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What else can I help you with?
What are allopathic treatments for insulin resistance?
Allopathic treatments include the drugs biguanides and thiazolidinediones but they are not as effective as healthy diet and exercise.
What are the classifications of antidiabetic drugs?
Antidiabetic drugs may be subdivided into six groups: insulin, sufonylureas, alpha-glucosidase inhibitors, biguanides, meglitinides, and thiazolidinediones.
How does thiazolidione work?
Thiazolidinediones work by activating peroxisome proliferator-activated receptor gamma (PPAR-gamma) in the cell nucleus, which helps regulate glucose and lipid metabolism. By activating PPAR-gamma, thiazolidinediones help improve insulin sensitivity, decrease glucose production in the liver, and increase glucose uptake in muscle and fat cells. This ultimately leads to lower blood glucose levels and improved control of diabetes.
What are the cautions for taking biguanides and thiazolidinediones used for treating insulin resistance?
Both classes of drugs have the potential for very severe adverse effects. They are also not approved by the FDA for control of insulin resistance.
What precautions are associated with thiazolidinediones?
It is strongly recommended that all patients treated with pioglitazone or rosiglitazone have regular liver function monitoring.pregnant women should be switched to insulin.It is recommended that these drugs not be administered to nursing mothers.
What category are thiazolidinediones classified in for pregnancy?
The drugs are classified as pregnancy category C, based on evidence of inhibition of fetal growth in rats given more than four times the normal human dose.
Is metformin a thiazolidinedione?
No, metformin is not a thiazolidinedione. It is an antihyperglycemic medication primarily used to treat type 2 diabetes by improving insulin sensitivity and reducing glucose production in the liver. Thiazolidinediones, on the other hand, are a different class of medications that work by activating peroxisome proliferator-activated receptors (PPARs) to increase insulin sensitivity in muscle and adipose tissue.
What are the medications available to treat Type 2 diabetes?
Oh honey, there's a whole buffet of medications to tackle Type 2 diabetes. We've got metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, and good ol' insulin. Just remember, what works for one person may not work for another, so always consult with your doctor to find the right cocktail for you.
How do the glitazones work?
The glitazones are also called thiazolidinediones, or TZDs. The original TZD was called troglitazone (Rezulin) but has been taken off the market because it caused serious liver damage. There are two glitazones still on the market called rosiglitazone (Avandia) and pioglitazone (Actos). They work by going right inside cells that respond to insulin (like fat cells and muscle cells), where they make those cells respond to insulin better. They make it easier for glucose to be taken inside fat cells and muscle cells, where it can be used. It often takes several weeks before the full effect of a glitazone is seen on the blood glucose. The glitazones do many other things in the body. They change some of the lipid (fat) levels in the blood. They make it harder for your body to make new bone tissue.
How do glitazones work?
The glitazones are also called thiazolidinediones, or TZDs. The original TZD was called troglitazone (Rezulin) but has been taken off the market because it caused serious liver damage. There are two glitazones still on the market called rosiglitazone (Avandia) and pioglitazone (Actos). They work by going right inside cells that respond to insulin (like fat cells and muscle cells), where they make those cells respond to insulin better. They make it easier for glucose to be taken inside fat cells and muscle cells, where it can be used. It often takes several weeks before the full effect of a glitazone is seen on the blood glucose. The glitazones do many other things in the body. They change some of the lipid (fat) levels in the blood. They make it harder for your body to make new bone tissue.
Can diabetic medicine cause cancer?
The relationship between diabetes medications and cancer risk is complex and not fully understood. While some research suggests a potential association between certain diabetes medications and an increased risk of cancer, other studies have found no significant link or even a potential protective effect. It's essential to consider various factors when evaluating this association: Metformin: Metformin is a commonly prescribed medication for type 2 diabetes and has been studied extensively for its potential anti-cancer effects. Some research suggests that metformin may reduce the risk of certain cancers, including breast, colon, and prostate cancer. However, other studies have not found a significant association between metformin use and cancer risk. Insulin and Insulin Analogs: Insulin therapy is often used to manage diabetes, particularly in individuals with type 1 diabetes or advanced type 2 diabetes. While there is limited evidence suggesting a potential link between insulin therapy and an increased risk of certain cancers, the overall consensus is inconclusive. Some studies have suggested a modestly increased risk of breast cancer with long-term insulin use, while others have not found a significant association. Other Diabetes Medications: Other classes of diabetes medications, such as sulfonylureas, thiazolidinediones (TZDs), and dipeptidyl peptidase-4 (DPP-4) inhibitors, have been studied for their potential impact on cancer risk. Results have been mixed, with some studies suggesting a possible association with an increased risk of certain cancers, while others have not found a significant link. It's important to note that diabetes itself is a risk factor for certain types of cancer, including liver, pancreatic, colorectal, and breast cancer. Factors such as obesity, insulin resistance, chronic inflammation, and elevated blood glucose levels may contribute to this increased cancer risk in individuals with diabetes. Overall, while some research suggests a potential association between certain diabetes medications and cancer risk, the evidence is inconclusive and often conflicting. More research is needed to better understand the relationship between diabetes medications and cancer risk, as well as the underlying mechanisms involved. Individuals with diabetes should work closely with their healthcare providers to manage their condition effectively and monitor for any potential side effects or complications associated with diabetes medications.
Heart failure?
DefinitionHeart failure, also called congestive heart failure, is a condition in which the heart can no longer pump enough blood to the rest of the body.Alternative NamesCHF; Congestive heart failure; Left-sided heart failure; Right-sided heart failureCauses, incidence, and risk factorsHeart failure is almost always a chronic, long-term condition, although it can sometimes develop suddenly.The condition may affect the right side, the left side, or both sides of the heart.Right-sided heart failure means the right ventricle of the heart loses its pumping function.Left-sided heart failure means the heart's ability to pump blood forward from the left side of the heart is decreased. The left side of the heart normally receives blood rich in oxygen from the lungs and pumps it to the remainder of the body.Heart failure is often classified as either systolic or diastolic.Systolic heart failure means that your heart muscle cannot pump, or eject, the blood out of the heart very well.Diastolic heart failure means that your heart's pumping chamber does not fill up with blood.Both of these problems mean the heart is no longer able to pump enough blood out to the rest of your body, especially when you exercise or are active.As the heart's pumping action is lost, blood may back up in other areas of the body, producing congestion in the lungs, the liver, the gastrointestinal tract, and the arms and legs. As a result, there is a lack of oxygen and nutrition to organs, which damages them and reduces their ability to work properly.Perhaps the most common cause of heart failure is coronary artery disease, a narrowing of the small blood vessels that supply blood and oxygen to the heart. For information on this condition and its risk factors, see: Coronary artery disease.Heart failure can also occur when an illness or toxin weakens the heart muscle or changes the heart muscle structure. Such events are called cardiomyopathies. There are many different types of cardiomyopathy. For information, see: CardiomyopathyOther heart problems that may cause heart failure are:Congenital heart diseaseHeart valve diseaseSome types of abnormal heart rhythms (arrhythmias)Diseases such as emphysema, severe anemia, hyperthyroidism, or hypothyroidism, may cause or contribute to heart failureSymptomsCommon symptoms are:Shortness of breath with activity, or after lying down for a whileCoughSwelling of feet and anklesSwelling of the abdomenWeight gainIrregular or rapid pulseSensation of feeling the heart beat (palpitations)Difficulty sleepingFatigue, weakness, faintnessLoss of appetite, indigestionOther symptoms may include:Decreased alertness or concentrationDecreased urine productionNausea and vomitingNeed to urinate at nightInfants may sweat during feeding (or other activity).Some patients with heart failure have no symptoms. In these people, the symptoms may develop only with these conditions:Abnormal heart rhythm (arrhythmias)AnemiaHyperthyroidismInfections with high feverKidney diseaseSigns and testsA physical examination may reveal the following:Fluid around the lungs (pleural effusion)Irregular heartbeatLeg swelling (edema)Neck veins that stick out (are distended)Swelling of the liverListening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds.The following tests may reveal heart swelling,decreased heart function, or lung congestion:Chest x-rayECGEchocardiogramCardiac stress testsHeart CT scanHeart catheterizationMRI of the heartNuclear heart scansThis disease may also alter the following test results:Blood chemistryBUNComplete blood countCreatinineCreatinine clearanceLiver function testsUric acid-blood testSodium - blood testUrinalysisSodium - urine testTreatmentIf you have heart failure, your doctor will monitor you closely. You will have follow up appointments at least every 3 to 6 months and tests to check your heart function. For example, an ultrasound of your heart (echocardiogram) will be done once in awhile to see how well your heart pumps blood with each beat.You will need to carefully monitor yourself and help manage your condition. One important way to do this is to track your weight on a daily basis. Weight gain can be a sign that you are retaining fluid and that your heart failure is worsening. Make sure you weigh yourself at the same time each day and on the same scale, with little to no clothes on.Other important measures include:Take your medications as directed. Carry a list of medications with you wherever you go.Limit salt intake.Don't smoke.Stay active. For example, walk or ride a stationary bicycle. Your doctor can provide a safe and effective exercise plan based on your degree of heart failure and how well you do on tests that check the strength and function of your heart. DO NOT exercise on days that your weight has gone up from fluid retention or you are not feeling well.Lose weight if you are overweight.Get enough rest, including after exercise, eating, or other activities. This allows your heart to rest as well. Keep your feet elevated to decrease swelling.Here are some tips to lower your salt and sodium intake:Look for foods that are labeled "low-sodium," "sodium-free," "no salt added," or "unsalted." Check the total sodium content on food labels. Be especially careful of canned, packaged, and frozen foods. A nutritionist can teach you how to understand these labels.Don't cook with salt or add salt to what you are eating. Try pepper, garlic, lemon, or other spices for flavor instead. Be careful of packaged spice blends as these often contain salt or salt products (like monosodium glutamate, MSG).Avoid foods that are naturally high in sodium, like anchovies, meats (particularly cured meats, bacon, hot dogs, sausage, bologna, ham, and salami), nuts, olives, pickles, sauerkraut, soy and Worcestershire sauces, tomato and other vegetable juices, and cheese.Take care when eating out. Stick to steamed, grilled, baked, boiled, and broiled foods with no added salt, sauce, or cheese.Use oil and vinegar, rather than bottled dressings, on salads.Eat fresh fruit or sorbet when having dessert.Your doctor may consider prescribing the following medications:ACE inhibitors such as captopril, enalapril, lisinopril, and ramipril to open up blood vessels and decrease the work load of the heartDiuretics including hydrochlorothiazide, chlorthalidone, chlorothiazide, furosemide, torsemide, bumetanide, and spironolactone to help rid your body of fluid and salt (sodium)Digitalis glycosides to increase the ability of the heart muscle to contract properly and help treat some heart rhythm disturbancesAngiotensin receptor blockers (ARBs) such as losartan and candesartan to reduce the workload of the heart; this class of drug is especially important for those who cannot tolerate ACE inhibitorsBeta-blockers such as such as carvedilol and metoprolol, which are particularly useful for those with a history of coronary artery diseaseCertain medications may make heart failure worse and should be avoided. These include nonsteroidal anti-inflammatory drugs, thiazolidinediones, metformin, cilostazol, PDE-5 inhibitors (sildenafil, vardenafil), and many drugs that treat abnormal heart rhythms.Valve replacements or repair coronary bypass surgery (CABG), and angioplasty may help some people with heart failure.The following devices may be recommended for certain patients:A single or dual chamber pacemaker to help with slow heart rates or certain other heart signaling problemsA biventricular pacemaker to help the left and right side of your heart contract at the same time.An implantable cardioverter-defibrillator to correct or prevent severe arrhythmias (abnormal heart rhythms)Severe heart failure may require the following treatments:Intra-aortic balloon pump (IABP), a temporary device placed into the aortaLeft ventricular assist device (LVAD), which takes over the role of the heart by pumping blood from the heart into the aorta; it's most often used by those who are waiting for a heart transplant.Note: These devices can be life saving, but they are not permanent solutions. Patients who become dependent on circulatory support will need a heart transplant.Heart failure symptoms may be improved with biventricular pacemaker or cardiac resynchronization therapy. Ask your provider if you are a candidate for this type of treatment.Expectations (prognosis)Heart failure is a serious disorder. It is usually a chronic illness, which may get worse with infection or other physical stress.Many forms of heart failure can be controlled with medication, lifestyle changes, and treatment of any underlying disorder.ComplicationsIrregular heart rhythms (can be deadly)Pulmonary edemaTotal heart failure (circulatory collapse)Possible side effects of medications include:CoughDigitalis toxicityGastrointestinal upset (such as nausea, heartburn, diarrhea)HeadacheLight-headedness and faintingLow blood pressureLupusreactionMuscle crampsCalling your health care providerCall your health care provider if weakness, increased cough or sputum production, sudden weight gain or swelling, or other new or unexplained symptoms develop.Go to the emergency room or call the local emergency number (such as 911) if you experience severe crushing chest pain, fainting, or rapid and irregular heartbeat(particularly if other symptoms accompany a rapid and irregular heartbeat).PreventionFollow your health care provider's treatment recommendations and take all medications as directed.Keep your blood pressure , heart rate, and cholesterol under control as recommended by your doctor. This may involve exercise, a special diet, and medications.Other important treatment measures:Do not smoke.Do not drink alcohol.Reduce salt intake.Exercise as recommended by your health care provider.ReferencesHunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult. J Am Coll Cardiol. 2005;46:1-82.Mann DL. Management of heart failure patients with reduced ejection fraction. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007: chap 25.Hess OM and Carroll JD. Clinical assessment of heart failure. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Libby: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007: chap 23.Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG, et al. 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009 Apr 14;119(14):1977-2016. Epub 2009 Mar 26.
