diabetes mellitus
Research
Treatment
Source: The Lancet
Comparison of two second-line drugs for patients with type 2 diabetes poorly controlled with Metformin
In a nutshell
The present study compared the effctiveness of two types of drugs that can be added to Metformin (Glucophage) for the treatment of poorly controlled type 2 diabetes mellitus (T2DM).
Some background
Type 2 diabetes mellitus affects almost 10% of all adults. Metformin (Glucophage) is the most common drug used to treat T2DM. When patients on Metformin are unable to control their blood glucose levels (have poor glycemic control), they need additional drugs. Usually, Sulfonylureas are offered to such patients, for example Glimepiride (Amaryl). However, this class can cause weight gain, hypoglycemia (very low glucose levels), reduce the quality of life, and increase the risk of heart attack and stroke. Another optional second medicine is one of the DPP-4 inhibitors class of anti-diabetic drugs, such as Linagliptin (Tradjenta, Trajenta). These oral drugs slow digestion, and indirectly increase insulin release.
Methods & findings
This large study was conducted in 209 medical centers throughout 16 countries for 2 years. 1551 patients were divided into 2 groups, receiving either Linagliptin or Glimepiride in addition to Metformin.
The results show that Linagliptin and Glimepiride were equally successful in lowering blood glucose levels. However, Linagliptin significantly reduced the risk of hypoglycemia compared to Glimepiride. Patients treated with Glimepiride had almost 5 times more hypoglycemic events. Patients who took Linagliptin gained significantly less weight and were also less likely to suffer from cardiovascular events, such as heart attack and stroke.
The bottom line
In conclusion, both drugs showed equal efficiency in glycemic control, but Linagliptin had a safer side effect profile compared to Glimepiride.
The fine print
This trial was funded by Boehringer Ingelheim, the pharmaceutical company that manufactures Linagliptin.
Disclaimer:
This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided by Medivizor solely at your own risk. Medivizor makes no warranties or representations as to the accuracy of information provided herein. If you have any concerns about your health, please consult a physician.
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I asked my Dr. about this very thing and the first time he kind of blew it off the second time he said they were find serious side effects with the Linagliptin but didn't say what they are. I would like to know more about the negative side effects of the Linagliptin, this study says different .Are there any more studies comparing these two drugs. I have been on Metformin and Glimepiride for 1 year now and at the same time have been on a diet and I haven't lost any weight . I wasn't aware that the glimepiride was associated with weight gain, I think that is something I should have been made aware of. I have high blood sugar episodes fairly . I get light headed and feel exhausted and sleepy. I have neuropathy in my legs and when hypoglycemic the neuropathy kicks into overdrive some painful sometimes I can't walk 15 feet its to painful.I am concerned Glimepiride may be contributing to the complications associated with type 2. Any suggestions? Reply
I have had the same reaction from my dr. But I reseach myself. So far almost DM-2 meds cause weight gain. Metformin, Januvia & Byetta help with keeping the weight down or causing weight loss. Sorry for the brands but I don't know the chemical names. Do more reseach & then take questions to your dr. Reply
Glimepiride has indeed been shown to be associated with weight gain in several studies. As with any glucose lowering drug, hypoglycemia is a possible side effect. Glimepiride has also been shown to cause weakness and dizziness in some patients. However, there is no evidence that glimepiride is associated with increased diabetic-related complication. On the contrary. Strict control over blood glucose levels and comorbidities is the optimal prevention of diabetic complications, and the benefits of glimepiride have been shown to outweigh the risks in this respect.
Linagliptin as well, like any drug, may cause several side effects. Cough, sore throat, hyperlipidemia, hypoglycemia and weight gain are the most commonly encountered adverse effects. Acute inflammation of the pancreas has recently been reported as a rare, yet potentially fatal, side effect of linagliptin.
If you feel as if the side-effects of your current treatment are affecting your quality of life you should consult with your physician regarding alternative medications. Reply
hi,
l'm on Janumet XR 100mg /1000mg which l have 1 tablet at night not having any side effects with it. When given Metforim 500mg my body copes but when Dr puts it up to 1000mg my body is unable to cope and l feel dizzy, nausea, stomach cramps. My BSL show 11+ - 15mmols, l live in Australia. My BSL's are out of control. My Dr wants to put me on Insulin injections. Can you help me.
Liz Reply
Hi Liz, you don't mention if you have been on any other treatments in the past. If you're worried about starting insulin, you could speak with your doctor about whether or not trying a different medication would be effective. However, the most important thing in diabetes is to get your blood sugar levels under control, through diet, exercise, and medication. Your doctor may think insulin is the best treatment choice for you at this time. Best of luck! Reply
As well as metaformin and diamicron,my doctor has put me on Byetta injections, twice a day. Except for slight constipation in the beginning,I have had no other side effects. Reply
Hi Liz .. I was on both metformim 500 mg an glmapryde neither made me ill Reply
I have been using metformin and Dlimepride for 10 years. I realized that I had to cut down on food intake and get rid of starches. I have no side effects and a around 7 A1C. Diabetis is a pain and we have to make changes in the amount o calories we eat and get extra exercise. The combo of metfrmin and glimerpride is working for me with very occasional low blood sugars and no weight gain.
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I am on glyburide plus metformin plus insulin glargine but only at nite my sugars still isnt staying down at all ive changed my deit and watch what I eat plus how much sugars in it but it isn't helping to keep them down to normal Reply
Besides watching sugar content, try watching for carb percentages. Typical normal carb amount per day. Reply
I have tried both meteor in normal and slow release but have had very bad side effects to both namely diorhea and sickness, hot and cold sweats and chronic fatigue. Reading your report today makes me feel reluctant to try other drugs? My type 2 diabetes was caused by 2 acute bouts of pancreatitis and I was required to stay in hospital for 2 weeks each time! Should I persevere with the drugs?
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Hi Beth, The most important thing in type 2 diabetes is to get your blood glucose levels under control, and for many patients that means drug therapy is required. I understand your reluctance to try other treatments - it sounds like you've been having a tough time! You might want to discuss your options with your doctor, if you haven't already. Side effects can be different for each patient with each drug, so just because you experience side effects with one does not mean you will with all treatments. Best of luck! Reply
i am also very reluctant to try new drugs. If there is an unusual side effect I'll be the one to have it. Plus, the new drugs seem to cause too many other conditions while correcting the one you take it for.
Drug companies trying to get themselves more money it would seem. Take this drug and then you need another drug to correct the newly developed condition! It's all about mine, and that's disgusting! Reply
I was taking jaunt but I stop because of the side affect. Why isn't they somethings to help control your problems without all the size affect. They want you to lose weight but you gain on the medcation come on now what's going on with this I wanted get better not take all this medicine Reply
I'm just sick & tired plus fusterated at the same time I just want to drop all drugs I'm on I get very tired all the time I sleep a lot I don't feel like eating I have a hurya my doctor wont do any surgery to fix it unless I lose 40 pounds I just cant lose it so I'm always feeling sick my bowels movement s only happen if I'm lucky move 1or two times in a month but when I do it hurts a lot I do have hot & cold sweats always I have to keep a fan going all the time with a window open even in the winter I have try a lot of things to help like hot water mixed with honey & cinnamon some times it helps but in a lot of pain I get these horsebite feelings then I cant bend or pivit in any way I cant even walk for 15 mins and I'm in so much pain I just feel like crying nonthing seems to work
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At this time I'm taking the metformin I'm satisfied with it I know that I have a diet that I watch and manage very well every now and then I do go off of my diet maybe by once every 3 months but other than that I stay on a diet and I try to keep my sugar bounce and I monitor my a1c every 90 days my doctor take and check it Reply
Hi, I'm on Metphormin, Minocyclin.Saw Palmetto, ASA 81mg, Amlodipine, Indomethacin, Valsartan, Zyloprim. My sugar level varies between 5.6 and 10.5, my blood pressure varies between 112/70 to 126/79. Last visit I reported a mark discoloration of my feet ,my ankles and my legs up to about 4" from my knees and I'm very worried about this, My ankles feel stiff and the top of my feet hurt when I walk. I used to go for long walks in the forest but I have a hard time to walk to the end of the street and back. My question is: How do I stop this discoloration from progressing? I was planning to bring my bike out of retirement. Would this help? I know I have to lose weight and change my eating habit but can't seem to do it on my own. Could depression be a factor? I'm 68 years old and fully retired and I would sure like to enjoy life a little before departing for the land of dreams and happiness. At the moment, I wear socks when walking in the house. I only wear running shoes when going out and although I don't tie them thight, my feet still hurt. Is there anything that can be done to alleviate this? I have a feeling that if this was taken care of I could walk more. You now have my problem in a nutshell. Are you glad to have invited me here? Reply
600mg of Alpha lipolic acid, complete diabetic vitamin and magnesium, selinium, and cromium gtf. Reply
Hi everyone, I was just diagnosed type 2 diabetic August 2015.I have other problems RA & Chf,asthma. So exercising feels out of reach so looking for ideas.Also I've cut out all bread,sugar etc but still high sugars.My problem is I have to take Prednisone for my breathing and RA.Any ides?Good day,And God bless Reply
Hi Anonymous,
I suggest going to the indoor heated pool in winter, and normal pool in summer and swimming or walking up and down this burns of calories and gives you exercise without inter-fearing with your other conditions. Start eating Salads fresh with raw vegetables no pasta use rice instead. eat salmon or fish plus other meats hot or cold, see a dietician. Magnesium is very good 2 tablets at night but check with your Chemist first.
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Oh and Thank you for this site,sometimes you just need to vent! Reply
Thanks for sharing to all you ! And God bless to all !! Reply
I'm on janumet and i get dihierra a lot and feel sick some times .Hot a lot the pain i get in my legs some times to Reply
Metformin and Glimepiride , are my two medicines That I 'm taking right at the moment, sometimes, I think too much chemicals are bad, because it cause a problem in a long term . However, I eat green, fish, fruits, vegetables, and coffee . Well, last I walk the dog for while, and this makes me feel, well. Reply
I am not real fond of pharmaceuticals if I can at all avoid them, I will. Any recommendations for nutraceuticals that have efficacy in reducing A1C?
I have been provided a couple of options, one hasn't helped the other I haven't tried yet.....interested in any thoughts. Reply
I am about to start Berberine and I already take, cinnamon and Curumin. I would prefer not to augment them with Metfformin. Any comments would be helpful. I have comer off my statins too and I think Berberine is recommended for reducing cholestrol too. Reply
More and more doctors you're saying you're better off with diabetes than taking Metformin are any diabetes drugs Reply
Dr.Martin I am not making any claims here but am from experience ..I have Found Cinnamon to help ..it regulates the blood sugar Reply
I like you don't like phrama. If you get any tips I am interested. Raw Vegan, protein from whey and legumes, nuts ect...is good I hear. Chromium GTF on empty stomach, magnesium, selinium, multiple food source vitamin formulated for diabetic, for cholesterol red yeast rice,with a combination call phytomega from melalueca.com, cinnomen, tumeric, ginger (keeps blood thin and flowing, fights inflamation), garlic-hawthorne-cheyanne combo for high blood pressure, alpha lipolic acid for neuropathy in extremities prevention and to stop. Reply
I AM ON VICTOZA 1.8 INJECTION AND LEVILMERE 40 TO 50 CC SHOT INJECTION AND GLIMEPIRIDE MY SUGAR IS OUT OF CONTROL. GOING TO SEE A DIFFERENT ENDOCRINOLOGIST I CAN NOT AFFORD THE MEDICINES 500.00 FOR 2 INJECTABLES IF I DO NOT EAT MY SUGARS ARE OKAY Reply
Try calling which ever pharm company that makes the meds you can't afford. Most have what's called a PAP (Patient Assistant Program). Besides diabetes 2, I also have high blood pressure, high cholesterol, plus I'm bipolar so I take MANY drugs every day. Many of them I get free through a PAP program.
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If you can avoid carbon do it.,sometimes when I don't eat and just drink water, everything is normal ( high blood pressure ,blood sugars ,and pain my joints ) eat veggies as mutch as you like! Reply
I'm currantly taking Actos and 16 units of Lantis at night.ive been on insulin for over a year now. Had my A1c down to 6.9 then went back up to 7.2 I have problems staying away from foods that I'm not suppose to eat and sometime licorice which is my weakness! I'm trying harder to be good, I just don't have much willpower Reply
I'm currantly taking Actos and 16 units of Lantis at night.ive been on insulin for over a year now. Had my A1c down to 6.9 then went back up to 7.2 I have problems staying away from foods that I'm not suppose to eat and sometime licorice which is my weakness! I'm trying harder to be good, I just don't have much willpower Reply
I'm currantly taking Actos and 16 units of Lantis at night.ive been on insulin for over a year now. Had my A1c down to 6.9 then went back up to 7.2 I have problems staying away from foods that I'm not suppose to eat and sometime licorice which is my weakness! I'm trying harder to be good, I just don't have much willpower Reply
I have been taking Metformin for years but I prefer to control my Diabetes with diet and herbs. What is your opinion of Berberine which I have just purchased and cinnamon and Curcumin. Reply
I have been taking Metformin for years but I prefer to control my Diabetes with diet and herbs. What is your opinion of Berberine which I have just purchased and cinnamon and Curcumin. Reply
I would LIKE to control my diabete with diet only but it's tough. I was on metformin, 1,000 mg 2x a day, then my dr added Invokana..i lost a lot of weight and felt better, but suddenly i fell into the donut hole with my insurance and had to stop the invokana...also i was afraid of all the warnings on tv. I was seeing some changes in my kidneys. Hopefully no damage was done., checkup coming up soon. Its a very expensive drug and it, combined with metformin did control my bs very well. Now back to just the metformin again...i'm almost afraid to have my bloodwork done. sigh...so frustrating. I have other issues also, so it always seems like a darned if i do, darned if i dont scenario. Reply
can I find linagliptin in Canada and berberine
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I presently taken sadoz metformin 850,and90act losartan hct,but Ialways at between 9.5 and 10
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Hi Ed, linagliptin (Trajenta) has been approved for use in Canada, so you could speak to your doctor about that. Berberine is a supplement that may be available locally. However, we always like to remind patients to discuss supplement use with their physicians before starting. Reply
I took Metformin for about 7-8 years and hated the diarrhea, so my Dr. switched me to Januvia. It was great but on Jan 1st, 2015 it doubled in price and I just can't afford it even though they tell I make too much money to get any help. So now my Dr. put me on Metformin ER, 1000 mg twice/day. My A1c is around, it was never that high on Januvia and the diarrhea has become debilitating. Reply
I live in the UK where Diabetes is treated slightly differently to the US.
I originally took Metformin but didn't like the side effects, same as many I suppose. My Doctor offered a different drug pluse Byetta injections but I must admit that they didn't control my Blood Glucose so he referred me to our local Hospital where, thankfully, there is a Specialist Nurse (Marie) who knows what she is talking about. She recommended I went back on to Metformin together with an Exenotide injection, my numbers are now under control. Reply
Chemicals in our food and air causes diabetes in a latest rechearch, and obesity for million of years food was not enough always so diabetes 2 was not a epidemic as today so is a food. Born illness so we should stop hedonistic eating and eat as less foods as we can manage otherwise prepare for a better world in heaven s above,! Reply
Can't tolerate Metformin, I was so dizzy I couldn't stand up for 2 days after 2 pills. Reply
I too have a hard time on Glucophage xr, upset stomach, dizzy, dirahea. My doctor keeps upping the dosage which makes me sicker. My numbers are high which I don't understand, I am diet and have lost 15 pounds. I use to take actors 30mg and did well on it my numbers were great Reply
Dear Gerontas99 - grandparents, great Aunts etc raised on farms - no chemicals - all diabetic type 2 - both mum and dad DT2 - now me - its just heredity and so forth -
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I have been on Metformin for about 5 yrs and find it very hard to lose weight even with a healthy vegetarian diet. Could the Metformin cause this? Reply
I take Janumeny like candy and take lantus 28 ml. twice a day my sugar goes from 5 to 13 iat night. My doctor said my bodie has no control with insulyn. I was born with a sweet tooth.
I don't have control from a diet I don,t no one. Please any help would be appreciated? I have had diabetes since 1995 Thanks (sherrardkeith@gmail.com) Reply
I take metformin 2 pills in the morning and2 at supper time.I loss some weight and the diabete doctor told me not to loss no more weight.But i have thyroid problems.The doctor put me on thyroid pills.I had all my toe removed on left foot.I am taking nerve pills for the rest of my life.The pills are Gabapentin and dose are 300 mg.2at moring,2lunch,2supper,2 at bedtime.I have high blood pressure i take pills for that too.I have more wrong with me.I have clog arterys,neck and stomach put legs.So my diabetes act up. Its high or goes low or stays 5-6.The new pills for diabetes cost so much i cant afford it.I know when my sugar is to high or low.I am a happy person diabetes dont bother me at all.tyvm for the info about diabetes and medication. Reply
I take Metformin 1000 2 times a day and Tanzeum 30 inj once a week dr put me on Glipizide 5 because GLIMEPIRIDE caused sores in my mouth A1C went from 11 to 7 but the tanzeum seems to stop controling BS after 3 -4 days doesn't work the full week Reply