One of the most common and beneficial T2DM drugs may contribute to neuropathy and vitamin deficiency The link between metformin and vitamin B12 lowering is well-known and mentioned in American Diabetes Association guidelines as a disadvantage of the drug. However, there are no recommendations for monitoring and prevention of vitamin B12 deficiency for patients taking metformin. Vitamin B12 deficiency is associated with adverse effects such as fatigue, mental status changes, and neuropathy. Given the prevalence of neuropathy in diabetic patients, metformin-induced vitamin B12 deficiency is clinically relevant. The relationship between vitamin B12 deficiency and metformin was studied in a recent randomized placebo-controlled trial. The trial lasted 52 months and included 390 type 2 diabetes patients. They were treated with 850 mg metformin at doses up to three times a day or placebo. Glimepiride, sold under the trade name Amaryl among others, is medium-to-long-acting sulfonylurea antidiabetic medication. It is sometimes classified as either the first third-generation sulfonylurea, Glimepiride is indicated to treat type 2 diabetes mellitus; its mode of action is to increase insulin secretion by the pancreas. However it requires adequate insulin synthesis as prerequisite to treat appropriately. It is not used for type 1 diabetes because in type 1 diabetes the pancreas is not able to produce insulin. Its use is contraindicated in patients with hypersensitivity to glimepiride or other sulfonylureas. Side effects from taking glimepiride include gastrointestinal tract (GI) disturbances, occasional allergic reactions, and rarely blood production disorders including thrombocytopenia, leukopenia, and hemolytic anemia. In the initial weeks of treatment, the risk of hypoglycemia may be increased. Alcohol consumption and exposure to sunlight should be restricted because they can worsen side effects.
Sodium–glucose cotransporter 2 (SGLT2) inhibitors improve glycaemia in patients with type 2 diabetes by enhancing urinary glucose excretion. We compared the efficacy and safety of canagliflozin, an SGLT2 inhibitor, with glimepiride in patients with type 2 diabetes inadequately controlled with metformin. We undertook this 52 week, randomised, double-blind, active-controlled, phase 3 non-inferiority trial at 157 centres in 19 countries between Aug 28, 2009, and Dec 21, 2011. Patients aged 18–80 years with type 2 diabetes and glycated haemoglobin A) of 7·0–9·5% on stable metformin were randomly assigned (1:1:1) by computer-generated random sequence via an interactive voice or web response system to receive canagliflozin 100 mg or 300 mg, or glimepiride (up-titrated to 6 mg or 8 mg per day) orally once daily. Patients, study investigators, and local sponsor personnel were masked to treatment. The primary endpoint was change in Hb A from baseline to week 52, with a non-inferiority margin of 0·3% for the comparison of each canagliflozin dose with glimepiride. If non-inferiority was shown, we assessed superiority on the basis of an upper bound of the 95% CI for the difference of each canagliflozin dose versus glimepiride of less than 0·0%. Also known as: Amaryl The following information is NOT intended to endorse drugs or recommend therapy. While these reviews might be helpful, they are not a substitute for the expertise, skill, knowledge and judgement of healthcare practitioners in patient care. "I just started glimeperide 2mg 3 days ago so far no effects just hungry... I was on metformin 500mg at first it gave me real bad side effects diarrhea urinating all the time and losing 2lbs a day. Glimepiride seems to work better for me.""I was put on Glimepiride because I could no longer afford my other medication. I was on it four months, gained ten pounds in seven days, and my A1c jumped way up. Befroe this I was reaching my next goal weight..two pounds away..this sudden gain was devastating.
Living with daily blood sugar levels above 300 mg/dl or close to 200 mg/dl rapidly brings about diabetes side effects. You want to see fasting levels between 60/70-99 mg/dl and your postprandial [2-3 hrs after meal] Some doctors no longer use sulfonureas as their treatment due to the side effects and the more rapid pancreas burnout. An option may be low dose insulin combined with metformin. You may also try a low carb diet avoiding sugars (including fructose) and grains or severly cutting these, and combine with exercise (if you have time then 30 minutes exercise / walk after each meal could help). Metformin short circuits to some degree insulin's negative role. Metformin also reduces lipids (cholesterol) and so has very positive effects to preventing heart disease and reducing blood pressure. Google any of these terms in relation to Metformin and you will see. New research suggests that several commonly prescribed drugs for Type 2 diabetes may not be as effective at preventing death and cardiovascular diseases, such as heart attacks and stroke, as the oral anti-diabetic drug, metformin. New research suggests that several commonly prescribed drugs for type 2 diabetes may not be as effective at preventing death and cardiovascular diseases, such as heart attacks and stroke, as the oral anti-diabetic drug, metformin. Insulin secretagogues (ISs),* such as glimepiride, glibenclamide (known as glyburide in the USA and Canada), gliclazide and tolbutamide, have been used to treat type 2 diabetes since the 1950-1970s, Nevertheless, the long-term risk associated with these drugs has largely been unknown. Metformin is the first drug of choice in type 2 diabetes, but, until now, there have not been studies investigating the long-term risk of individual ISs compared with metformin. A study published online April 6 in the followed a large, unselected group of everyone living in Denmark, aged over 20, who had been treated with either an IS or metformin (monotherapy) between 19 -- a total of 107,806 people. It found that, compared to metformin treatment, monotherapy with most ISs, including glimepiride, glibenclamide, glipizide and tolbutamide, was associated with a greater risk of death from any cause, and a greater risk of heart attacks, stroke or death from cardiovascular diseases. This was the case both for patients who had already suffered a heart attack and for patients who had not.
Glimepiride or metformin already being taken. When switching from combination therapy of glimepiride plus metformin as separate tablets. Amaryl M should be. Drug Information on Amaryl glimepiride includes drug pictures, side effects, drug interactions, directions for use, symptoms of overdose, and what to avoid.