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Insulin Resistant


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#1 DoneWithCrap

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Posted 20 June 2017 - 10:02 PM

I have been off Cymbalta for at least a couple years so I don't know if this is related but for the past few years my fasting glucose has been slightly high. This year my doctor ordered a glucose tolerance test which shows that I'm prediaberic aka insulin intolerant. Has anyone else had this issue?

#2 fishinghat

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Posted 21 June 2017 - 08:48 AM

It is good to hear from you again DWC.

 

All I can tell you is that there is some research out there that shows that being on it for several years causes a risk of diabetis/prediabetic.

 

I will see what documentation is out there and if there is any type of recommendation for treatment.


#3 fishinghat

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Posted 21 June 2017 - 09:40 AM

                                                               Cymbalta and Diabetes

You will note that most of the research is of short duration. It is likely that the longer you are on Cymbalta the greater the risk. The FDA info however covers a time period that includes long term users and shows a low risk potential.

https://dailymed.nlm...f2-c185fbad64ba

Drug insert

Glucose Control in Diabetes: In diabetic peripheral neuropathic pain patients, small increases in fasting blood glucose, and HbA1c have been observed (5.14)

Glycemic Control in Patients with Diabetes — As observed in DPNP trials, CYMBALTA treatment worsens glycemic control in some patients with diabetes. In three clinical trials of CYMBALTA for the management of neuropathic pain associated with diabetic peripheral neuropathy, the mean duration of diabetes was approximately 12 years, the mean baseline fasting blood glucose was 176 mg/dL, and the mean baseline hemoglobin A1c (HbA1c) was 7.8%. In the 12-week acute treatment phase of these studies, CYMBALTA was associated with a small increase in mean fasting blood glucose as compared to placebo. In the extension phase of these studies, which lasted up to 52 weeks, mean fasting blood glucose increased by 12 mg/dL in the CYMBALTA group and decreased by 11.5 mg/dL in the routine care group. HbA1c increased by 0.5% in the CYMBALTA and by 0.2% in the routine care groups.

What should I tell my healthcare provider before taking Cymbalta?

Before starting Cymbalta, tell your healthcare provider if you:
⦁ have diabetes (Cymbalta treatment makes it harder for some people with diabetes to control their blood sugar)

https://www.ncbi.nlm...pubmed/20874076

Curr Med Res Opin. 2010 Nov;26(11):2579-88. doi: 10.1185/03007991003769241. Epub 2010 Sep 27.
Duloxetine treatment and glycemic controls in patients with diagnoses other than diabetic peripheral neuropathic pain: a meta-analysis.
Crucitti A1, Zhang Q, Nilsson M, Brecht S, Yang CR, Wernicke J.
Abstract
OBJECTIVE:
Mood disorders are often associated with poor glycemic control, and antidepressant treatments for mood and pain disorders can alter plasma glucose levels in patients with diabetes. A previous meta-analysis from three studies showed that duloxetine modestly increased fasting plasma glucose (FPG) and HbA(1c) levels in patients with diabetic peripheral neuropathic pain (DPNP). This meta-analysis examined whether there were any short- and long-term effects of duloxetine (20-120 mg/day) on glycemic control in patients with diagnoses other than DPNP.

RESEARCH DESIGN AND METHODS:
Short-term data (9-27 weeks): seven studies of duloxetine in general anxiety disorder, fibromyalgia, and chronic lower back pain (CLBP). Long-term data: 41-week, uncontrolled extension of the short-term CLBP study and 52-week study in patients with recurrence of major depressive disorder.

MAIN OUTCOME MEASURES:
Baseline-to-endpoint changes in FPG and HbA(1c) levels.

RESULTS:
In short-term studies, patients were randomly assigned to placebo (n = 1098) or duloxetine (n = 1563). Mean baseline-to-endpoint changes in FPG and HbA(1c) did not significantly differ in duloxetine-treated patients compared with placebo-treated patients. In the 41-week study (n = 181), duloxetine-treated patients experienced a small but significant within-group baseline-to-endpoint increase in HbA(1c) (mean change = 0.1%; p < 0.001). This result was in contrast to absence of effect on mean baseline-to-endpoint within-group changes in FPG (p = 0.326) in that study, and to absence of between-treatment changes in FPG (p = 0.744) and HbA(1c) (p = 0.180) in the 52-week placebo-controlled study.

https://www.ncbi.nlm...pubmed/17192327
Diabetes Care. 2007 Jan;30(1):21-6.

Does treatment with duloxetine for neuropathic pain impact glycemic control?
Hardy T1, Sachson R, Shen S, Armbruster M, Boulton AJ.
Abstract
OBJECTIVE:
We examined changes in metabolic parameters in clinical trials of duloxetine for diabetic peripheral neuropathic pain (DPNP).
RESEARCH DESIGN AND METHODS:

Data were pooled from three similarly designed clinical trials. Adults with diabetes and DPNP (n = 1,024) were randomized to 60 mg duloxetine q.d., 60 mg b.i.d., or placebo for 12 weeks. Subjects (n = 867) were re-randomized to 60 mg duloxetine b.i.d. or routine care for an additional 52 weeks. Mean changes in plasma glucose, lipids, and weight were evaluated. Regression and subgroup analyses were used to identify relationships between metabolic measures and demographic, clinical, and electrophysiological parameters.

RESULTS:
Duloxetine treatment resulted in modest increases in fasting plasma glucose in short- and long-term studies (0.50 and 0.67 mmol/l, respectively). A1C did not increase in placebo-controlled studies; however, a greater increase was seen relative to routine care in long-term studies (0.52 vs. 0.19%). Short-term duloxetine treatment resulted in mean weight loss (-1.03 kg; P < 0.001 vs. placebo), whereas slight, nonsignificant weight gain was seen in both duloxetine and routine care groups with longer treatment. Between-group differences were seen for some lipid parameters, but these changes were generally small. Metabolic changes did not appear to impact improvement in pain severity seen with duloxetine, and nerve conduction was also not significantly impacted by treatment.

CONCLUSIONS:
Duloxetine treatment was associated with modest changes in glycemia in patients with DPNP. Other metabolic changes were limited and of uncertain significance. These changes did not impact the significant improvement in pain observed with duloxetine treatment.

https://www.ncbi.nlm...les/PMC2350145/

Review of duloxetine in the management of diabetic peripheral neuropathic pain

A minor but statistically significant increase in blood glucose compared with placebo treated patients has been observed in controlled clinical trials.

http://www.ehealthme...betes mellitus/

90,467 people reported to have side effects when taking Cymbalta.
Among them, 725 people (0.8%) have Type 2 diabetes mellitus

90,467 people reported to have side effects when taking Cymbalta.
Among them, 303 people (0.33%) have Hyperglycemia

Cymbalta and Insulin resistance - from FDA reports

Summary
Insulin resistance is found among people who take Cymbalta, especially for people who are female, 40-49 old , have been taking the drug for 2 - 5 years, also take medication Seroquel, and have Bipolar disorder. This review analyzes which people have Insulin resistance with Cymbalta. It is created by eHealthMe based on reports of 90,467 people who have side effects when taking Cymbalta from FDA, and is updated regularly.

90,467 people reported to have side effects when taking Cymbalta.
Among them, 11 people (0.01%) have Insulin resistance


 





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