1) Is the reason why ppl tend to gain less fat while using Metformin w/ Slin because the fact thier using less Slin or because Metformin does something else? Again it comes to metformins ability to make insulin receptors more sensitive Which in turn means your utilizing most of the insulin and glucose is shuttled more efficiently........Therefore you dont have any excess insulin (which is a trigylceride) being store as fat.
2) Do you recommend using Avandia over metformin? Ive heard that it is better for "our needs."
Avendia is a totally different drug.
Targeting insulin resistance
Type 2 diabetes occurs for different reasons. For some people, the pancreas doesn't produce enough insulin (a hormone that helps the sugar in your blood enter the cells of your body).
However for other people, the cells throughout the body develop a condition called insulin resistance. Although the pancreas produces insulin, the body's cells cannot use it effectively, and the sugar (sometimes called glucose) stays in the blood. Over time, blood sugar levels rise, and type 2 diabetes develops.
Avandia works to help overcome this insulin resistance by making the body's cells more sensitive to insulin.
Insulin sensitizers — how they work
Avandia contains an insulin-sensitizing drug called rosiglitazone maleate — a TZD. TZDs target a special "receptor site" at the center of certain cells. This decreases the cells' resistance to insulin and allows more sugar to enter. As more sugar enters the cells, sugar and insulin levels in the bloodstream drop. This results in lower blood sugar levels.
Avandia may be a good choice if:
Diet and exercise alone aren't giving you the blood sugar control you need.
A sulfonylurea (such as AmarylÆ [glimepiride, Aventis Pharmaceuticals] or Glucotrol XL® [glipizide, Pfizer Inc.]), metformin or insulin alone aren't giving you the blood sugar control you need.
You want to target insulin resistance, an underlying cause of type 2 diabetes.
You're looking for long-term blood sugar control.
You'd like a medication with convenient dosing options.
You should not take Avandia if:
You're allergic to rosiglitazone, or any of its components.
You have active liver disease.
You are in the later stages of heart failure (Class III or IV).
You experienced yellowing of the skin with REZULIN® (troglitazone, Parke-Davis).
You have type 1 diabetes or diabetic ketoacidosis.
You have diabetic ketoacidosis.
In addition, when taking Avandia with a sulfonylurea or insulin, you may be at risk for low blood sugar. Ask your doctor whether you need to lower your sulfonylurea or insulin dose.
Bro this is a copy and paste becuase I have never used this drug. i have used metformin and can speak from experience. maybe someone else has some long term experience with this.
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Here's some interesting health info on avandia
Defective Drugs: Actos/Avandia (Generic name – Pioglitazone Hydrochloride)
September, 9 2003
Mayo Clinic Study Links Actos and Avandia to Heart Damage.
Actos and Avandia are oral antidiabetic agents that act primarily by decreasing insulin resistance. Pharmacological studies indicate that Actos improves sensitivity to insulin in muscle and adipose tissue and inhibits hepatic gluconeogenesis. Actos improves glycemic control while reducing circulating insulin levels. Pioglitazone belongs to a class of drugs called thiazolidinediones, which help lower blood sugar, or glucose, in people with type 2 diabetes mellitus.
Pioglitazone is the newest type of thiazolidinedione approved for use in the US. The drug company, Lilly, co-markets the drug with the maker, Takeda Pharmaceuticals North America. In 2000, the thiazolidinedione drug troglitazone (Rezulin) was taken off the market in the US and Europe after it was linked to dozens of deaths and cases of severe liver damage.
According to a report published in the March 19th issue of the Annals of Internal Medicine, a 49-year-old diabetic man taking Actos developed liver damage after taking the drug for 6 months. Blood tests excluded the possibility of a viral, metabolic, or autoimmune disorder, the authors state. Analysis of hepatic tissue revealed a mixed hepatocellular-cholestatic injury pattern consistent with drug toxicity. After discontinuing use of Actos, his liver returned to normal. Although this case does not prove that Actos was the cause, Dr. Louis D. May of Gastrointestinal Associates of Rockland in New City, New York, and colleagues suggest that patients treated with the medication should be monitored for evidence of hepatitis. "Physicians should be aware that this frequently prescribed agent is potentially hepatotoxic," Dr. May and colleagues write. “Careful monitoring for liver dysfunction, particularly during the first year of therapy, is warranted”, they add. The patient's initial symptoms included anorexia, nausea, and upper abdominal discomfort, as stated by the researchers. A few weeks later, he developed icteric sclera and acholic stools. The patient's hepatic function tests were severely abnormal.
In a similar case Dr. David W. Nierenberg, from Dartmouth Medical School in Hanover, New Hampshire, comments, "It now appears highly probable (but not definite) that pioglitazone can cause symptomatic, mild-to-moderate drug-induced hepatitis." He adds, “More patient data will need to be accumulated before the actual frequency of this reaction is known”.
A statement was issued by Takeda and Lilly, pointing out that any adverse events related to Actos use are reported to the FDA, and any cases involving questions of liver function are further evaluated by an independent panel of hepatologists. The statement continued, "To date, Actos has been prescribed to more than 2 million patients (12 million Rxs and over 1 million patient years of use) and the experience in regard to safety matches well with U.S. placebo-controlled clinical trials with Actos in which there was no evidence of drug-induced liver toxicity".
"Pending the availability of the results of additional large, long-term controlled clinical trials and additional, post-marketing safety data, current package labeling recommends that patients treated with Actos have their liver enzymes monitored at baseline, every 2 months for the first year and periodically thereafter. Actos should not be used in patients with active liver disease." Ann Intern Med 2002;136:449-452,480-483.
Actos Warning Label
http://www.actos.com/sub_sec2_safety.asp
The NY Times stated in May of 2000 that “Doctors warn patients taking new drugs Avandia and Actos, both approved last year for type 2 diabetes, should be monitored carefully for potential liver damage; similar drug Rezulin was taken off market by FDA”
