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Metformin or Glucophage ranks as the first choice in treating Type 2 Diabetes when diet and exercise fail.  This drug remains one of the true bargains in American medicine – especially in diabetes care – typically costing less than $30 a month.

Of course the main issue in Type 2 Diabetes remains excess body fat.  Cure by weight loss would be preferable to treatment by pill or injection.  Metformin offers the opportunity to decrease blood sugar without the risk of hypoglycemia when prescribed as the sole agent.

Unfortunately as time progresses, most overweight individuals continue to add extra pounds which requires supplemental therapy.  Metformin may be combined with most other classes of anti-diabetic therapy.

Metformin functions by altering a number of metabolic pathways.  It lowers blood sugar by decreasing intestinal absorption and stimulating tissue uptake of circulating carbohydrate.  In diabetes, the liver actually manufactures excessive glucose from fat between meals.  Metformin down regulates this process.

With Metformin, glucose levels fall by as much as 60-80 points with an average decline of glycosylated hemoglobin or HbA1c by up to 2%.  The pill may be taken with or without meals and is available as an extended release product which simplifies administration.

Generally well tolerated, the most common side effects relate to altered stomach and intestinal function as manifest by diarrhea, nausea, abdominal cramps and excess gas.  These appear more frequently with the immediate release drug rather than the more commonly prescribed long acting or extended release form.

Recent investigations suggest Metformin may play a role in treating polycystic ovary disease and non-alcoholic fatty liver.  As with Type 2 Diabetes, both of these conditions occur more frequently in overweight / obese individuals.

Exciting studies hint that Metformin may act as a cancer preventive.  Early research suggests Metformin decreases the likelihood of premalignant colon polyps while simultaneously boosting survival of individuals with colon cancer.  It may similarly be effective in reducing the development of breast and prostate cancer.  Further research must be performed to interpret the meaning of this information.

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