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February 22, 2002

Pills for Diabetes, Research: Other Research

Question from Meskanaw, Saskatchewan, Canada:

I am a 30 year old female who has had type 1 diabetes for 23 years, and my doctor recently prescribed metformin for my insulin resistance. It works great, however, the side effects such as heartburn and bloating are bothersome. My pharmacist suggested that Avandia would be the next drug of choice. Does Avandia work the same as metformin? Have there been any studies done on the effects of metformin and Avandia in type 1 diabetes?

Answer:

Avandia [rosiglitazone] and Glucophage [metformin] work by different mechanisms. However, both are used to treat insulin resistance.

Studies have been done with both agents in type�1 diabetes. However, their effects on lowering blood sugar are modest when you are already on insulin. As you would expect, most of the studies have been performed on patients with type�2 diabetes.

There have been a number of patients who have been identified as having type 1 diabetes but who also have the genetics/family history of type 2, diabetes, making them insulin resistant. The biggest problem with Avandia and the drugs in that class is a propensity to cause weight gain, whereas metformin does not induce weight gain. It may help to cut the dose of metformin back and work up slowly.

Any changes you make should be discussed with your physician.

JTL