Health
Dr. Roach: Physicians and endocrinologists disagree on metformin doses | Healthy aging
Dear Dr. Cockroach: I was diagnosed with type 2 diabetes and was prescribed 1,500 mg of metformin. My A1C went to 6.0, but even if it was 5.8, endocrinologists maintained the same dose. My GP suggested reducing the dose to 1,000 mg, but endocrinologists said taking 1,000 mg instead of 1,500 mg was like “taking nothing.” I’ve read that taking metformin has benefits, so for now I’m continuing the course. — — CD
Answer: Almost all drugs have a dose-response relationship. In other words, the more medicine you have, the more effective it is in general. However, they are also toxic, and the higher the dose, the higher the risk of toxicity. The prescriber’s job is to find an acceptable toxic and optimally effective dose.
For metformin, the usual dose is 1,000 mg to 2,550 mg per day. In my experience, 1,000-1,500 mg is about as effective as over 2,000. Many people have stomach upset and diarrhea at high doses. The use of sustained-release formulations significantly reduces this effect.
Metformin has other benefits, especially helping people to lose weight. Endocrinologists may be concerned about this, as 5.8% or 6% of A1C is lower than the goal required for most people with type 2 diabetes.
As a primary care physician, I have great respect for the specialists who help me manage my patient’s condition. Despite similar effects in most people, an endocrinologist may have found that a dose of 1,000 mg was not effective for you, but 1,500 mg was effective.
Dear Dr. Cockroach: I’m a 55-year-old woman who was recently hospitalized for severe shingles, but fortunately she didn’t penetrate her eyes and her eyesight wasn’t impaired. Shingles caused severe migraine headaches, eye pain, swelling, vomiting, fever and weakness on the left side of my face. Do I need to get the Shingrix vaccine? Also, what period should I inoculate? I read that after developing shingles, you have to wait three years before getting the vaccine.
I wanted to get the vaccine at last year’s annual test, but my doctor told me to wait. She wanted to see what the long-term effects of the vaccine would be. I don’t want to experience this again. — — So
Answer: The new shingles vaccine, Shingrix, can be given as soon as the shingles rash has settled, but the risk of shingles recurrence within a year of its onset is low. You can get it at any time of the year.
Although some doctors understand that they are reluctant to prescribe new treatments, the Shingrix vaccine data and years of experience are compelling enough and all over the age of 50 for no medical reason. Recommended for people. This is true for those who have previously had shingles and those who have not.
What Are The Main Benefits Of Comparing Car Insurance Quotes Online
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