01-03-2009, 06:03 PM
Cr MORE THAN 1. RT OR RNG
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no metformin in - highsky
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01-03-2009, 07:01 PM
01-03-2009, 07:18 PM
http://radiology.rsnajnls.org/cgi/conten.../225/1/311
it should be 1.5 read the 130 umol guideline in many other places too
01-03-2009, 07:21 PM
Metformin's primary action is on the liver, reducing hepatic gluconeogenesis by activating adenosine monophosphate-activated protein kinase (AMPK), which acts as an intracellular energy sensor, and has a critical role regulating gluconeogenesis. LKB1 is a protein threonine kinase that phosphorylates and activates AMPK; it was recently reported that deletion of LKB1 function in the liver results in hyperglycemia with increased gluconeogenic and lipogenic gene expression. The deletion of LKB1 also eliminated the glucose lowering effect of metformin, providing genetic proof for the hypothesis that metformin lowers glucose levels by AMP kinase activation.
Metformin has a half-life of 1.5“3 hours, is not bound to plasma proteins, and is not metabolized in humans, being excreted unchanged by the kidneys. Metformin may be used as an adjunct to diet for the control of hyperglycemia and its associated symptoms in patients with type 2 diabetes, particularly those who are obese or are not responding optimally to maximal doses of sulfonylureas. A side benefit of metformin therapy is its tendency to improve both fasting and postprandial hyperglycemia and hypertriglyceridemia in obese diabetics without the weight gain associated with insulin or sulfonylurea therapy. Metformin is not indicated for patients with type 1 diabetes and is contraindicated in diabetics with serum creatinine levels of 1.5 mg/dL or higher, hepatic insufficiency, alcoholism, or a propensity to develop tissue hypoxia. |
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