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- Diabetes Friendly Dining
- Type 2 Diabetes: Test Your Medical IQ
- Why is Actos (pioglitazone) prescribed to patients?
- What is Actos (pioglitazone)?
- Do I need a prescription for Actos (pioglitazone)?
- Is Actos (pioglitazone) available as a generic drug?
- What are the side effects of Actos (pioglitazone)?
- What is the dosage for Actos (pioglitazone)?
- Which drugs or supplements interact with Actos (pioglitazone)?
- Is Actos (pioglitazone) safe to use during pregnancy or while breastfeeding?
- What else should I know about Actos (pioglitazone)?
Why is Actos (pioglitazone) prescribed to patients?
- Actos is used for the treatment of type 2 diabetes in adults. It is used along with a healthy diabetic diet, regular exercise, weight control, smoking reduction, and careful monitoring of blood glucose.
- Actos may be used alone or in combination with metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet), a drug in a different class of anti-diabetic drugs, that also lowers blood glucose.
- Actos requires naturally-secreted insulin to be effective so it is not recommended in type 1 diabetes where the amount of insulin is very low or absent.
- Nevertheless, Actos is approved for treating type 2 diabetes in combination with insulin as well as another class of diabetes drugs, the sulfonylureas, that increases the amount of insulin produced.
What is Actos (pioglitazone)?
- Pioglitazone is an oral drug that reduces the amount of glucose (sugar) in the blood. It is in a class of anti-diabetic drugs called thiazolidinediones that are used in the treatment of type 2 diabetes. The other member in this class is rosiglitazone (Avandia). (Another member of this class, troglitazone or Rezulin, was removed from the market because of liver toxicity.)
What are the side effects of Actos (pioglitazone)?
ACTOS BLACK BOX WARNING
- Actos and similar drugs can cause or women congestive heart failure in some patients.
- Patients should be monitored for signs and symptoms of heart failure (for example, excessive, rapid weight gain, dyspnea, and/or edema) at the beginning of treatment and after dose increases.
- Actos is not recommended for patients with symptomatic heart failure and patients with established New York Heart Association (NYHA) Class III or IV heart failure should not use Actos.
Other side effects of Actos
The most common side effects of Actos alone or in combination with sulfonylureas, metformin, or insulin are:
- Upper respiratory tract infection
- Muscle aches
- Tooth disorders
- Hypoglycemia (low blood sugar)
- Sore throat
Possible serious side effects of Actos include:
Dose related fluid accumulation (edema) can occur especially when combined with insulin. Fluid accumulation can worsen or lead to heart failure. Actos should not be used in patients with heart disease classified by the New York Heart Association (NYHA) as Class III and IV heart failure or symptomatic heart failure.
Fluid accumulation also may lead to macular edema, resulting in reduced vision. Actos also can reduce red blood cells.
There have been post-marketing reports of liver failure while taking Actos.
Actos has been associated with liver injury. Periodic monitoring of liver-related side effects and liver tests should be conducted in patients taking Actos.
Symptoms of liver injury are:
Actos should be stopped if patients have symptoms of liver injury and liver function test results that are greater than three times the normal level. Liver blood tests are obtained before starting treatment. Monitoring liver tests during treatment is not recommended for patients without liver disease.
Actos may cause ovulation in women who have stopped ovulating if they are premenopausal and insulin resistant. This may lead to pregnancy. For women (but not men) taking Actos, there is an increased risk of bone fractures of the distal bones of the arm and leg. Patients taking Actos should maintain proper bone health.
What is the dosage for Actos (pioglitazone)?
- Actos is prescribed once daily in doses ranging from 15 to 45 mg.
- The recommended starting dose for patients without heart failure is 15 or 30 mg and for those with heart failure it is 15 mg daily. The dose may be increased in 15 mg intervals to a maximum dose of 45 mg daily if needed.
- Actos may be taken any time of the day, with or without meals.
- If a dose is missed on one day, two doses should not be taken the next day to make up for the missed dose.
Which drugs or supplements interact with Actos (pioglitazone)?
- Gemfibrozil reduces the break down of Actos by certain liver enzymes, increasing blood levels and possibly side effects of Actos. The maximum dose of Actos should not exceed 15 mg daily when combined with gemfibrozil or other drugs that reduce the activity of liver enzymes that break down Actos. Conversely, rifampin increases the breakdown of Actos by the liver, reducing blood levels and possibly the effects of Actos.
Is Actos (pioglitazone) safe to use during pregnancy or while breastfeeding?
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What else should I know about Actos (pioglitazone)?
What preparations of Actos (pioglitazone) are available?
- Tablets: 15, 30 and 45 mg.
How should I keep Actos (pioglitazone) stored?
- Tablets should be kept at room temperature, 15 C -30 C (59 F -86 F).
How does Actos (pioglitazone) work?
- Patients with type 2 diabetes cannot make enough insulin, and the cells of their body respond less to the insulin that is produced. Since insulin is the hormone that stimulates cells to remove glucose from the blood, the reduced amount of insulin and its reduced effect cause cells to take up less glucose from the blood and the level of glucose in the blood to rise. Pioglitazone often is referred to as an "insulin sensitizer" because it attaches to the insulin receptors on cells throughout the body and causes the cells to become more sensitive (more responsive) to insulin. As a result, more glucose is removed from the blood, and the level of glucose in the blood falls. At least some insulin must be produced by the pancreas in order for pioglitazone to work. Pioglitazone also lowers the level of glucose in the blood by reducing the production and secretion of glucose into the blood by the liver. In addition, pioglitazone may alter the blood concentrations of lipids (fats) in the blood. Specifically, it decreases triglycerides and increases the "good" (HDL) cholesterol.
When was Actos (pioglitazone) approved by the FDA?
- Pioglitazone received FDA approval in July 1999.
Actos (pioglitazone) is a drug prescribed for the treatment of type 2 diabetes. Side effects include:
- Sore throat
- Low blood sugar (hypoglycemia)
- Tooth disorders
- Upper respiratory tract infection
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Related Disease Conditions
Type 2 Diabetes Diet Plan
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
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.
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. There are no signs or symptoms of insulin resistance. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use. Some of the risk factors for insulin resistance include fatty liver, heart disease, strokes, peripheral vascular disease, high cholesterol, and smoking. Treatment for insulin resistance are lifestyle changes and if necessary, medication.
A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may also help stabilize blood glucose levels. Keeping track of when you take your diabetic medicine, keeping track of food choices, eating the proper amount of fruits, vegetables, carbohydrates, and fats will also help maintain proper blood glucose levels.
Type 1 vs. Type 2 Diabetes: Differences
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by: Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.) Consuming too many products with artificial sweeteners (We found out that they are bad for us!) Lack of activity Exercise Stress Genetics While the signs and symptoms of both types of diabetes are the same, which include: Increased urination Increased hunger Increased thirst Unexplained weight loss. However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
Diabetes Treatment: Medication, Diet, and Insulin
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.
Type 2 Diabetes
Type 2 diabetes is a chronic condition that may be reversible with diet and lifestyle changes. Symptoms include excessive thirst, frequent urination, weight loss, fatigue, and an unusual odor to your urine. Most people don't know they have type 2 diabetes until they have a routine blood test. Treatment options include medications, a type 2 diabetes diet, and other lifestyle changes.
Fatty Liver (NASH)
Nonalcoholic fatty liver disease or NASH occurs due to the accumulation of abnormal amounts of fat within the liver. Fatty liver most likely caused by obesity and diabetes. Symptoms of fatty liver disease are primarily the complications of cirrhosis of the liver; and may include mental changes, liver cancer, the accumulation of fluid in the body (ascites, edema), and gastrointestinal bleeding. Treatment for fatty liver includes avoiding certain foods and alcohol. Exercise, weight loss, bariatric surgery, and liver transplantation are treatments for fatty liver disease.
Diabetes Foot Problems
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
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.
Lipodystrophy (Acquired, Generalized, Inherited)
Lipodystrophy is a syndrome in which fat deposits accumulate all over the body, or sometimes just portions of it, like just the upper or lower body, or places on the skin where you give yourself daily allergy or insulin shots). You can be born with the generalized congenital or inherited type, or you can acquire it from HIV treatment drugs, infections, autoimmune diseases, trauma, or from repeated injections in the same place on the skin. The symptoms, treatment, and management depend upon the patient's type of lipodystrophy.
Sex, Urinary, and Bladder Problems of Diabetes
Having diabetes can mean early onset and increased severity of bladder symptoms (urinary incontinence and urinary tract infections) and changes in sexual function. Men may have erectile dysfunction; and women may have problems with sexual response and vaginal lubrication. Keep your diabetes under control, and you can lower your risk of sexual and urologic problems.
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.
Types of Diabetes Type 2 Medications
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and exercise. There are nine classes of drugs approved for the treatment of type 2 diabetes. Examples of type 2 oral diabetes medications include acarbose (Precose), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), and metformin (Glucophage). Side effects, drug interactions, warnings and precautions, dosage, and breastfeeding and pregnancy safety information should be reviewed prior to taking any medication.
The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for clotting. Patients are most often overweight or obese. Lifestyle modification such as the Mediterranean diet, exercise, and quitting smoking are the preferred treatment of metabolic syndrome.
Diabetes and Kidney Disease
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
Diabetes: Caring for Your Diabetes at Special Times
Taking care of a disease such as diabetes is a life-long process. Learn how to care for yourself or loved one with diabetes in situations such as illness, work, school, travel, or a natural disaster.
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