Which Type 2 Diabetes Medication Is Right for Me?
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Sep 10, 2020 • 3 min read
Today there are 34.2 million Americans living with diabetes—or 10.5% of the US population. Of those cases, approximately 90-95% have type 2 diabetes which most often develops in people over age 45, but more and more children, teens, and young adults are also developing it. The good news: there are ways to manage and even reverse type 2 diabetes with diet, exercise, and medication. Here's a quick overview of the pros and cons of two of the most commonly prescribed medications—metformin and glimepiride—and what questions to ask your doctor to find the treatment that’s right for you.
With type 2 diabetes your body is unable to properly use the hormone insulin, which leads to high blood sugar levels. Left untreated, high blood sugar can have devastating health impacts, which include heart disease, kidney problems, stroke, eye problems (including blindness), nerve damage, amputation, and even death. Some people are able to control blood sugar effectively with a healthy diet and exercise, while others need medication.
Metformin has been the most widely prescribed medication to treat diabetes for more than 50 years. As a biguanide drug, it controls glucose (sugar) in your blood, reducing the amount of sugar absorbed from food and the amount of glucose made in your liver. Metformin is usually taken with meals, either once or twice a day depending on guidance from your doctor. Available dosage of pills include 500 mg, 850 mg, and 1000 mg.
Side Effects of Metformin
Common side effects of metformin include:
Low blood sugar
Bloating or stomach pain
Gas, constipation, or indigestion
Metallic taste in your mouth
You may also experience chest pain or rash, which can be serious; contact your doctor or seek emergency medical care immediately if these occur.
Metformin can interact with drugs, nutrients, and some diseases, which can be harmful.
Cimetidine, an antacid to treat stomach ulcers or acid reflux, competes with metformin in the kidneys and may increase metformin levels.
Metformin can deplete vitamin B12 and cause anemia.
Conditions that increase the likelihood of lactic acidosis with metformin include congestive heart failure, hypoxic states, septicemia, shock, alcohol consumption, severe liver disease, and renal insufficiency.
Glimepiride was first introduced in the U.S. for type 2 diabetes in 1995. It is a third-generation sulfonylurea that stimulates the pancreas to produce insulin and helps the body use insulin more efficiently.
Side Effects of Glimepiride
In general, sulfonylurea medications are safe, cost-effective, and predictable. However, they do come with a potentially serious side effect called hypoglycemia (extremely low blood sugar), so they’re not right for everyone. If you are taking glimepiride and experience frequent or severe hypoglycemia, talk to your doctor about switching to metformin.
Other side effects include:
Yellowing skin or eyes (jaundice)
Abnormal bruising or bleeding
Light-colored stools or diarrhea
Stomach pain on the upper right side
Fever or sore throat
If you are considering glimepiride, common interactions are:
CYP2C9 inhibitors, such as Clopidogrel (Plavix) or Fluconazole (Diflucan)
Alcohol (causing flushing, nausea, vomiting)
Severely impaired liver function or renal insufficiency can impact glimepiride metabolization
Which One Is Right for You?
Metformin is the most frequently prescribed standalone medication for type 2 diabetes because it’s proven effective in lowering blood sugar and can also reduce the risk of heart attack and stroke. Glimepiride may be prescribed for patients who are allergic to or who experience side effects from metformin, or who do not respond well to metformin. These medications differ in the way they lower blood sugar levels, so doctors may prescribe them together if taking one doesn't lower blood sugar levels enough.
Questions to Ask Your Doctor
Each of these medications has advantages and risks. Your doctor will take other health conditions and drug interactions into account when recommending a treatment, so be prepared with detailed information about your medical history and any other medications you’re taking. Here are a few questions to ask during your appointment:
How much experience do you have in treating diabetes patients?
How often should I test my blood sugar at home?
What blood sugar levels should I aim for?
What is an A1C test? What do my A1C results mean?
What dietary and exercise changes can I make to improve my health?
At what point should I consider medication to lower my blood sugar?
What are the side-effects of the medications you recommend?
What happens if I miss a dose of medication?
Are there other doctors I should visit?
When should I schedule my next appointment?
As you and your healthcare provider establish or revise your treatment plan, remember to check to see if your prescription for metformin or glimepiride is available for less with Blink Health. (We’ll even deliver it to your home for free).
This article is not medical advice. It is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, immediately call your physician or dial 911.
Blink Health is not insurance. The discount prescription drug provider is Blink Health Administration, LLC, 1407 Broadway, Suite 2100, New York, NY 10018, 1 (844) 265-6444, www.blinkhealth.com.
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