The drug metformin is used against diabetes.
German Diabetes Society for the treatment of type 2 diabetes: metformin remains standard
according to German Diabetes Society
Berlin If a lifestyle change does not lower the blood sugar, people need with type 2 diabetes medication. Here, the classic metformin remains the first choice alone. This represents the German Diabetes Society (DDG) fixed at the publication of a new U.S. guidelines. If other drugs are needed to reach the goal of therapy should decide in the regulation not only the price but the security must be in the foreground, the DDG. While disease management (DMP) in this country programs as recommended in combination with metformin or glyburide metformin intolerance basically is the professional association of the opinion that on the individual patient's risk of other drugs often depend appropriate.
Healthy diet, exercise and weight loss are the best prescription to avoid a type 2 diabetes, DDG-President Professor Dr. Stephan Matthaei. Even though there has already come to a type 2 diabetes mellitus, is the head of the Diabetes Center, according to the Christian hospital Quakenbrück first a change of lifestyle to pursue. Only when it is no success in lowering blood sugar permanently drugs would be used. The doctors today stands for a selection of a dozen ingredients available.
A recently published in the Annals of Internal Medicine guideline, the Clinical Practice Guideline from the American College of Physicians has published the results of more than a hundred studies summarized in which the effect of each drug was compared directly. With interesting results: metformin showed more effective than other drugs in terms of reduction in HbA1c as monotherapy or combination therapy, explains Professor Matthaei. As a target HbA1c value is considered under seven percent in the U.S. guideline. This target is also the view of the German Diabetes Society individually tuned sense for most patients. However, lowering the blood sugar is not the only goal of diabetes therapy, Matthaei says: The real object is to reduce the long-term consequences of diabetes on the heart and kidneys, eyes and nerves.
It is therefore important that the medications that lower blood sugar, do not increase the risk elsewhere. A number of antidiabetic drugs leads to weight gain and impaired fat metabolism. The comparative study revealed here for metformin a drug that has been used for over 50 years, the lowest effect. Metformin may reduce body weight and in many patients improve cholesterol and triglyceride levels, says Professor Matthaei. For diabetologists this is a strong argument, metformin is preferable to other agents. They also state that for metformin has beneficial effects on long-term complications of diabetes are well documented.
Metformin belongs also among the safest drugs, so the DDG: The risk of hypoglycaemia is much lower than for example with sulfonylureas, adds Professor Dr. Andreas Fritsche added from the University Hospital Tuebingen. The safety aspect is especially important in combination therapies: The practice shows that many patients get by with Type 2 diabetes mellitus is not a drug, so the DDG spokesman. The U.S. guideline has therefore also compared the effect of different combinations. It was found that sulfonylureas such as glibenclamide in combinations significantly increase the risk of hypoglycaemia. Sulfonylureas are often preferred for reasons of cost in Germany as monotherapy or in combination, says Professor Fritsche. But they are not for the reasons the first choice. In view of the patient should be decisive in the regulation of antidiabetic not only the price.
Literature: Amir Qaseem, Linda L. Humphrey, Donna E. Sweet, Melissa Starkey, Paul Shekelle for the Clinical Guidelines Committee of the American College of Physicians. Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine 2012; 156: 218231
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