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Insulin Resistance (cont.)

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Medications

Metformin (Glucophage) is a medication that is used for treating type 2 diabetes. It exerts two actions that help to control blood glucose levels. Metformin prevents the liver from releasing glucose into the blood, and it increases the sensitivity of muscle and fat cells to insulin. So, the muscle and fat remove more glucose from the blood. By these actions, metformin lowers blood insulin levels.

The DPP studied the effects of metformin, in addition to diet and exercise, for prevention of type 2 diabetes in insulin resistant people. Metformin reduced the development of type 2 diabetes by 31%. Note, however, that the benefit was not as great as with diet and intense exercise. Metformin is a reasonably safe medication when used in the proper population. Although occasionally associated with gastrointestinal side effects, metformin is usually well-tolerated. While there are no FDA-approved drugs to prevent type 2 diabetes or to treat pre-type 2 diabetes (insulin resistance), the American Diabetes Association has recommended that metformin be the only drug considered for the prevention of type 2 diabetes.

The STOP NIDDM (Study to Prevent Non-insulin Dependent Diabetes Mellitus) trial assessed individuals with insulin resistance by treating with acarbose (Precose). Acarbose slows the gut's absorption of sugars, which reduces the demand for insulin after a meal. This study suggested that acarbose could reduce the development of type 2 diabetes by 25%.

Thiazolidinediones comprise another class of drugs which increase sensitivity to insulin, including pioglitazone (Actos) and rosiglitazone (Avandia). These medications are no longer used routinely, in part because of liver toxicity that requires monitoring of liver blood tests. Avandia has been associated with an increased risk of heart attack and stroke, but experts have debated the severity of these concerns since this risk was first reported. In September 2010, the U.S. Food and Drug Administration (FDA) significantly restricted the use of Avandia to patients who cannot control their type 2 diabetes on other medications (including pioglitazone). These restrictions responded to data suggesting an elevated risk of cardiovascular events (such as heart attack and stroke) in patients treated with Avandia.

The TRIPOD (Troglitazone in Prevention of Diabetes) study assessed troglitazone (Rezulin) for treating women with gestational diabetes, a precursor of insulin resistance and type 2 diabetes. However, due to severe toxicity to the liver, troglitazone has been taken off the market and is no longer available. Type 2 diabetes was prevented in 25% of those women treated with troglitazone.

Medically Reviewed by a Doctor on 6/12/2014

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Insulin Resistance - Symptoms Question: What were the symptoms of your insulin resistance?
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Source: MedicineNet.com
http://www.medicinenet.com/insulin_resistance/article.htm

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