Science topic

Metformin - Science topic

A biguanide hypoglycemic agent used in the treatment of non-insulin-dependent diabetes mellitus not responding to dietary modification. Metformin improves glycemic control by improving insulin sensitivity and decreasing intestinal absorption of glucose. (From Martindale, The Extra Pharmacopoeia, 30th ed, p289)
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I did an experiment for a positive control phos-tag system to detect phosphorylated AMPK in min6 cells. I incubated min6 cells for 12h with metformin to induce AMPK phosphorylation then check the result by phospho-specific antibody and get a confirmation of increased phosphorylation but after I check with phostag system I did not get the result that I expected. Anyone has experience in this technique, your feed back is appreciated. here I include my result and condition
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Hi! I am having issues with my Phos-tag gels. My resolution is poor. I did the 3X EDTA washes (20 minutes each) but it didn't help. I just wanted to ask how the washes improved the result? Did you get better resolution or more protein?
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CAN ANYONE PLEASE HELP ME WITH THIS QUESTION?
I HAVE READ MANY MANY ARTICLES ABOUT THE POSITIVE CORRELATION BETWEEN THE TWO VARIABLES BUT NO ONE DESCRIBED AN UNDERLYING MECHANISM.
PLEASE SHED SOMETIME
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"'Metformin improves insulin sensitivity, promotes cellular repair, is anti-inflammatory, and antioxidant. All these properties contribute to its anti-aging effects,' Merrill told us. Studies in people with type 2 diabetes have shown that metformin activates the AMP-activated protein kinase (AMPK).
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"Los ensayos clínicos aleatorizados que nos pudieran ofrecer una mejor evidencia sobre los efectos antienvejecimiento de la metformina están apenas en curso o planeación." https://revistamedicina.net/index.php/Medicina/article/view/2350/3094
Le sugiero revisar varios artículos para que pueda tener una idea más clara de este efecto que aún está en investigación.
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Can you explain the off-label uses of metformin discussed in the review?
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Respected Sir;
Metformin is a well-known medication primarily used to treat type 2 diabetes by improving blood sugar control. However, it has several off-label uses due to its various metabolic effects. Here are some notable off-label uses of metformin:
1. Polycystic Ovary Syndrome (PCOS):
- Metformin is frequently prescribed to women with PCOS to improve insulin resistance, reduce insulin levels, and help regulate menstrual cycles. It may also aid in weight loss and improve ovulation, thereby increasing fertility.
2. Weight Management:
- Metformin has been used off-label for weight management, particularly in individuals with insulin resistance. It can help reduce appetite and promote modest weight loss, especially in those with obesity or metabolic syndrome.
3. Prediabetes:
- For individuals with prediabetes, metformin can help prevent or delay the progression to type 2 diabetes by improving insulin sensitivity and lowering blood glucose levels.
4. Gestational Diabetes:
- Although insulin is the standard treatment for gestational diabetes, metformin is sometimes used off-label for blood sugar control in pregnant women when lifestyle changes alone are insufficient.
5. Anti-Aging:
- Metformin is being researched for its potential anti-aging effects. Some studies suggest that it may improve longevity and reduce the risk of age-related diseases due to its effects on metabolism and cellular processes.
6. Cancer Prevention and Treatment:
- Emerging research indicates that metformin might have anti-cancer properties, particularly for breast, colorectal, and prostate cancers. It is thought to inhibit cancer cell growth by reducing insulin and glucose levels and affecting cellular pathways related to cancer progression.
7. Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH):
- Metformin has been used to treat NAFLD and NASH, conditions characterized by fat buildup in the liver. It may help by improving insulin sensitivity and reducing liver fat accumulation.
8. Cognitive Impairment and Neurodegenerative Diseases:
- There is ongoing research into the potential benefits of metformin for cognitive impairment and neurodegenerative diseases like Alzheimer's. The drug’s effects on insulin signaling and inflammation may offer protective benefits for brain health.
While these off-label uses are promising, it is important to note that metformin should only be used under the guidance of a healthcare provider, as its safety and efficacy for these indications may not be as well-established as for diabetes management. Additionally, ongoing research is needed to fully understand the benefits and risks associated with these off-label uses.
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What are the primary indications for metformin usage according to the FDA?
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Why does the ADA recommend metformin for individuals with prediabetes?
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What are some potential contraindications to metformin therapy?
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How does metformin compare to other antidiabetic medications in terms of efficacy and safety?
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What ongoing research is being conducted to explore metformin's potential in antiaging, anticancer, and neuroprotective effects?
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How important is patient education in ensuring optimal outcomes with metformin therapy?
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What role does the interprofessional healthcare team play in managing patients on metformin?
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Can you discuss some common adverse effects associated with metformin use?
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How might the future of metformin therapy evolve based on current research trends and advancements in diabetes care?
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Are there any published papers on the comparison between the effect of metformin and oral cotraceptive pills on polycystic overian syndrome?
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Metformin and oral contraceptive pills (OCPs) are commonly used treatments for PCOS. Metformin improves insulin sensitivity and regulates menstrual cycles, while OCPs regulate cycles and reduce androgen levels. Studies show metformin’s effectiveness in improving metabolic parameters and menstrual irregularities (PMID: 21302921), and OCPs’ efficacy in managing PCOS symptoms like hirsutism and acne (PMID: 18375013). These treatments can be used alone or together, depending on individual symptoms and fertility goals.
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I'm working on cancer biology in AMPK pathway.
I use some AMPK activator like metformin, and when I treat that activator, I detect the phospho-AMPK (Thr172) is increasing in western blot data.
And I treat the Compound C in same sample, but the phospho-AMPK is extremely upregulated!
I saw same result in many times. I don't know how to troubleshoot.
I never saw in any paper that using Compound C. All of the references show phospho-AMPK is decreased when Compound C treat.
I already try pretreatment method, and ATP adding method.
Is there anything that can I do??
If someone use the Compound C, please tell me detail procedure..
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I also encountered a similar problem. May I ask the teacher how to solve it in the end?
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Hello,
We need the pdb of metformin for docking studies in ClusPro.
We tried to make it from the 5G5J pdb but that pdb does not work in ClusPro. I added the pdb we made by splitting from 5G5J. Pymol can recognize it but not ClusPro.
Any recommendation would be helpful.
Thanks,
Bidisha
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If you mean this ClusPro https://cluspro.org/ that you want to use?
It is said clearly that it is a protein-protein docking server. Metformin is not part of protein structure, it is a small molecule ligand.
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Anemia with low normal MCV, ferritin, serum iron refractory to iron and folate supplements. Other causes of anemia have been ruled out like GI pathology. Other cell lines WBC and differential and platelets are normal. These side effects have been described in the literature. Metformin can cause B12 deficiency and macrocytic anemia due to reduced absorption in the GI tract. ACEI can rarely cause anemia due to concurrent inhibition of erythropoietin and RBC synthesis. Has anyone seen these effects in clinical practice?
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The association between metformin use and anemia, as described in the review you provided, is an interesting observation.
Long-term metformin use has been associated with a decrease in hemoglobin levels and an increased risk of anemia in some individuals.
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I work with cultured cells which I treat with metformin prepared in aqueous solution. I keep the stock at 4°C but I have noticed that after a few months it stops doing what it usually does in my biological system. I would like to know if anyone knows the approximate half-life in aqueous solution. Thank you
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I am facing an issue with the dissolution profile of Sitagliptin and metformin tablets ,there is significant drop in dissolution release of both components while compared with initial dissolution profile..
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check water content (absorption), hardness and disintegration time b/w initial sample and stability sample
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Salam (Greetings),
I'm working on Metformin and wanna test its effect on some cell lines when combined with other drugs, which are mainly soluble in DMSO.
I've looked up metformin solubility and found it soluble in both water (up to 2 M) and, to less extent, in DMSO (up to 100 mM).
My question is: which one should I use to prepare it?
- Both stock and serial dilutions with DMSO, while maintaining its concentration <0.5%
- Stock with DMSO and serial dilution with water
- Both stock and serial dilutions with water
I would appreciate sharing ur experience and enlightening me with the pros and cons, if any.
Thank you
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The choice of solvent for metformin will depend on several factors, including the concentration of metformin needed for your experiments, the solubility of the other drugs you are combining with metformin, and the potential toxicity of the solvent to your cell lines.
Metformin is soluble in both water and DMSO, but it is more soluble in DMSO, which can be beneficial when preparing high concentrations of the drug. However, DMSO is a potent solvent that can have toxic effects on cells, especially at high concentrations. Therefore, it is generally recommended to keep the DMSO concentration in the culture media below 0.5%.
If you need to prepare high concentrations of metformin, it may be more convenient to prepare a stock solution in DMSO and then make serial dilutions in water. This will help to minimize the concentration of DMSO in your final treatment solutions.
On the other hand, if you only need low-to-moderate concentrations of metformin, it may be more appropriate to prepare a stock solution in water and make serial dilutions in water as well. This will help to minimize the potential toxic effects of DMSO on your cells.
It is important to consider the solubility of the other drugs you are combining with metformin, as some drugs may not be soluble in water or DMSO. In such cases, you may need to use a different solvent, or adjust the conditions to achieve sufficient solubility.
In summary, the choice of solvent for metformin will depend on several factors, including the concentration of metformin needed for your experiments, the solubility of other drugs, and the potential toxicity of the solvent. You may need to experiment with different conditions to determine the best approach for your specific needs.
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  1. 20 tablets were weighed and powdered. A quantity of the powder containing 0.1 g of Metformin Hydrochloride was shaken with 70 mL of water for 15 minutes.
  2. The solution was diluted to 100 mL with distilled water and filtered using filter paper. The first 20 ml of the filtered solution was discarded.
  3. 10 mL of filtrate solution was diluted to 100 mL with distilled water.
  4. 10 mL of resulting solution was diluted to 100 mL with distilled water.
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To calculate the dilution factor for this assay, you need to take into account the total volume of the final solution and the initial volume of the solution containing the Metformin Hydrochloride.
First, you need to find the initial concentration of Metformin Hydrochloride in the solution. This can be done by dividing the weight of Metformin Hydrochloride (0.1 g) by the volume of the initial solution (70 mL):
(0.1 g) / (70 mL) = 0.00143 g/mL
Next, you need to find the final concentration of Metformin Hydrochloride in the solution after the first dilution. This can be done by dividing the initial concentration by the dilution factor, which is the ratio of the final volume to the initial volume:
0.00143 g/mL / (100 mL / 70 mL) = 0.00143 g/mL / 1.428 = 0.001 g/mL
Then you will repeat the same steps with the next two dilutions:
0.001 g/mL / (100 mL / 10 mL) = 0.0001 g/mL
0.0001 g/mL / (100 mL / 10 mL) = 0.00001 g/mL
The final dilution factor is the product of all of the dilution factors from each step: 1.428 x 10 x 10 = 1428 So the final solution is 1428 times more dilute than the initial solution.
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im clinical pharmacist , i would like to ask why sometimes endocrinologist prefer initiating Pioglitazone with metformin for managing diabetes type 2 patients meanwhile, there are much better treatment option are available managing type 2 diabetes ?
Regards
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It is case to case basis. All standard guidelines advice to go with metformin and sulphonyl urea.
If expected changes are not achieved additional drugs may be preferred based on the changes in respective fasting or post pradial values.
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How Metformin and exercise affects the plasma glucose concentration?
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Research suggests metformin, a widely prescribed diabetes medication, may diminish the benefits of exercise when used in combination. In this study, however, metformin combined with exercise training, but not exercise alone, lowered proinsulin concentrations and increased insulin clearance in adults with prediabetes.Jul 18, 2017
Exercise training and metformin, but not exercise training alone ...
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I was reviewing data glycted haemoglobin in patients with type-2 diabetes. Some patients seem to respond excellent metformin but some just do not did well. Yes i confirmed associated life style changes and some times their dosages were increased by concerned physicians.
Reviewing the data showed the some polymorphism affecting he metformin response. These were few that eent through my literature search: SLC22A2 rs316019 and SLC47A2 rs12943590 and were probably associated with good response in comparison to patients who carry the G‐allele type.
Because we are so blind-folded in prescribing metformin as a starter to every type -2 diabetics, i was wondering how significant these genetic polymorphysims/mutations are in reality? Should they not matter in a patient who has to take metformin for life????
Can anybody elaborate on this?
Regards
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I need to write a critical analysis of this paper ( ) and I have a question regarding dropout rates. 25% of the participants in the trial decrease the dose of the drug they are taking due to side effects. Would these participants be considered dropouts?
The authors perform statistical analyses including and excluding these participants. Would excluding these participants dramatically reduce the power of the analysis?
Thank you,
a confused student.
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A total of 25% of the participants in the trial decrease the dose of the drug they are taking due to side effects. Would these participants be considered dropouts?
No they are not dropouts but they differ from the other group and you can compute the difference and see if it is significant.
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We are performing an antidiabetic assay by inducing alloxan in rats and we have to share with metformin, glibenclamide, or actrapid for the positive control.
Which of these three drugs is the best to use?
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Dear Nantenaina, thank you for sharing this very interesting technical question with the RG community. For streptozotocin-induced hyperglycemia please have a look at the following potentially useful article:
Glibenclamide or Metformin Combined with Honey Improves Glycemic Control in Streptozotocin-Induced Diabetic Rats
(please see the attached pdf file)
Also see the following interesting paper: Comparative effects of glibenclamide, metformin and insulin on fetal pancreatic histology and maternal blood glucose in pregnant streptozotocin-induced diabetic rats
This article has been posted by the authors as public full text on RG. Thus you can freely download it as pdf file. Good luck with your research and best wishes!
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For undergraduate lab class
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Metformin Hydrochloride is freely soluble. Not suddenly it will soluble requires some time.
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We would like to treat our tissue culture cells with metformin, so the metformin needs to be sterile, TC specific. Any local distributors or is it ok to just sterile filter?
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Hi Maritza Kruger. I have used Metformin in the past to treat breast cancer cell lines - I prepared it fresh each time in sterile PBS and then filter sterilized prior to treating cells. Hope it works for you :)
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I am having an issue regarding sitagliptin 50mg and Metformin 1000 mg formulation (Janumet formula)… Tablets are very weak and Friability 0.6% hardness NMT 25 Kp… Which causes splitting, capping and broken edges during coating process.
Is there any chance to solve this issue??
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Dear Seeddeeg, Metformin formulations usually have the same issue, because the compatibility properties are very poor, so you have to correctly design your granulation process and select excipient with excellent plastic properties. Please consider the following recommendations:
1. Employ Kollidon VA 64 Fine (Copovidone with high superficial area). Use moist aqueous granulation (MAG). Moist granulation: 1.5-2.0 %
2. Add a little aerosil 200 or Syloid (0.5-1.5 %), this will reduce the sticking problem and does not impact in the tablet hardness
2. Add Avicel PH105 or PEG 8000 as extragranular for capping issue and conferring better plastic properties to the powder
3. For the coating process employ PVA-PEG co-polymer due to the rapid film formation (Opadry Qx or Kollicoat IR) High solid aqueous dispersion give you a rapid application thus reducing the broken edges.
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I am working on MDA-MB-231cell line and kind of a modified drug, metformin that we made in our labratory for better intestinal premeation.both metformin and modified metformin had a good effect on deacreasing invasion but surprisingly did not prevent its migration.how its possible ?
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hello malcom
what do you mean by that receptor controles both invation and invasion.my be you are speaking about same chemotaxic agent.any way MDA-MB-231 is a tripele negative one cell .
l ill be thankful if you describe more details
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Is there a reason why the pioneering and potentially important findings of Dr. Gualano (Gualano B, Creatine in type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Med Sci Sports Exerc. 2011May;43(5) showing! ~1% decrease of HBa1c in patients taking creatine supplements even in the presence of metformin !) were not tested anywhere in larger clinical trials?
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People with diabetes and / or kidney disease should also avoid taking creatine. Research has shown that taking supplements can make certain cases worse. Also, taking a higher dose than recommended can cause kidney damage and increase the chances of developing kidney disease or damage.
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Hello everyone. I am curently working on a protocol to measure glucose uptake in HepG2 cells using 2-NDBG. The work involves the pre-treatment of cells with an active material and observe if it has an effect on increasing glucose uptake. Metformin is used as a positive control. I have come across several threads on ReaserchGate which gave me the impression that this experiment is kind of tricky.
I have read several references. In some references, the cells are pre-treated with the drug, next incubated with glucose-free medium, and lastly the fluorescent 2-NBDG (in glucose-free medium) is added. In others, after incubation with the drug and before the addition of 2-NBDG, there is an extra step in which cells are stimulated with insulin for only 15 min.
I have a couple of questions.
-Is the stimulation with insulin necessary? Or I can skip this step?
- What´s the mechanism that makes metformin or other drug pre-treated with cells and then completely washed away cause an increase in glucose uptake? Why the drug is not added simultanously with 2-NBDG?
-Why after treatment cells are incubated with glucose-free medium? How important is this step? What happens if we drop this step and incubate cells directly with 2-NBDG?
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yes: this link will help you.
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Lately, there have been wave upon wave of recalled medicine since FDA has been starting doing an investigation on present of problematic human carcinogen substance which is NDMA in mostly common prescribed drug such as Ranitidine. The latest news has mentioned that Glucophage (Metformin) has been suspected to have NDMA as well. Why do you think that this finding was not discovered before, and we have only recently started to hear about this critical threat that exists in mostly used medications?. Is it because pharmaceutical companies have started to not follow strictly Good Manufacturing Practice (GMP) ?
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I have contaminated Metformin but I cannot find ANY info about how much NDMA is in my 500 mg tablets. If it is at very low levels, no worries but if there is 10 or 20 mg of NDMA per tablet, that could do serious liver damage. Anyone have any idea how I can find out what NDMA levels they found? They were above normal environmental levels, I presume.
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let me know the complete reaction for electrooxidation/electrocoagulation mineralization of metformin in water environment? whether ammonium ion will form or nitrate ion will form.
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thanks for your reply durrani ji, metformin is also antiepileptic drug used in medication similar to metformin hydrochloride. but my question is whether ammonium ion or nitrate ion will be form due to metformin mineralization?
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Metformin, not only an extensively used oral hypoglycemic agent, but also a proven antimalarial and antiviral. I request that someone analyze the two groups treated for COVID-19, comparing those already on metformin, versus not. Thank you.
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In the case of controversial outcome, was chloroquine administered to COVID-19 patients in combination with drugs inducing an acid environment (i.e. beta blockers, statins, metformin, some antibiotics etc.)? Should it be the case, these drugs might hinder or compensate the beneficial effect of chloroquine. It would be interesting in testing its effectiveness alone or in combination with a drug/substance inducing an alkaline environment.
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The most difficult scientific advances become possible when you ask the right question. In the case of COVID-19, I understand that the right question is: why do some people become seriously infected when exposed to low viral load, while others are not sick even when exposed to high viral loads? The situation resembles the film The Andromeda Strain, which I used for many years as an example of scientific research in my Philosophy of Science classes. There is a deathly virus that came in a spaceship, which kills the vast majority of people. However, a baby and a drunk are immune to the action of this virus. A scientist then asks the right question: why are these two people immune? When investigating the physiology of these people, he discovers that both have their PH in certain ranges, the baby alkaline due to excessive crying, and the drunk acid from the ingested drink. In the case of Corona, we have indicators that its action occurs mainly in the mitochondria (see Castalia Francon´s insights below), which has an evolutionary origin due to endosymbiosis (when the eukaryotic cell incorporates bacteria that help it perform certain functions). Mitochondrial DNA is exclusively maternal in origin. Some factors that affect the mitochondria, such as nicotine and metformin, may predispose to the action of the virus. All this indicates that it is necessary to research the affinity of the virus with certain segments of the mitochondrial DNA, to verify if there is a segment present in the mitochondrial DNA of susceptible people, which is not found in the DNA of people not susceptible to the disease. After this discovery CRISPR technology may be used succssfully.
The mechanisms of action of Metformin against Diabetes, boosting mitochondria and reducing the stress caused by excess glucose, may be useful for the fight against the new Coronavirus. I have discussed with experts the action of Metformin and its relation to cancer tumor genesis in another RG question (https://www.researchgate.net/post/Does_the_use_of_metformin_against_type_2_diabetes_increase_or_decrease_the_probability_of_appearance_of_cancer_tumors).
To answer the above question, it is necessary to take into account recent data on the mechanism of action of the virus and empirical statistical (positive or negative) correlation between use of Metformin and the lethality of the virus. Is there any data on this correlation?
According to comments by Castalia Francon, "Neutrophils are known as the core of the 'innate immune systems". They are our 'first responders" to any imminent medical holocaust...NETS, 'Neutrophilic Extracellular Traps" as the battlefield. These powerful products of our neutrophils are essentially a nuclear option against the pathogens. As such they do whatever they can to prevent that explosive death of the neutrophil that will ensnare them...
For bacteria and viruses, their goal of survival entails first avoiding, by whatever means they have, the phagocytosis efforts and then countering the next move of the neutrophils, their death by NETosis.
To attempt this, they seek to manipulate the communications between mitochondria and the cell so as to stall the Neutrophil in a limbo known as "autophagy" while the microbe can continue to reproduce and spread.
The term "autophagy" came into use to denote a systematic, almost "thoughtful" process by means of which the neutrophils, just like macrophages, could move sequentially through a series of considerations pertaining to how to deal with their situation in terms of life and death. But by its very nature as an extremely complex process entailing many dimensional considerations, it is also readily exploitable by pathogens, and in particular by viruses
Many pathogens have been shown to evade or exploit autophagy in macrophages, aiming to establish an intracellular niche for long-term survival and replication Subversion of autophagy by microbes in neutrophils is far less studied but the Corona situation seems to point to it...Our best analogy to it is how when we with to delete", 'our computers ask us, "Are you sure'?" It appears most likely that autophagy is the manifestation of a process that almost always goes on, and eventuates in some adaptive response....unless, of course, the communications between mitochondria and cell are distorted or diminished by pathogen actions.
Viruses and bacteria have evolved over millions of years as each others nemeses, long before we were on the scene, thus the virus is naturally inclined to maniupulate the mitochrondira and by means of that to in turn manipulate the entire cell which is driven by the mitochondria and their needs...
Unfortunately the current 'expert' narrative speaks dichotomously of either "promoting" or 'inhibiting" autophagy instead of coming to terms that there is an ongoing and complex battle going on where any one aspect can shift the nature of the complex decision making.one way or the other. The pathogen, however, is most happy when no clear decisions at all is reached.
The essential treatment for Corona Virus infection is to assure that once the phagocytosis fails....which it often does...that the neutrophils are not stalled from their productive and special death with its Neutrophilic Extracellular Trap creation...which releases the remarkable power of their own DNA to act as a potent immune system weapon against microbes.
We would not be surprised if the CRISPR technology which is now surfacing with so much promise is not an aspect of the manner in which DNA/chromatin sections can be used productively to kill viruses...as they have been used for millennia, apparently, by bacteria.
In summary
• Previous smoking habit is highly associated with the dire effects of Corona Infection....and it also leads to a maladaptive tendency towards' "autophagy" which renders those persons' neutrophils unable to engage in "NETosis " and create "NETS""t
• Smokers neutrophils seem to have phenotypically altered over the course of their previous smoking habit so that they are unable to properly engage in their intense first line of defense, phagocytosis (via NADPH mechanisms).
We only need to observe that in Italy, where the death rates from Corona are soaring, they differ in the terms of their 'lockdown" from ours. Whereas, in the US, pharmacies and groceries and other vital retailers are excluded, in Italy, stunningly, tobacconists and vapes shops join pharmacies as essential and are exempted from lockdown.
Normally, the generation of the ROS products via phagocytosis is a prerequisite for the subsequent death via NETosis.. This is unsurprising since that a failure to be able to engage in phagocytosis would already connote some abnormality or deficit.
•It has however been found that even when the initial phagocytosis does not occur, that, if system can be induced downstream to generate ROS, then NETosis and the creation of those 'traps' is still possible.
• Chloroquine is known to be an "autophagy preventer" in that it can serve to rescue the neutrophil system and thus precipitate the creation of 'NETS. It seems to achieve a mobilization of the NET trap system even though phagocytosis has not succeeded. Exactly what it does is still not clear.
It appears that it is optimal to administer chloroquine early, but only after the first phagocytosis efforts of the neutrophil system but before the virus has seized the opportunity, by manipulating the communications between mitochondria and the cell, to spread and do maximum damage".
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Dear, Mr. Pereira,
The metformin do not boost mitochondria. The main effect is to kill the mitochondria of the liver responsible to process and transport the glycogen to the blood stream given the glucagon signal is there. Thus the glucose is confined in the liver and can not be released in the blood and the blood sugar level seems normal. It's very doubtful if this helps with infection, when the need of fast supply of energy is higher.
Linked with quinine group, the metformin is a binary poison. It reacts chemically, and can kill by itself. And if ACE inhibitors or similar are added, their side effects (most of them identical with COVID will pop up), and the chloroquine will just destroy the pancreas due to the excess of glucagon and Alpha cells activation that can not provide energy to the cells due to the O2 deficiency, when mainly anaerobic cycle is available.
Especially in very old males, the metformin deteriorates the energy cell balance and the outcome will be fatal.
I suppose, it will be better when treating COVID-19 to stop any diabetic medication and use insulins only with continuous blood glucose level tracing, keeping it higher.
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I have prepared 500 and 1000 mg metformin tablets with sitagliptin 50 mg respectively. The surface of the tablets although shiny are not smooth and the surface has small blisters. I have checked the tooling and it is fine further when i compress other formulation on the same tooling the tablet surface are smooth. I assume that there is some problem in granulation. we have passed the wet mass through 4 mm mesh and the dried mass through 1.5 mm mesh in an oscillating granulator. Please provide some suggestions to solve the problem.
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Tablet surface roughness:-
1. Tooling surface roughness
2. Granules/Fine ration not optimized
3. Higher amount of granules in blend
4. Larger granules size, eg:- reduce granule size
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what is the proper time for administration of metformin in type 2 diabetes ?
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Metformin should taken with the morning meal.
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Does XR/SR drug affect fasted state? If it was taken prior to fasting, then does the body not enter fasted state until the drug is fully released after 4-8 hours of release?
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Hileon,
The tablet itself does not impact fasted state. However, you are now asking about the biologic effect of the medication. Of course, this will depend on the mechanism of action for the specific medication in question.
In terms of Metformin, we do not fully understand the mechanism of action. There is a nice paper which describes what we seem to know to date: .
In general, metformin reduces glucose production in the liver and inhibits glucose absorption in the gut. Less glucose generally leads to increased ketosis. So overall, it is most likely that metformin, either immediate release or extended release, would lean toward promoting a fasted state (although this effect would be negligible even in setting of light meal).
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Hi, I am having trouble getting any elevation in AMPK (PRKAA1) gene expression in k562 cells when I am treating them with Metformin.
Culture system - K562 cells grown in media containing RPMI + 10% Hyclone FBS (Cat no. SH30910.03)
Metformin (Cat no. - 1115-70-4 , Santa Cruz)
I analyzed the gene expression using qPCR and found no elevation in AMPK gene expression when compared with control cells. Kindly let me know what factors I should look into that might be causing this in K562 cells. Thank you
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I am analyzing cells treated with metformin concentration 100 micromolar for 24 hrs and 48 hrs.
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metformin a drug that used to reduce the insulin in peripheral blood of patients with PCOS and then reduce of endrogen ; how the metformin reduce the INS gene expression ??
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inserted Hussein A. Abid
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I have a 60 y.o WF 5 years post total pancreatectomy secondary to cancer. Worsening hypoglycemia with minimal insulin. A1C 9.9%. Any recommendations? Metformin?
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Please have a look at this useful PDF attachment.
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After exposing rats to low fructose water(10%) for 2 wks and a single intraperitoneal injection of STZ (55mg/kg bw), to induce T2D, I want to compare the hypoglycaemic effect of my crude plant extract with a known standard drug.
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Thank you
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How long will take to adjust the dose of metformin after stable dose therapy is ineffective? 3 months?
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Type 2 diabetes mellitus patient
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Hi everybody!
I'm performing qRT-PCR for BCR and ABL transcripts from RNA samples. In one patient, the ABL copies are low and we´ve tried everything but we can´t improve it. We then found out that, in this particular case, the patient is taking metformin and fenofibric acid daily, so does anybody know if they could inhibit de PCR?
Thanks!!
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Hi Maria
GUS-β or GAPDH are other house keeping genes which are regularly used in BCR-ABL quantification. Although GAPDH, less so these days as it also has a pseudogene. However, in all my research with CML, I have not come across metformin inhibiting ABL expression. Metformin is transported by OCT-1 which is also been suggested to transport imatinib. And there have been no studies to suggest that metformin affects the expression of ABL.
The problem could be RNA degradation which you can test by stabilizing the whole blood in Trizol immediately upon collection OR this patient may have a heterozygous SNP at the primer binding junction? Hope this helps!
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Hi,
I am looking for A(1%,1cm) UV-VIS Spectrophotometer reference data for commonly used medicines - such as Metformin, Aspirin and other common medicines. Is there a reference table that is available?
Secondly, does the A(1%,1cm) vary depoending on the solvent used? - for some medicines I see some use Water and some use ethanol?
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Also a follow up please.
I am trying to check the efficacy of some medicines using a UV-vis 1280mini spectrophotometer. Can A(1%,1cm) figure of 798 at 232nm for metformin be used with reasonable accuracy in place of a Reference powder sample to answer the question - Does this Metformin 500 Tablet contain broadly 500mg of Metformin?
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Dear all, in vitro metformin can nicely lower glucose levels and increase lactate levels which correlates with increased glycolysis. I want to show this in vivo in WT mice, but an IP injection of 100mg/kg could not show hypoglycemia and hyperlactatemia. Anyone suggestions to show increased glycolysis with metformin? Kind regards
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Dear Rafi, Figure 1 in following paper: Madiraju et al. Nature 2014, 510 (542-546) coud show increased lactate levels and decreased glucoselevels after administration of metformin, however I'm not able to reproduce this. Do you have any recommendations on this?
Many thanks in advance,
Jolien
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What does metformin do to AKT, pGSK3-Beta and Glycogen synthase under insulin signaling ?
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Metformin is not a form of insulin and it has no effect whatsoever on insulin levels. Metformin works in some unknown way by making the cells use glucose differently, which then requires less insulin. Insulin is needed by cells in the body to get glucose from the blood. Type II diabetes occurs because cells build resistance to insulin and the body can't produce enough insulin to provide the cells with sufficient glucose. A person has Type II diabetes when insulin resistance becomes severe enough that calls can't absorb glucose from the blood. Metformin somehow seems to allow cells to take absorb or use glucose more readily.
My source also includes information about other diabetic medications as well as information about insulin: Natural trick to reverse diabetes
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Can Metformin use as a medicine for breast cancer?
What are the advantages and disadvantages of using Metformin in patients with breast cancer?
Is it possible to use Metformin for both diabetes mellitus and breast cancer?
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There is no known medication or therapeutic technique that is able to completely prevent malignancies, oral or otherwise. Anyone who claims that metformin completely prevents Breast cancer is either a misinformed medical lay person, or a quack practitioner.
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Biological Ageing is natural decline and deleterious effects in health and diminishing life span with more diseases like degenerative like Alzhemier, Parkinson in old age, diabetes, cardiovacular diseaes and cancer. Before, 1950s there was no mention of ageing but now its emerging field in research and thinking for better cure of diseases and reverse or delay aging, metformin, rapamycin some antioxidants, herbs and aspirin are screened for anti-aging agents, some trials are needing to finalize the ageing treatments, Hope, in future, there will be less diseases and less early deaths as happening now,
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Dear Malik, anti-ageing therapy can include multiple strategies such as gene therapy, physical exercise , diet (keto diet/Fasting/intermittent fasting/time restricted feeding/ dietary supplementation), hormones replacement therapy, enhancement of cognitive function or mental ...The goal here for anti-ageing medicine is to slow or to reverse (temporarily) the changes associated with age, so the combination between some strategies would be more beneficial than using one
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Autoantigen can be used to modulate the immune system and in best case to get tolerance. What/which autoantigen/s? Combinations? Should we combine with antiCD3 and/or TNFalfa-inhibition and/or ? If so, given before , after, or parallell to the auto-antigen treatment? Please argue! Would YOU suggest addition of Vitamin D? Nicotinamide? Omega3 fatty acids? Metformin? or..? We need an open discussion to get forward!
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First of all, I salute you for your crusade for beta cell preservation in Type 1 diabetes. As of now, a multi-pronged approach with combination therapy that may comprise an antigen, a Teff-depleting agent, and a Tregs-boosting agent (vitamin D) does appear to be the right choice.
The slower decline of residual beta cell function with prolonged vitamin D supplementation does occur and has been documented by several papers. And because vitamin D is really an inexpensive addition to immune interventions, there is no substantial reason why it should not be part of the combined approaches to beta cell preservation.
The other arguments in favour of vitamin D as one arm of combination therapy were discussed in the letter (attached for others' reference) that I wrote to your comprehensive review published in 'Drugs' in 2016. Meanwhile we conducted another study on vitamin D supplementation for 1 year (accepted for publication) and the results were better that our previous 6-month supplementation study.
Best wishes,
Devi Dayal
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I have a patient who was dx originally in 2012 with stage 3 ovarian cancer. She had complete debulking except for a 1.5 cm tumor implant on the diaphragm and under went 6 cycles of IV chemotherapy resulting in complete remission until October of 2014. At that time the PET showed a possible small tumor implant on the right kidney. Subsequent laparoscopy showed only suspicious washings and she had 6 cycles of IP and IV chemo finishing in 5/15.
In Feb 2018 her PET and CT scans showed retroperitoneal pelvic lymph node recurrence (5 on left, and 3 on the right) and a 2.5 cm liver implant. She was asymptomatic and this was done because of rising CA 125. While she was getting a second opinion for treatment she started herself on a very low carb diet, and I started her on metformin because of she does have prediabetes after reading the positive retrospective studies. The dose was gradually increased to 1500 mg daily.
The lesion on her liver shrunk by 50% by the end of March, and on her last PET scan done 6/15, has disappeared. only 1/5 lymph nodes remain in the left pelvis and the 2 of the 3 lymph nodes on the right side have remained unchanged, with one getting larger. Her CA 125 has decreased by 50% from it's highest level (in March) as of last week.
She would like to continue this treatment. Does anyone have any experience with using metformin for ovarian cancer? She has been measuring her serum ketones but since losing weight finds that she rarely exceeds 0.4. (Weight 118/ height 5'4"). I am suspicious that this is because she does not have that much fat left and apparently metformin decreases free fatty acids. I am also inclined to think the metformin is the key reason for the improvement rather than being in low ketosis.
Any suggestions or thoughts would be appreciated.
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Thank you for the response. I had already reviewed this article. I was hoping someone had experience outside of the in going trials regarding dosage.
Best Regards. MEM
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I always get less quantity of API than it should be. Often the difference is not more than 50 mg per tablet for both 750 or 1000 mg doses. The EP methodology doesn't work. Please, help me to figure it out
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Andrei Blasko and Isam Eldin Hussein Elgailani, thank you very much for your comments. Increasing organic part in solvent and duration of dissolving process gave us acceptable results.
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I have compressed tablets of granulates made by continuous twin screw granulation. I have done this for the three following formulations:
- mebendazole 5% + 5% HPMC + 90%lactose
- metformin 5% + 5% HPMC + 90%lactose
- metformin 5% + 5% HPMC + 45%MCC + 45%lactose
Now I was wondering which tensile strenght is required for these three formulations and is if there is a difference between the three formulation concercing required tensile strength. Or where can I find this in the literature?
Another question I have is, if it is possible that mebendazole and metformine show elastic behavior (or elastic recovery) at high compression forces.
Thanks in advance!
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Practically, there are two main factors affecting the tablet hardness and compression force. The first factor is the effect of the cross sectional area across in which a tablet breaking force is applied. Obviously, the tablet strength is directly proportional to the cross sectional area across which the force is distributed. The second factor is the effect of the applied compression force. If the same force is applied to a 6mm tablet and a 3mm tablet, the force per unit area on the small tablet is four times the force per unit area on the large tablet. This is because the area is directly proportional to the square of the diameter of a circle. Just take into your consideration these factors when comparing tablets.
Therefore, instead of comparing crushing (breaking) "strength" (measured in N or Kp), tablets should be compared using breaking “pressure”, which is called the “tensile fracture stress”. And instead of comparing compression (compaction) force we should compare "compaction pressure".
Refer to
- Fell, J. T., & Newton, J. M. (1970). Determination of tablet strength by the diametral‐compression test. Journal of Pharmaceutical Sciences, 59(5), 688-691.‏
- Pitt, K. G., Newton, J. M., & Stanley, P. (1988). Tensile fracture of doubly-convex cylindrical discs under diametral loading. Journal of materials science, 23(8), 2723-2728.‏
- Pitt, K. G., Newton, J. M., Richardson, R., & Stanley, P. (1989). The Material Tensile Strength of Convex‐faced Aspirin Tablets. Journal of pharmacy and pharmacology, 41(5), 289-292.‏
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I want to create a complex of dimetformin and copper(2+) from this article ( ) , but I cannot set bond lenghts (from table 2 (last string)), because when I change lenght of bond in "cyclically bound" atoms, I cannot fixate already specified bond lenghts, they change when I try to change next one.
Is there any way to create a molecule fully with already setted up bond lenghts?
Or there are any other software, where I can make it easily?
Thanks!
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You can try with material studio which is much more user friendly!
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Have been trying to get metformin to elute later than wave/solvent front on a Poroshell 120 C18 2.1x50x2.7. Tried with mobile phases, 0.1% formic acid with ACN + 0.1%FA, 0.1% FA with ACN and 10mM ammonium acetate with ACN. Tried isocratic and gradient elution. Thanks
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I thank you should used buffer solution less than 4( 0.02 MKH2PO4) with 1% trethylamine , such as mobile phase Methanol: buffer: triethylamine :( 55:44:1) increase the retention time of metformin .
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In diabetic patients, the insulin diet should include a base insulin(e.g NPH or Lantus) and a short or fast insulin(e.g Apidra). But sometimes metformin is prescribed instead of fast-acting insulin. what is the reason?
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It enables utilization of the insulin
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How a mutation in introns affect the gene expression. if a SNP is not present in any downstream regulatory elements but in somewhere intermediate region of intron and how those polymorphism differentiate a response of those patients against drugs? eg. How rs7903146 polymorphism in TCF7L2 gene lead to risk of T2DM and how they differentiate in response against drugs like metformin or gliptin?
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Mutations in intronic regions might not be significant if no association has been found to a disease state. In this case, several genome wide association studies conducted in heterogenoeus populations jave shown that the rs7903146 polymorphism is associated with T2D. The reasons behind the precise molecular mechanisms are still unclear; it is thought that this intronic variant induces disregulation in the WNT pathway, with impairment of beta-cell function and incretin-mediated insulin response after an increase in glucose concentration. A recent study conducted as a part of SUGAR-MGH, demosntrated that carriers of the rs7903146 polymorphism in TCF7L2 had a steeper glipizide response and lower fasting glucose levels after metformin administration. They were also able to show that glucose-mediated incretin-stimulated insulin response is impaired in carriers of the rs7903146 variant in TCF7L2, which could potentially indicate that DPP-IV inhibition or GLP-1 therapies in carriers of this risk allele might not be the better alternative; nevertheless, this still remains an area of opportunity for research.
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Hello,
I am working on a project which focuses on drug delivery using liposomes.I want to test the same on MCF-7 Breast cancer cell line,the effect of combination of cyclophosphamide and metformin on the cell line.
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Hi,
You can consider using Mozafari method to prepare liposomes and nanoliposomes. Details of this method are explained in the attached paper which also explains some other liposome preparation techniques.
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There are several clinical results suggesting that metformin is beneficial to prevent the formation of cancer tumors, but at least one result (see below) indicates that metformin can cause endoplasmatic stress and mitochondrial swelling, resulting in the possible impairment of calcium signaling related to the apoptosis of abnormal cells.
Sci Rep. 2017 Jul 11;7(1):5040. doi: 10.1038/s41598-017-05052-2.
The energy disruptor metformin targets mitochondrial integrity via modification
of calcium flux in cancer cells.
Loubiere C(1)(2), Clavel S(1)(2), Gilleron J(1)(2), Harisseh R(3), Fauconnier
J(4), Ben-Sahra I(5), Kaminski L(1)(2), Laurent K(1)(2), Herkenne S(6)(7),
Lacas-Gervais S(8), Ambrosetti D(9), Alcor D(1)(2), Rocchi S(2)(10), Cormont
M(1)(2), Michiels JF(9), Mari B(11), Mazure NM(12), Scorrano L(6)(7), Lacampagne A(4), Gharib A(3), Tanti JF(1)(2), Bost F(13)(14).
Author information:
(1)Inserm U1065, C3M, Team Cellular and Molecular Physiopathology of Obesity and Diabetes, Nice, France.
(2)Université Nice Côte d'Azur, Inserm, Nice, France.
(3)Inserm U1060/ INRA 1235/ Université-Lyon1/ INSA, Lyon, France.
(4)Inserm U1046, UMR CNRS 9214, Université de Montpellier, Montpellier, France.
(5)Northwestern University, Chicago, IL, USA.
(6)Department of Biology, University of Padua, Padua, Italy.
(7)Dulbecco-Telethon Institute, Venetian Institute of Molecular Medicine, Padua, Italy.
(8)Centre Commun de Microscopie Appliquée, Université de Nice Sophia-Antipolis, Nice, France.
(9)Centre Hospitalier Universitaire (CHU) de Nice, Hôpital Pasteur, Laboratoire
Central d'Anatomo Pathologie, 06002, Nice, France.
(10)Inserm U1065, C3M, Team Biology and pathology of melanocyte cells: From skin pigmentation to melanomas, Nice, France.
(11)CNRS, Institute of Molecular and Cellular Pharmacology, Sophia Antipolis,
France.
(12)Institute for Research on Cancer and Aging of Nice, CNRS-UMR 7284-Inserm U1081, University of Nice Sophia-Antipolis, Centre Antoine Lacassagne, Nice, France.
(13)Inserm U1065, C3M, Team Cellular and Molecular Physiopathology of Obesity and Diabetes, Nice, France. bost@unice.fr.
(14)Université Nice Côte d'Azur, Inserm, Nice, France. bost@unice.fr.
Mitochondrial integrity is critical for the regulation of cellular energy and
apoptosis. Metformin is an energy disruptor targeting complex I of the
respiratory chain. We demonstrate that metformin induces endoplasmic reticulum (ER) stress, calcium release from the ER and subsequent uptake of calcium into the mitochondria, thus leading to mitochondrial swelling. Metformin triggers the disorganization of the cristae and inner mitochondrial membrane in several cancer cells and tumors. Mechanistically, these alterations were found to be due to calcium entry into the mitochondria, because the swelling induced by metformin was reversed by the inhibition of mitochondrial calcium uniporter (MCU). We also demonstrated that metformin inhibits the opening of mPTP and induces mitochondrial biogenesis. Altogether, the inhibition of mPTP and the increase in mitochondrial biogenesis may account for the poor pro-apoptotic effect of metformin in cancer cells.
DOI: 10.1038/s41598-017-05052-2
PMCID: PMC5506014
PMID: 28698627
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According article "The Clinical Effect of Metformin on the Survival of Lung Cancer Patients with Diabetes: A Comprehensive Systematic Review and Meta-analysis of Retrospective Studies" I have question. If we have differences of clinical effect Metformin of cancer patients with and without DM?
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Why is metformin still prescribed for patients who can afford better drugs?
P.s.: I'm not a M.D.
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Metformin is a proven drug in long terms for its safety and efficacy. Long term safety yet to be established for other drugs. Hence metformin is the first line therapy. Also no other drug can withstand wrt cost.
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Insulin is the only drug that we have.
  • It doesn't modify disease progression.
  • Insulin preparations are available as parenteral, so possible factors for poor adherence.
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You can try it because probably it reduces the insulin requirements
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As you know poly cystic ovaries and infertility is difficult to control in many cases. Sometimes prescribing traditional hormonal drugs and metformin in over weight female with NIDDM is not effective. What is the best therapeutic agents to control these patients?
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PCOS therapy must be phenotype driven. I consider pregnancy wish as a particular case and I prefer letrozole combined or not with low dosis of FSH.
In the presence of biochemical hyperandrogenism the aim is to increase SHBG, inhibit LH pulsatility and diminish free testosterone. I do prefer EE 35ug combined with 2 mg cyproterone acetate. If necessary, I increase CPA
in 25 mg for 10 days each month. In the presence of glucose intolerance or insulin resistance I have experience only with metformin. In the presence of obesity I use a COC containg drospirenone associated with diet, exercise, and orlistat. If possible 1.8 mg day of liraglutide. In the presence of various phenotypes a combined therapy is indicated.For dislipidemia statins should be used.
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Hi all,
I'm looking to convert a Cmax value for the drug metformin to a Cmax value to use in nude mice for an experiment. Is this possible? I have not been able to find the Cmax value of metformin in nude mice and need it for experimental planning.
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The answer to your question is found in a paper by clintongrubbs@uabmc.edu <clintongrubbs@uabmc.edu>;
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animal is induced using stz (40 mg/kg) and nad(110mg/kg). when we checked the fasiting blood glucose one day it has decreased week later it has increased. pls clarify.
3 days after the induction of the dibetes using nicotinamide (110mg/kg) and streptozotocin(40mg/kg) the animal blood glucose was checked and it was treated with metformin(300 mg/kg). Glucose check was done for every 7 days with animal being fasted for 6 hours. first week FBG was found to be 168, 100 and 274. Metformin treatment was continued.   after one week when animal checked with fasting blood glucose again it showed 600+.
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Dear Gayathri,
In my view,you started your investigation sooner than diabetes establishment in the animals. Three days after STZ injection is suitable just for distinguishing diabetic from nondiabetic animals, but to confirm and establish diabetes in animal i recommend keeping diabetic animals at least for 2 weeks before starting investigation.
Regards,
Mehran
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I am going to investigate the effect of metformin on antioxidant status and changes in proteins and membrane lipids in red blood cells in BDL-induced cholestatic rats.
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Hi,
I have been treating my A549 cells with loads of drugs such as geftininb, erlotinib,metformin among others. Although only the cells that are in the 96 well plate are treated, but not the ones in cell culture flasks.
I believe that my cells have become drug resistant. The ic50 after 72 hours treatment were as follows:
Erlotninb (100 um)
geftininb (30 um)
Imatininb (30 um)
metformin (20 um)
Please let me know how can I see if they are indeed drug resistant apart from MTT assay for cell viability?
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Drug-treated A549 cells should exhibit a highly enlarged morphology, due to the onset of senescence as well as polyploidy and multinucleation. It is becoming increasingly evident that moderate, clinically relevant concentrations of virtually all genotoxic agents do not kill the majority of cancer cells (solid tumors, such as A540 cells treated with 10 uM cisplatin). Instead, in response to such treatments, cancer cells become highly enlarged and exhibit the ability to convert MTT to its water insoluble formazan metabolite at a rate ~10 times higher than untreated cells. As you might be aware, such giant cancer cells give rise to cancer-repopulating progeny. If you are interested to know the details of these observations, please search the PubMed for my name "Mirzayans R" and you will find a number of recent open access papers. Alternatively, please feel free to send me an email (razmik.mirzayans@ahs.ca).
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Acarbose or pioglitazone which will be more effective for diabete
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Thanks and appreciate from your all answers
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Hey Guys,
I'm culturing cancerous breast tissue cells in vitro. Today I took the 24 well plate out of the incubator, and, being done with the cells, I sprayed bleach in all 24 wells. Instantly, half of the wells turned a deep yellow and the other half did not react (change color) at all. The cells that did react were in normal media where the cells that did not react had metformin (a common diabetes drug) in the media. Has anyone every heard of this? Please help me out even if its just a guess or opinion.
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Since clorinated compound present in the bleach react with both phenol red (present in the medium) as well directly on the cells, the color may be changed. Actually higher concentration of bleach may degrade various cells, therefore definitely not good for the cells. Most possibly metformin may directly interact with bleaching and therefore bleaching may not be available to react with phenol red and on the cells.
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I conducted a short 5 day investigation exposing Mtilus edulis to Metformin concentrations (0ug/l, 100ug/l, 200ug/l, 500ug/l). I examined 1 specimen from day 1-4 from each variable and weighed both valves and flesh separately, on the final day I examine 5 mussels from each variable, and calculated an average.
Im wandering what statistic test to use to see whether there is 
a) significant difference between flesh weight and concentration of Metformin
b) significant difference between flesh weight and exposure period 
My data is as followed:
Day   |   0ug/L   |    100ug/l    |   200ug/L    |    500ug/l    |
1       |  1.5228  |   1.3204      |  1.6752       |  1.7080       |
2       |  0.9936  |   1.2145      |  1.3162       |  1.3493       |
3       |  1.3746  |    1.0422     |  0.8382       |  1.1621       |
4       |  1.4998  |   0.8381      |  0.8825       |  0.8212       |
5       |  1.1816  |  0.7263       |   0.7547      |   0.8747      |
-Values being flesh weight (g)
-Day 5 being an average of the 5 specimen examined
Thanks for the help! 
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Answer given by  Ette Etuk Sir is well appropriate to the problem. ANOVA should be used to test  given two hypotheses. One thing i want to add are the assumptions which must be checked before applying ANOVA
1. Independence of cases – this is an assumption of the model that simplifies the statistical analysis.
2. Normality – the distributions of the residuals are normal.
3. Equality (or "homogeneity") of variances, called homoscedasticity...
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I want to hydrophobize Metformin HCL before encapsulation into the solvent with the micelle to prepare nanoparticles,
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I am having a hard time to understand your question. Could you please be more specific?
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A 28 years old lady, height 5 feet, weight - 70 kg has been trying to conceive for the last on and a half years. She has a  32-33 days' menstrual cycle. Husband's semen analysis, follicular study and HSG reports are normal. Ultrasound of pelvis reveals evidence of polycystic ovaries with normal sized one ovary and other of 11 cc. She has been put on Tab Metformin 500 mg three times a day and Chirocyst by another Gynaecologist. She gives H/O partial seizures and is on Tab Orcabezapine. The patient uses Ovulation predictor kit to time intercourse. She used it on 14th and 16th day of the present cycle. The menstrual period got overdue by 6 days, yesterday. The patient used the Ovulation predictor kit and the result was positive. Today, she had a normal period. This is the first time that she had a delayed period. The query is, can ovulation predictor kit show positive result just one day prior to the onset of the menstrual period? Do the drugs she is taking interfere with LH levels?
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The specialty of the prescriber and age of the patient suggests possible PCOS in which case I would incline to link metformin to the unexpected changes noticed. Drug use is in that case appropriate and expected to contribute positively in the overall context
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In general, insulin is the preferred treatment for hyperglycemia in hospitalized patients previously treated with oral agents. However, there are some circumstances where insulin may not be necessary, it could maintain oral antidiabetic?
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Unless patient is restricted to nothing-by-mouth or glucose level is over 200 or patient is diagnosed with pneumonia/sepsis or there is a considerable risk for either, we should probably avoid insulin use and continue on the established oral regimen that patient was receiving at the time of admission. If not contraindicated, metformin should be part of the regimen for as long as possible (easy dose adjustment to mitigate lactic acidosis risk - too much overrated issue anyway). Must mention here that less than perfect renal function is not a contraindication for receiving metformin. Kinetics-speaking, in an average adult with diabetes, 500mg metformin given daily on the background of a CrCl of 20ml/min is estimated to control blood glucose with circulating levels approaching 5ug/ml (below 10% risk for lactic acidosis). In my experience, I noticed people giving up on metformin way to early and mostly due to inefficacy determined by underdosing or GI side effects. Metformin's GI-intolerance may suggests that H pylori evaluation is needed or the patient lacks a statin for cholesterol management (or both). This will be a great opportunity to improve health outcomes and address these issues while patient is in the hospital.
Insulin-wise: as we know, it is a hormone and its adjacent signaling will not simplify the picture that led to the hospitalization in the first place. Insulin does much more than lowering glucose. Unfortunately we take its safety for granted by only monitoring glucose levels. Glucose changes are only the results that we were taught to seek. We should all look at the insulin treatment from a far broader perspective.
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Reading some research recently on the anti-diabetic drug metformin and its mode of action I wondered if there were many explanations about its effect on Alzheimers patients ? Looking at the biochemistry around the drug I thought of other possible explanations for its effects.
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Some studies have found a decreased risk of developing neurodegenerative diseases, including Alzheimer's Disease, among people taking metformin and other insulin sensitizers over a prolonged period of time. This is not the same as curing the disease.