whatever it takes to get keep their blood sugar under control," American Diabetes Association (ADA) president Robert Rizza, MD, tells WebMD.

Some patients respond well to one medication alone such as metformin, while others do better on a combination of medications used to treat diabetes, he says. And some patients do not tolerate metformin because of side effects, which can include severe stomach cramps, nausea, and diarrhea.

"All things being equal, [metformin] is probably the drug that most people should start with, but if they can't take it there is something else out there," Rizza says. "The vast majority of people can normalize or nearly normalize their blood sugar with the medications we have today."

Independent Review

The new analysis was published under the auspices of the Cochrane Collaboration, an international, nonprofit research group that reviews health care interventions. The results were published in the July 20 issue of the Cochrane Database of Systematic Reviews.

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