Metformin and Radiological Contrast Medium

Page changed: The Truth about Oral Diabetic Drugs

Added information from updated Metformin prescribing information explaining that metformin should be discontinued at the time of or slightly before radiological procedures involving injected dye and not taken for the next 2 days. After that kidney function should be evaluated with a serum creatinine test before metformin is started again. The latter recommendation is courtesy of a radiologist who pointed me to these updated guidelines.

In rare cases in people with marginal kidney function the use of contrast dyes may cause kidney failure if a dose of metformin is taken after the dye is used. It is also possible to develop lactic acidosis when this happens. This is rare, but because many people with poorly controlled diabetes have significant kidney damage, it is important for people taking metformin to be aware of this.

These recommendations have changed from what they were a few years ago.

Stop it or you'll go blind: Actos Definitely Linked to Increased Blindness in Well Controlled Diabetics

Page changed: Actos and Avandia - Dangerous Diabetes Drugs

Cited brand new study published in an Opthalmology journal--not read by family doctors, alas, that demonstrated dramatically that Actos and Avandia both raise the risk of vision loss dramatically.

Glitazone Use Associated with Diabetic Macular Edema Donald S. Fong. Am J OphthVolume 147, Issue 4, Pages 583-586.e1 (April 2009)

This study analyzed the records of 170,000 people with diabetes treated by Kaiser Permanente Southern California. The researchers found that

In 2006, there were 996 new cases of ME. Glitazone users were more likely to develop ME in 2006 (odds ratio [OR], 2.6; 95% confidence interval [CI], 2.4 to 3.0). After excluding patients who did not have the drug benefit, did not have an eye exam, and had a HgA1c <7.0, glitazone use was still associated with an increased risk of developing ME (OR, 1.6; 95% CI, 1.4 to 1.8).

This means you are 60% more likely to develop retinal swelling leading to vision loss even with well controlled blood sugars if you take Actos or Avandia than if you don't.

It's worth noting, too, that the Science News report of this study adds, "Most of the glitazone users in the study were taking pioglitazone (Actos)."

Since the whole point of lowering blood sugar in diabetes is to avoid blindness, this study makes it crystal clear that no person with diabetes should be taking Actos or Avandia.

PRINT OUT THE ABSTRACT OF THIS STUDY AND GIVE IT TO YOUR FAMILY DOCTOR AT YOUR NEXT APPOINTMENT. YOU COULD SAVE SOMEONE'S VISION.

Benfotiamine May Not Live up to Claims: Cheaper Thiamine May Be Equivalent

Page changed: Helpful Supplements for Diabetes

Added link to study calling into question whether Benfotiamine is really lipid soluble as claimed and whether it has any advantages over much cheaper, regular thiamine supplements.

Benfotiamine, a synthetic S-acyl thiamine derivative, has different mechanisms of action and a different pharmacological profile than lipid-soluble thiamine disulfide derivativesMarie-Laure Volvert et al. BMC Pharmacology 2008, 8:10doi:10.1186/1471-2210-8-10