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What is the difference between metformin vs. Lantus?
- Metformin and Lantus (insulin glargine) are used to treat diabetes.
- A difference is metformin is used to treat only type 2 diabetes, while Lantus may be used to treat both type 1 and type 2 diabetes.
- Metformin is also used to treat polycystic ovaries and weight gain due to medications used for treating psychoses.
- Brand names of metformin include Glumetza, Glucophage, and Fortamet.
- Metformin is an oral medication and Lantus is administered by injection under the skin (subcutaneously).
- Side effects of metformin that are different from Lantus include nausea, vomiting, gas, bloating, diarrhea, and loss of appetite.
- Side effects of Lantus that are different from metformin include decreased blood sugar, injection site pain, water retention in the joints, weight gain, and local allergic reactions at the injection site (rash, itching, redness, irritation).
What is metformin? What is Lantus?
Metformin is an oral medication used to treat type 2 diabetes. Metformin works by increasing the sensitivity of liver, muscle, fat, and other tissues to the uptake and effects of insulin, which lowers blood glucose (sugar) levels. Metformin does not increase the concentration of insulin in the blood and does not cause low blood glucose levels (hypoglycemia) when used alone. Metformin can reduce complications of diabetes such as heart disease, blindness, and kidney disease. Metformin is also used to treat polycystic ovaries and weight gain due to medications used for treating psychoses.
Lantus (insulin glargine) is a man-made injectable form of long-acting insulin used to regulate sugar (glucose) levels in type 1 and type 2 diabetes. Individuals with type 1 diabetes do not produce insulin on their own; and individuals with type 2 diabetes do not produce enough insulin, or insulin is not as effective due to insulin resistance. Lantus works the same way as natural human insulin, but it's action lasts longer. It helps diabetic patients regulate glucose or sugar in the body. Lantus works by promoting movement of sugar from blood into body tissues and also stops sugar production in liver.
What are the side effects of metformin and Lantus?
The most common side effects with metformin are
These symptoms occur in one out of every three patients. These side effects may be severe enough to cause therapy to be discontinued in one out of every 20 patients. These side effects are related to the dose of the medication and may decrease if the dose is reduced.
Metformin may also cause:
- weakness or lack of energy
- respiratory tract infections,
- low levels of vitamin B-12,
- low blood glucose (hyperglycemia)
- indigestion, muscle pain,
- heartburn, and
A serious but rare side effect of metformin is lactic acidosis. Lactic acidosis occurs in one out of every 30,000 patients and is fatal in 50% of cases. The symptoms of lactic acidosis are
- trouble breathing,
- abnormal heartbeats,
- unusual muscle pain,
- stomach discomfort,
- light-headedness, and
- feeling cold.
Patients at risk for lactic acidosis include those with reduced function of the
Common side effects of insulin glargine are:
- Decreased blood sugar and injection site pain
- Water retention in the joints and weight gain
Local allergic reactions that may occur at the injection sites are:
Long-term use of insulin glargine can lead to thickening of fat tissues at the injection site. Severe allergic reactions are:
- Swelling under the skin
- Very low blood pressure
- Bronchospasm (tightening of chest that leads to difficulty breathing)
Individuals should contact a healthcare professional if they experience any of the above reactions.
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What is the dosage of metformin vs. Lantus?
- For treating type 2 diabetes in adults, metformin (immediate release) usually is begun at a dose of 500 mg twice a day or 850 mg once daily. The dose is gradually increased by 500 mg weekly or 850 mg every two weeks as tolerated and based on the response of the levels of glucose in the blood. The maximum daily dose is 2550 mg given in three divided doses.
- If extended tablets are used, the starting dose is 500 mg or 1000 mg daily with the evening meal. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg except for Fortamet (2500 mg of Fortamet, once daily or in two divided doses). Glumetza tablets (500 -1000mg formulations are given once daily (either 1000 to 2000mg). Fortamet and Glumetza are modified release formulations of metformin. Metformin should be taken with meals.
- For pediatric patients 10-16 years of age, the starting dose is 500 mg twice a day. The dose can be increased by 500 mg weekly up to a maximum dose of 2000 mg in divided doses.
- Children older than 17 years of age may receive 500 mg of extended-release tablets daily up to a maximum dose of 2000 mg daily. Extended-release tablets are not approved for children younger than 17 years of age.
- Metformin-containing drugs may be safely used in patients with mild to moderate renal impairment. Renal function should be assessed before starting treatment and at least yearly.
- Metformin should not be used by patients with an estimated glomerular filtration rate (eGFR) below 30 mL/minute/1.73 m2 and starting metformin in patients with an eGFR between 30-45 mL/minute/1.73 m2 is not recommended.
- Metformin should be stopped at the time of or before administering iodinated contrast in patients with an eGFR between 30 and 60 mL/minute/1.73 m2; in patients with a history of liver disease, alcoholism, or heart failure; or in patients who will be administered intra-arterial iodinated contrast. Kidney function should be evaluated 48 hours after receiving contrast and metformin may be restarted if kidney function is stable.
- The starting dose should be individualized based on the type of diabetes and whether the patient is insulin-naïve
- Administer subcutaneously once daily at any time of day, but at the same time every day.
- Rotate injection sites within an injection area (abdomen, thigh, or deltoid) to reduce the risk of lipodystrophy.
- Converting from other insulin therapies may require adjustment of timing and dose of Lantus. Closely monitor glucose especially upon converting to Lantus and during the initial weeks thereafter.
What drugs interact with metformin and Lantus?
- Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.
- Ioversol (Optiray) and other iodinated contrast media may reduce kidney function, which reduces elimination of metformin, leading to increased concentrations of metformin in the blood. Metformin should be stopped 48 hours before and after use of contrast media.
- Thiazide diuretics, steroids, estrogens, and oral contraceptives may increase blood glucose and reduce the effect of metformin. When these drugs are stopped, patients should be closely observed for signs of low blood glucose.
- Alcohol consumption increases the effect of metformin on lactate production, increasing the risk of lactic acidosis.
There are many drugs that do not directly interfere with insulin glargine, but they may affect glucose breakdown in the body. This necessitates adjustments of insulin glargine doses.
Other drugs that can decrease the blood-sugar-lowering effect of insulin glargine are:
Are metformin or Lantus safe to use while pregnant or breastfeeding?
- There are no adequate studies in pregnant women. Most experts agree that insulin is the best treatment for pregnant women with diabetes.
- Metformin is excreted into breast milk and can, therefore, be transferred to the nursing infant. Nursing mothers should not use metformin.
- Safe and effective use of insulin glargine is not established for pregnant females.
- It is not known whether insulin glargine enters breast milk; therefore, it should be used with caution in females who are breastfeeding.
Metformin and Lantus (insulin glargine) are used to treat diabetes. A difference is metformin is used to treat only type 2 diabetes, while Lantus may be used to treat both type 1 and type 2 diabetes. Metformin is also used to treat polycystic ovaries and weight gain due to medications used for treating psychoses.
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Related Disease Conditions
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Diabetes Symptoms in Men
Diabetes mellitus is a disease in which a person's blood sugar (blood glucose) is either too high (hyperglycemia) or too low (hypoglycemia) due to problems with insulin regulation in the body. There are two main types of diabetes mellitus, type 1 and type 2. Type 1 diabetes usually occurs during childhood, while type 2 diabetes usually occurs during adulthood, however, rates of both types of diabetes in children, adolescents, and teens is increasing. More men than women have diabetes in the US, and the disease can affect men differently than women.Warning symptoms of diabetes that men have and women do not include low testosterone (low-t), sexual problems, impotence (erectile dysfunction), decreased interest in sex, and retrograde ejaculation. Type 1 and type 2 diabetes symptoms and signs that are the same in men and women include skin infections, numbness or tingling in the feet or hands, nausea, excessive thirst or hunger, fatigue, irritability, blurred vision, weight gain, weight loss, urinary tract infections (URIs), and kidney problems. Treatment for type 1 diabetes is insulin, and treatment for type 2 diabetes are lifestyle changes like eating a healthy diet, getting exercise daily, and if necessary, diabetes medications.
Diabetes Treatment (Type 1 and Type 2 Medications and Diet)
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Diabetes Symptoms in Women (Early and Late)
Diabetes symptoms in women include vaginal itching, pain, or discharge, loss if interest or pain after having sex, polycystic ovarian syndrome (POS), and urinary tract infections or UTIs (which are more common in women. Symptoms of diabetes that are the same in women and men are excessive thirst and hunger, bad breath, and skin infections, darkening of skin in areas of body creases (acanthosis nigricans), breath odor that is fruity, sweet, or acetone, and tingling or numbness in the hands or feet, blurred vision, fatigue, tingling or numbness in the hands or feet, wounds that heal slowly, irritability, and weight loss or gain. Complications of type 1 and type 2 diabetes are the same, for example, skin, eye, and circulation problems, low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), ketoacidosis, and amputation. If diabetes is not managed a person may not survive.
Diabetes insipidus is a condition in which the patient has frequent urination. Symptoms of diabetes insipidus include irritable, listless, fever, vomiting, or diarrhea due to the loss of large volumes of urine. There are three types of diabetes insipidus, central, nephrogenic, dipsogenic, and gestational. Treatment depends upon the type of diabetes insipidus.
How to Prevent Diabetes Naturally
Prediabetes is a condition in which a person has early symptoms of diabetes, but has not yet fully developed the condition. If prediabetes is not treated with lifestyle changes, the person could develop type 2 diabetes. Type 2 diabetes and prediabetes can be prevented with lifestyle changes, for example, eating a healthy diet, getting more exercise, reducing stress, quitting smoking, reducing or managing blood pressure and cholesterol, and managing any other health conditions or risk factors that you may have for developing type 2 diabetes.
Eye Problems and Diabetes
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
Diabetes and Safe Medications for Colds and the Flu: OTC Medication Guide
If you have diabetes and catch a cold or the flu, can be more difficult to recover from infections and their complications, for example, pneumonia. Home remedies and over-the-counter (OTC) drugs used for the treatment of the signs and symptoms of colds and the flu may affect blood sugar levels in people with diabetes.Some medications are OK to take if you have diabetes get a cold or the flu include nonsteroidal anti-inflammatory drugs or NSAIDs, like acetaminophen (Tylenol) and ibuprofen (Motrin) to control symptoms of fever and pain. Most cough syrups are safe to take; however, check with your pediatrician to see what medications are safe to give your child if he or she has type 1 or 2 diabetes. If you have diabetes and are sick with a cold or flu, you need to check your blood sugar levels more frequently. Continue taking your regular medications. Eat a diabetic low-glycemic index diet rich in antioxidants. To prevent colds and the flu drink at least eight 8 ounce glasses of water a day. To replenish fluids, drink sports drinks like Gatorade and Pedialyte to replenish electrolytes. Avoid people who are sick, sneezing, coughing, or have other symptoms of a cold or flu.
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