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  • Q&A with Australian Health Practitioners

    Is taking Diabex long term bad if you do not have insulin resistance?

    Related Topics
    Endocrinology Type 2 Diabetes
    Ive recently had an insulin resistance test. One GP claims my results are normal, the other suggests I start taking Diabex ?

    My result was 10. I was told 9 is normal…

    Is taking Diabex long term if you do not have insulin resistance bad for you ?
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  • 10

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    Mark Surdut

    Dietitian

    Leading Melbourne Accredited Practising Dietitian -Mark Surdut APD AN. Mark runs a practise in North Caulfield with expertise in Medical Nutrition Therapy. Mark has a … View Profile

    this needs to be answered by a medical doctor please. MS

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    akaferrari

    HealthShare Member

    Im new to this site, are there any medical doctors/GPS available on this site to comment ?

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  • 5

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    akaferrari

    HealthShare Member

    Thank you for your response..
    Oh thats funny, I was told to have a Glucose tolerance test, which would determin if I was insulin resistant.   Its the same test they give pregnant woman to find out if they have gestational diabetes, only its over 3 hours..

    If you like I can send my results to you ?

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  • 11

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    Dr Stephen Leow

    HealthShare Member

    The Oral Glucose Tolenace Test  (OGTT) does not measure insulin resistance. It merely tells you whether you have diabetes or not. The actual measure of insulin resistance is far more complicated. The OGTT does not differentiate between Type 1 Diabetes and Type 2 Diabetes. There are moves to use a single blood test (HbA1c) instead of the OGTT to test for diabetes. In this test, <5.5 is normal 5.5-6.5 is prediabetic and >6.5 is diabetic. If there is a worry about autoimmune T1DM, the better test is Anti GAD antibodies.

    Your doctor will interpret the test for you, bearing in mind that the OGTT is ONLY a test for diabetes.

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  • 5

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    Janelle Collins

    Credentialled Diabetes Educator (CDE), Diabetes Educator, Registered Nurse

    Janelle Collins is a Credentialed Diabetes Educator and Registered Nurse who has over 18 years experience in working with people with Diabetes of all ages.Janelle … View Profile

    Diabex or Metformin is generally a well-tolerated medication, and most people that are on it are on it for long-term. I would recommend you talk to the doctor about why he or she has prescribed you Diabex in the first place, so then you can make an informed decision about what to do.

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    akaferrari

    HealthShare Member

    She said my result was 10 and that this is borderline and suggested I take Diabex as a preventative for Diabetes (as I have family history). 

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    Dr Simon Easterbrook-Smith

    Health Professional

    My research interests include immunology and the mechanisms of amyloid formation. The latter has implications for people who are dealing with Alzheimer's Disease, Parkinson's Disease … View Profile

    A Cochrane meta-analysis of many clinical trials (with 5259 subjects) supports the idea that Metformin is beneficial for people with Type 2 Diabetes:

    http://summaries.cochrane.org/CD002966/metformin-monotherapy-for-type-2-diabetes-mellitus

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    akaferrari

    HealthShare Member

    Thank you all for your assistance.

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  • 11

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    Dr Stephen Leow

    HealthShare Member

    Studies indicate that Metformin slows the progression of pre diabetes to diabetes by 27%. However, exercise and changes to diet slow the progression even more.

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  • 3

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    Dr Kevin Lee

    Endocrinologist, Nuclear Medicine Physician

    Consultant Physician in Endocrinology, Diabetes & Nuclear Medicine. I am on Twitter @dr_kevinlee. I am on Facebook https://www.facebook.com/kevinleefracp/ I help patients with obesity, diabetes, thyroid, … View Profile

    Please bear in mind that there is no 100% safe medication. Even metformin therapy is not without risks.

    Metformin in pre-diabetes is off-label use in Australia.

    It means it's not subsidised and has significant limitations for routine use in pre-diabetes.

    Prescribers need to ensure patients get ample opportunity to discuss rationale, pros and cons and alternatives for off-label indications.

    In fact, if one looks carefully at the Diabetes Prevention Program 10-year follow up study (1), metformin/lifestyle slows progression to diabetes only during active therapy.

    This means once the active therapies are ceased, if a patient didn't already get diabetes, they will have similar chance of getting diabetes whether placebo/metformin/lifestyle.

    Does this mean there is no legacy effect for pre-diabetes?


    1. Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, Hamman RF, Christophi CA, Hoffman HJ, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009 Nov 14;374(9702):1677–86.

    Regards,
    Dr Kevin Lee
    BSc(Med), MBBS, MHS(Clin Epi), FRACP
    Consultant Physician Endocrinologist

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