Metformin vs Jardiance: Which Diabetes Drug is Best For You?

Understanding Metformin and Jardiance

Metformin and jardiance are two common medications used to manage type 2 diabetes. They work in different ways to lower blood sugar levels. Metformin is an older, established drug that has been used for decades. Jardiance is a newer drug that belongs to a class called SGLT2 inhibitors. But which one is better for controlling diabetes?

What is Metformin?

Metformin is an oral medication that helps control blood sugar levels. It was approved for medical use in the United States in 1995 but has been used in Europe since the 1950s. The drug works by:

• Reducing glucose production in the liver
• Decreasing absorption of glucose from food in the intestines
• Improving insulin sensitivity in cells

This leads to lower fasting and post-meal blood sugar levels. Metformin also has extra benefits like promoting weight loss and improving cholesterol levels.

Metformin Benefits and Uses

Metformin is primarily used for:

• Treating type 2 diabetes - It can be used alone or combined with other medications like insulin.
• Preventing diabetes - For people at high risk of developing type 2 diabetes, metformin may delay or prevent its onset.
• Polycystic ovary syndrome - Metformin helps restore regular menstrual cycles and fertility in this hormonal disorder.

Some research indicates metformin could have anti-aging and anti-cancer properties as well, but more evidence is needed.

Metformin Precautions

Metformin is typically well tolerated, but does come with some precautions:

• Can't be used in people with impaired kidney function due to risk of lactic acidosis.
• Should be temporarily stopped before procedures requiring IV contrast dye.
• May cause digestive side effects like nausea, diarrhea, abdominal pain.
• Needs to be monitored closely if also taking heart/blood pressure medications.
• Not recommended in people over 80 years old.

What is Jardiance?

Jardiance is the brand name for empagliflozin, an oral diabetes medication that belongs to the sodium-glucose cotransporter 2 (SGLT2) inhibitor class. It was approved for use in the U.S. in 2014. Jardiance works by blocking reabsorption of glucose in the kidneys, leading to excretion of excess sugar from the body.

How Jardiance Helps Control Blood Sugar

Jardiance lowers blood sugar in a unique way by causing the kidneys to remove glucose from the body through urination. Specifically, it inhibits SGLT2 proteins that normally reabsorb filtered glucose back into the bloodstream. This promotes loss of excess sugar through the urine.

In addition, Jardiance also reduces glucose production in the liver, improves insulin production in pancreatic beta cells, and increases insulin sensitivity. The combined effects lower hemoglobin A1C levels in people with type 2 diabetes.

Benefits of Jardiance

FDA approved uses of Jardiance include:

• Treating type 2 diabetes - It can be prescribed alone or with other diabetes medications including insulin.
• Reducing the risk of cardiovascular death in type 2 diabetes and established heart disease.

Jardiance may also protect kidney function in diabetics based on some studies.

Risks and Warnings With Jardiance

As with most medications, Jardiance has some safety concerns to discuss with your doctor:

• Dehydration and hypotension - Increased urination can lead to fluid loss.
• Yeast infections - Excess sugar in the urine promotes overgrowth of genital yeast.
• Kidney problems - Not recommended with severe renal impairment.
• Increased LDL cholesterol - Monitor lipid panel while taking Jardiance.

Comparing Metformin and Jardiance

When considering if metformin or jardiance is better for managing diabetes, here's how the two drugs stack up:

Glucose Lowering Effects

Both are effective at reducing blood sugar levels on their own and enhance the effects of other diabetes medications when combined. However, jardiance may lower A1C slightly more than metformin alone.

Other Health Benefits

Metformin offers cholesterol lowering effects and weight loss benefits. Jardiance is associated with reduced risks of kidney disease progression and cardiovascular death.

Side Effects

The most common side effects of metformin include digestive discomfort like diarrhea, nausea, vomiting. Jardiance is more likely to cause yeast infections and urinary tract infections.

Cost and Availability

Metformin is available as a low-cost generic, while jardiance is still sold under patent protection at a higher branded price. Both come in oral tablet form.

Safety Issues

Jardiance carries risks of dehydration and urinary tract infections. Metformin can rarely cause lactic acidosis so it requires monitoring of kidney function.

Who Should Take Metformin vs Jardiance?

When determining if metformin or jardiance is more appropriate for a particular person with type 2 diabetes, doctors consider factors like:

Age

Metformin shouldn't be used in people over 80 years old due to concerns over vitamin B12 deficiency. Jardiance can be used in older adults.

Kidney Function

Metformin is contraindicated in people with moderate to severe kidney impairment. Jardiance may be used for mild kidney disease but dose adjustments are needed.

Affordability

For patients with limited income or poor prescription coverage, metformin is the more affordable option over brand-name jardiance.

Weight Loss Goals

Metformin is more likely to result in weight loss, making it advantageous for overweight or obese diabetics trying to slim down.

Cardiovascular Disease

Jardiance is associated with reduced risk of death from cardiovascular causes based on research. This makes it preferred for diabetes patients with heart disease.

Using Metformin and Jardiance Together

While metformin and jardiance belong to different medication classes, they are often prescribed together. Reasons the drugs may be combined include:

• For better blood sugar control - The drugs work synergistically to lower glucose more than either alone.
• To minimize side effects - Lower doses of each drug can be used together.
• For cardiovascular protection - Metformin improves cholesterol while jardiance benefits the heart.

Of course, combining the medications also increases the risk of side effects. Your doctor will determine if using metformin and jardiance together is appropriate for your health status and diabetes treatment goals.

Dosing Metformin and Jardiance

The dosage of each medication may be reduced when used together to improve tolerability. For example, metformin immediate release is typically prescribed at 500-1000 mg twice daily. When combined with jardiance, doses may start at 500 mg once or twice daily. Jardiance doses range from 10-25 mg daily.

Lifestyle Changes To Complement Medications

While drugs like metformin and jardiance help control diabetes, making healthy lifestyle changes enhances their effects:

• Following a balanced, low-sugar diet
• Exercising regularly to help manage weight
• Quitting smoking to improve cardiovascular health
• Limiting alcohol intake
• Reducing stress through yoga, meditation, etc.

Lifestyle adjustments combined with medications gives the best chance of managing diabetes, avoiding complications, and improving quality of life.

Talk to Your Doctor

Metformin and jardiance offer effective yet different mechanisms for lowering blood glucose in type 2 diabetes. Your doctor will take into account your medical history, health status, treatment goals and preferences when deciding if metformin or jardiance is the better choice for your diabetes management. Don't hesitate to discuss all your questions to make an informed decision.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.