Skip to content
My WebMD Sign In, Sign Up

Diabetes Health Center

Font Size
A
A
A

Old Diabetes Drug Has Advantages

Report: Metformin Effective With Fewer Side Effects Than Newer Drugs
By
WebMD Health News

Diabetes Drugs Compared

July 16, 2007 -- Most type 2 diabetes drugs are equally effective for lowering blood sugar, but the generic drug metformin has fewer side effects than several newer, pricier medications, a government report finds.

Metformin users are less likely to gain weight than type 2 diabetes patients who take Avandia, Actos, or other newer medications, researchers concluded, and they are more likely to show improvements in so-called "bad" cholesterol.

The report was issued by the Agency for Healthcare Research and Quality (AHRQ), a division of the Department of Health and Human Services.

Researchers from Johns Hopkins University’s Evidence-based Practices Center reviewed 216 previously published studies in their effort to compare the effectiveness, risks, and costs of older and newer diabetes pills.

The study, which was made public today, will appear in the Sept. 18 issue of the Annals of Internal Medicine.

Diabetes Drugs: Old and New

All diabetes medications help to lower blood sugar, but they work in different ways. Metformin and drugs in the class known as sulfonylureas, such as Glipizide or Glyburide, are among the least-expensive oral diabetes medications because generic versions are now available.

The newer oral medications Avandia (by GlaxoSmithKline) and Actos (by Takeda Pharmaceuticals) -- both in the drug class thiazolidinedione (TDZ) -- are now among the most widely prescribed diabetes drugs.

Among the highlights of the report:

  • Metformin was one of the few diabetes drugs not associated with an increase in weight. The report noted that other widely prescribed diabetes drugs have been shown to increase body weight by an average of 2 to 11 pounds.
  • Use of metformin was associated with a decrease in blood levels of low-density lipoprotein, or "bad" cholesterol, while use of the TDZ class of drugs raised levels good cholesterol and had a harmful effect on LDL "bad" cholesterol.
  • Amaryl, Glucotrol, and other sulfonylurea drugs were more likely to cause unsafe drops in blood sugar (hypoglycemia) than other diabetes drugs.
  • Patients on metformin or the drug acarbose complained of diarrhea and other gastrointestinal problems more than users of other drugs. Patients who took only metformin were more likely to experience these digestive problems than patients who took lower doses of metformin in combination with other diabetes drugs.
  • Use of Avandia and Actos was associated with a greater risk of congestive heart failure.

Diabetes Drugs and the Heart

Concerns about heart failure risk led the FDA to announce last month that labels for Avandia and Actos will soon carry a "black box" warning to alert doctors and patients to the risk. A highly publicized study recently linked Avandia to an increased risk of death from heart attacks, but the drug's manufacturer has challenged the findings.

In testimony before a congressional committee in June, a GlaxoSmithKline spokesman said there is no evidence that Avandia carries more heart risk than other drugs of its class. And an interim report from an ongoing company-sponsored study assessing Avandia's impact on the heart found the data on heart attack risk to be inconclusive.

Is This Normal? Get the Facts Fast!

Check Your Blood Sugar Level Now
What type of diabetes do you have?
Your gender:

Get the latest Diabetes newsletter delivered to your inbox!


or
Answer:
Low
0-69
Normal
70-130
High
131+

Your level is currently

If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Did You Know Your Lifestyle Choices
Affect Your Blood Sugar?

Use the Blood Glucose Tracker to monitor
how well you manage your blood sugar over time.

Get Started

This tool is not intended for women who are pregnant.

Start Over

Step:  of 

Today on WebMD

Woman holding cake
Slideshow
feet
Slideshow
 
man organizing pills
Slideshow
Close up of eye
Slideshow
 

Woman serving fast food from window
Video
Can Vinegar Treat Diabetes
Video
 
Middle aged person
Tool
are battery operated toothbrushes really better
Video
 

Prediabetes How to Prevent Type 2 Diabetes
Article
type 2 diabetes
Slideshow
 
food fitness planner
Tool
Are You at Risk for Dupuytrens Contracture
Article
 

WebMD Special Sections