Cut back on portions. Plus, you get delicious Atkins bars and shakes from day one and every step of the way. Cochrane Database Syst Rev. Metformin may reduce the insulin requirement in type 1 diabetes. Low-density lipoprotein cholesterol LDL and creatinine did not change significantly.
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The usual synthesis of metformin, originally described in , involves the one-pot reaction of dimethylamine hydrochloride and 2-cyanoguanidine over heat. According to the procedure described in the Aron patent,  and the Pharmaceutical Manufacturing Encyclopedia ,  equimolar amounts of dimethylamine and 2-cyanoguanidine are dissolved in toluene with cooling to make a concentrated solution, and an equimolar amount of hydrogen chloride is slowly added.
Steady state is usually reached in one or two days. Metformin has acid dissociation constant values pKa of 2. The metformin pKa values make metformin a stronger base than most other basic medications with less than 0. Furthermore, the lipid solubility of the nonionized species is slight as shown by its low logP value log 10 of the distribution coefficient of the nonionized form between octanol and water of These chemical parameters indicate low lipophilicity and, consequently, rapid passive diffusion of metformin through cell membranes is unlikely.
As a result of its low lipid solubility it requires the transporter SLC22A1 in order for it to enter cells. More lipophilic derivatives of metformin are presently under investigation with the aim of producing prodrugs with superior oral absorption than metformin. Metformin is not metabolized. It is cleared from the body by tubular secretion and excreted unchanged in the urine; metformin is undetectable in blood plasma within 24 hours of a single oral dose.
The biguanide class of antidiabetic medications, which also includes the withdrawn agents phenformin and buformin , originates from the French lilac or goat's rue Galega officinalis , a plant used in folk medicine for several centuries. Metformin was first described in the scientific literature in , by Emil Werner and James Bell, as a product in the synthesis of N , N -dimethylguanidine. Interest in metformin resumed at the end of the s. In , metformin, unlike some other similar compounds, was found not to decrease blood pressure and heart rate in animals.
Garcia  used metformin he named it Fluamine to treat influenza; he noted the medication "lowered the blood sugar to minimum physiological limit" and was not toxic. Garcia believed metformin to have bacteriostatic , antiviral , antimalarial , antipyretic and analgesic actions. Instead he observed antiviral effects in humans. French diabetologist Jean Sterne studied the antihyperglycemic properties of galegine , an alkaloid isolated from Galega officinalis , which is related in structure to metformin and had seen brief use as an antidiabetic before the synthalins were developed.
Sterne was the first to try metformin on humans for the treatment of diabetes; he coined the name "Glucophage" glucose eater for the medication and published his results in Metformin became available in the British National Formulary in It was sold in the UK by a small Aron subsidiary called Rona.
Broad interest in metformin was not rekindled until the withdrawal of the other biguanides in the s. Metformin was approved in Canada in ,  but did not receive approval by the U. Liquid metformin is sold under the name Riomet in India. Metformin IR immediate release is available in , , and mg tablets. All of these are available as generic medications in the U.
Metformin SR slow release or XR extended release was introduced in It is available in , , and mg strengths, mainly to counteract common gastrointestinal side effects, as well as to increase compliance by reducing pill burden.
No difference in effectiveness exists between the two preparations. When used for type 2 diabetes, metformin is often prescribed in combination with other medications.
Several are available as fixed-dose combinations , to reduce pill burden and simplify administration. A combination of metformin and rosiglitazone was released in and sold as Avandamet by GlaxoSmithKline. By it had become the most popular metformin combination. In , the stock of Avandamet was removed from the market, after inspections showed the factory where it was produced was violating good manufacturing practices. However, following a meta-analysis in that linked the medication's use to an increased risk of heart attack ,  concerns were raised over the safety of medicines containing rosiglitazone.
In September the European Medicines Agency EMA recommended that the medication be suspended from the European market because the benefits of rosiglitazone no longer outweighed the risks. In November , the FDA lifted its earlier restrictions on rosiglitazone after reviewing the results of the RECORD clinical trial a six-year, open label randomized control trial , which failed to show elevated risk of heart attack or death associated with the medication.
Dipeptidyl peptidase-4 inhibitors inhibit dipeptidyl peptidase-4 and thus reduce glucagon and blood glucose levels. In Europe, Canada, and elsewhere metformin combined with linagliptin is marketed under the trade name Jentadueto. Sulfonylureas act by increasing insulin release from the beta cells in the pancreas.
Metformin is available combined with the sulfonylureas glipizide Metaglip and glibenclamide US: Meglitinides are similar to sulfonylureas. The combination of metformin with pioglitazone and glibenclamide  is available in India as Triformin. From Wikipedia, the free encyclopedia. B No risk in non-human studies. S4 Prescription only CA: Pharmacy and pharmacology portal Medicine portal. Clinical Pharmacology and Therapeutics. A review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus".
Archived from the original on 24 December Retrieved 2 January A Systematic Review and Meta-analysis". Annals of Internal Medicine. Archived from the original on Archived PDF from the original on First choice for monotherapy: Analogue-based Drug Discovery II. Herb, nutrient, and drug interactions: Archived PDF from the original on 13 December Retrieved 8 December Archived from the original on 3 August Retrieved 11 January Blake; Stanifer, John W.
Diab Vasc Dis Res. International Journal of Obesity. Consuming foods that are considered low-calorie dense aids in weight loss. These foods will provide a high volume without a lot of calories. By replacing foods that are considered high-calorie dense, you save additional calories. Some find it more satisfying to focus on consuming low-calorie dense foods in large quantities versus counting calories.
The Pritikin diet also encourages daily exercise and stress -reduction techniques. The most controversial part of this diet is the severe fat restriction. There has been a considerable amount of research showing the health benefits of omega-3 fats, including protecting your heart.
The American Heart Association now recommends that people without coronary heart disease eat a variety of omega-3 fat-containing fish at least twice a week and that those with coronary heart disease consume one gram of omega-3 fats per day.
Dietary fat is also needed to transport the fat-soluble vitamins A, D, E, and K. Without fat to transport them, they will not be able to serve their functions in your body.
Our diets are meant to have a balance of protein, carbohydrates, and fat. When you consume too little of one of these nutrients it means you are consuming too much of another nutrient. Most people who follow a very low-fat diet end up consuming an excess amount of carbohydrates. Too much of any nutrient can cause health problems. The Dietary Reference Intake DRI established the need for each one of these nutrients based on research for optimal health and weight.
If you follow the Pritikin Principle it would be best to adjust your intake to meet the DRI guidelines. The Zone diet is a high-protein, low-carbohydrate, fat-controlled eating plan. It is not as restrictive as other high-protein diets and it allows for a broad range of foods to be consumed. A small amount of protein is combined with twice the amount of "favorable" carbohydrates, including fruits and vegetables.
If choosing "less desirable" carbohydrates, the portion size is smaller. Sears' Zone diet is based on the theory that the human body is genetically programmed to reach peak efficiency when all meals, including snacks, consist of a set caloric ratio of carbohydrates, proteins, and fats. When this ratio is achieved, the body is working within the "zone.
The Zone diet promotes eating a balance of each nutrient, without severely restricting calories. Protein increases your feeling of fullness, helping you to avoid eating between meals, and there is a guide to what kind of fat you can consume. Healthy fats are encouraged in place of the saturated and trans fats. The calorie restriction will help you lose weight. The claims made about the health implications of carbohydrates and protein are controversial.
As with other fad diets, one nutrient is being made to look like the enemy carbohydrates , while protein is made to look like the key to weight loss and health. Most diets that are against carbohydrates use the arguments that we consume less fat and more carbohydrates than we did 10 years ago, and obesity is on the rise. This is half true. We consume more carbohydrates, which means we consume more calories.
Our fat intake remains above the recommendations, but the percent of our total calories from fat has come down because we are now consuming more calories. Again, research clearly shows that a balance of each of these nutrients is needed and that an excess or deficiency in any of them will cause problems.
This diet can be difficult to stick with long-term, so weight regain can be an issue. The South Beach Diet. The South Beach diet is the newest high-protein, low carbohydrate, and fat-controlled diet. This diet claims that the cause for obesity "is simple: The faster the sugars and the starches you eat are processed and absorbed into your bloodstream, the fatter you get. The first phase claims to eliminate cravings and kick-start weight loss; the second phase is for long-term, steady weight loss; and the third phase is to be followed for days a year once you have achieved your weight loss goal.
The second and third phases of this diet promote a balanced diet that can be beneficial to your health and weight. These phases promote consistent meal times, healthy snacks and desserts, and water.
The meal plans and recipes can be useful for those who need some guidance on what to eat. There are now six other books and an interactive web site supporting this plan. The theory behind the diet is not the reason you will lose weight if you follow this plan. Weight loss can only occur when you consume fewer calories than your body needs. In the introduction chapter the author makes numerous claims that you do not need to limit the quantity of food that you consume and then provides portion restrictions on many high calorie foods, such as nuts.
It's appealing to hear you can eat unlimited quantities, but weight loss will not be achieved without limitations. The initial phase of this diet should be avoided. This two-week phase claims to produce a weight loss of eight to 13 pounds with severe dietary restrictions; including fruit, dairy, and starches. Phases like this are usually included so people see quick results, but are limited in time because they are not nutritionally balanced and can't be followed for a long period.
It tends to be more discouraging than motivating to lose quickly and to feel like you are "on a diet. It's best to begin slowly and to always consume a nutritionally balanced diet. Eat more, weigh less: Eat More, Weigh Less is one of the few diets developed as a result of research. The primary goal of this diet was to reverse heart disease. The basis for this diet is to consume a high-fiber, low-fat, vegetarian diet with limited amounts of dairy foods.
The goal is to consume primarily complex carbohydrates vegetables, fruit, and whole grains , low total fat primarily from omega-3 fatty acids and limited in saturated fat, and low sugar. Physical activity and stress management are also emphasized. The research does support the health benefits of this diet, and you will lose weight if you stick with the plan.
The web site provides recipes and detailed information on nutrition , exercise, and stress management. The primary con to this diet is that it can be extremely limited and difficult for some people to follow.
This limitation is because meat is omitted from the plan. Cutting out an entire food group may be too much of a restriction to maintain over the long-term, so some people do best by modifying this diet to allow for a moderate amount of meat. The high fiber intake may also pose a problem initially. It's best to slowly increase the amount of fiber you consume so your body can get used to it.
The goal is always long-term weight loss and maintenance. This diet does have the research to support it, but it may need modifications to make it work for you. Jenny Craig has become best-known for the celebrities who are followed while losing weight on this diet.
They explain how easy it is and how delicious the food is, and you see the results as they are happening. This diet provides you with your foods and snacks to ensure you consume the exact amount of calories your body needs to lose weight. You add fresh produce and dairy. You meet with a consultant on a weekly basis to discuss your progress, and who will assist you with transitioning to your own food when you are ready to do so.
Physical activity is emphasized throughout the diet. The primary advantage to this diet is that you will lose weight if you eat what you are given. Portion-and-calorie-controlled meals are great tools for long-term weight loss and maintenance. They take away the guesswork of how many calories you consume, they can be nutritionally balanced, they are quick and easy to prepare, and they teach you about healthy portion sizes.
As with all diets, nothing works for everyone, and nothing works forever. The celebrity endorsements are great when they work, but the celebrities who regain their weight once they discontinue this plan are proving that this is not the answer for everyone.
Many people prefer to be able to eat food they prepare and do not like the idea of prepackaged foods. The consultants are not professionals in this field. They undergo a training course but are not trained therapists, registered dietitians, or exercise physiologists, so the advice and support that you receive will be limited to what they have been taught to say.
If you are taking any medications or have any health conditions, it is best to work with trained professionals. The NutriSystem Advanced diet is a low glycemic index , high-fiber, and high-protein diet. The prepackaged food is provided for you by ordering online or by calling the toll free number. This diet does address the three necessary components for successful weight loss and maintenance; diet, physical activity, and behavior. Prepackaged foods can be an effective tool for weight loss.
You will be provided with the appropriate number of calories for weight loss without having to worry about counting anything. This will give you the opportunity to learn what appropriate portion sizes are and which foods are necessary for a well-balanced diet based on your specific needs. The variety of programs based on gender, age, health, and dietary preference is another positive component of this diet. The Mindset Makeover was developed by one of the leading psychologists in the weight loss field, Gary Foster, Ph.
It is designed to "help people learn new behaviors when it comes to weight loss and related lifestyle issues. You are given access to this and an online account with community support as part of each of the programs. Prepackaged foods are not for everyone and typically not something to use forever. They can be very limiting and create the sense of being "on a diet.
Most people find that they only want to use this type of a diet for the short-term or for one or two meals per day.
One easy way to lose weight quickly is to cut out liquid calories, such as soda, juice, and alcohol. Replace them with zero-calorie drinks like lemon water , unsweetened tea , or black coffee. Diet drinks will save you calories, compared with sugary beverages. You might think that fasting is a quick way to drop pounds.
Some involve skipping all food. There are also fasts where you eat every other day. During the first days of your fast, you may feel hungry and grumpy. You may also get constipated. Drink lots of water and take a daily multivitamin.
You should also tell your doctor, especially if you take medications that will probably need to be adjusted. No matter how you kick-start your weight loss, the best way to keep it off is with long-lasting lifestyle changes, like a healthy eating plan and physical activity.
You want to drop pounds, now. And you want to do it safely. There are many ways you can do this, without cutting calories too much. Cut back on portions. Figure out how many calories you get in a usual day, and trim back a bit.
Read food labels to know how many calories are in each serving. Get Accountability and Support Many apps can help you track your eating. Lastly, reward yourself for making a different choice.