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June 5, 2001

Pills for Diabetes

Question from Australia:

I was diagnosed with type 1 diabetes 11 years ago and I have always tried to have my diabetes in good control. My highest A1c level ever was 7.7%, and it is currently 6.8%. I am always looking for new ways to treat my diabetes. Recently, I have seen all these ads for Avandia, Actos, and metformin. Are they useful in type 1 diabetes? Some time ago I heard that metformin might be good at lowering fasting blood glucose.

Answer:

Avandia [rosiglitazone], Actos [pioglitazone], and Glucophage [metformin] are primarily used to treat type 2 diabetes, in which insulin resistance is an issue.

Unless you have a large insulin requirement and a family history of type 2 diabetes, I would suggest these drugs offer little chance for improving your already very good results with insulin. These agents have been studied in type 1 diabetes, and they have a minor benefit of a less than 1% improvement in hemoglobin A1c.

JTL