Is Diamicron MR and Glucophage Safe for Diabetes Management?

Q: Is Diamicron MR and Glucophage Safe for Diabetes Management?

Dear： <br>1. <br>Subject of the inquiry： How serious is diabetes? Response： Diabetes is a chronic disease, and if blood sugar levels are poorly controlled over a long period, it can lead to various complications affecting both large and small blood vessels (such as cardiovascular

How serious is diabetes?

Taking Diamicron MR 30 mg once in the morning and once at night on an empty stomach, along with 850 mg of Glucophage (metformin) after meals, and administering insulin, is generally considered safe for the liver and kidneys.
Is this regimen better?

Duo Duo, 50~59 year old female. Ask Date: 2013/01/03

Dr. Liao Lingmei reply Pharmacology

Dear:
1.
Subject of the inquiry: How serious is diabetes? Response: Diabetes is a chronic disease, and if blood sugar levels are poorly controlled over a long period, it can lead to various complications affecting both large and small blood vessels (such as cardiovascular, cerebrovascular, renal blood flow, and lower limb vascular issues), neuropathy (such as peripheral neuropathy and optic neuropathy), and poor wound healing, among others.
If a physician has decided to initiate oral medication as a treatment option, it is crucial to adhere strictly to the prescribed medication and maintain a proper diabetic diet (consulting a diabetes educator is advisable).
It is not acceptable to control diet only before specific appointments; the physician needs to evaluate the effectiveness of the medication and the severity of the disease based on fasting blood glucose levels and hemoglobin A1c values to adjust the dosage or type of medication accordingly.
2.
If diabetes leads to deteriorating kidney function due to long-term poor blood sugar control, it can also affect the metabolism and excretion of medications in the body.
In particular, the oral hypoglycemic agent Glucophage (containing Metformin) should not be used in patients with any degree of renal impairment.
3.
Typically, when hemoglobin A1c levels cannot be reduced to the desired range, physicians may consider insulin therapy.
However, patients must understand and accept the administration method.
Many patients believe that starting insulin indicates that their diabetes is severe, but this is not necessarily the case; all treatment recommendations from physicians aim to achieve optimal therapeutic outcomes.
Wishing you all the best! Stay healthy and happy!

Reply Date: 2013/01/03

More Info

When considering the management of diabetes, particularly with the use of medications such as Diamicron MR (gliclazide) and Glucophage (metformin), it is essential to evaluate their safety, efficacy, and potential impact on the liver and kidneys. Both medications are commonly prescribed for type 2 diabetes, but they work through different mechanisms and have distinct profiles regarding safety and side effects.

Diamicron MR (Gliclazide) is a sulfonylurea that stimulates the pancreas to release more insulin. It is effective in lowering blood glucose levels, particularly postprandial (after meals). However, it carries a risk of hypoglycemia (low blood sugar), especially if meals are skipped or if there is excessive physical activity. Additionally, long-term use of sulfonylureas may lead to a decrease in their effectiveness due to beta-cell exhaustion in the pancreas.

Glucophage (Metformin), on the other hand, is often the first-line treatment for type 2 diabetes. It works primarily by decreasing hepatic glucose production and improving insulin sensitivity. Metformin is generally well-tolerated and has a favorable safety profile. However, it is contraindicated in patients with significant renal impairment due to the risk of lactic acidosis, a rare but serious complication. Regular monitoring of kidney function is essential for patients on metformin, especially in those with pre-existing kidney issues.

In your case, you mentioned taking Diamicron MR 30 mg twice daily on an empty stomach and Glucophage 850 mg twice daily after meals, along with insulin therapy. This combination can be effective for managing blood glucose levels, but it is crucial to monitor for potential side effects, including hypoglycemia from Diamicron and gastrointestinal issues from Metformin.

Regarding the concern about liver and kidney safety, both medications are generally considered safe for patients with normal liver and kidney function. However, if there are any pre-existing conditions affecting these organs, it is vital to consult with a healthcare provider. Regular blood tests to monitor liver enzymes and kidney function (e.g., serum creatinine and eGFR) should be part of the management plan.

In summary, the combination of Diamicron MR and Glucophage can be effective for diabetes management, provided that kidney function is regularly monitored and that the patient is educated about the signs of hypoglycemia. It is also essential to maintain a healthy lifestyle, including a balanced diet and regular physical activity, to optimize diabetes control. If there are concerns about liver or kidney health, or if the patient experiences any unusual symptoms, it is crucial to seek medical advice promptly. Always follow the guidance of a healthcare professional regarding medication adjustments and monitoring.

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