Incretin Mimetics

Antidiabetics/Nutrient Depletion:

  • Coenzyme Q10Coenzyme Q10: Based on secondary sources, some oral diabetic medications such as chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, tolbutamide, and acetohexamide, may reduce the levels of coenzyme Q10 (CoQ10). Based on secondary sources, biguanides may reduce CoQ10 concentrations.
  • DHEADHEA: Insulin has decreased dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) in healthy populations, apparently by increasing metabolic clearance rate (9059564, 15536111). Based on human evidence, decreases in serum DHEAS have been noted following rosiglitazone use (12749433, 16335907).
  • FolateFolate: Based on human study, reduced folate levels may occur in some people treated with metformin (1017538). According to secondary sources, the reduced folate levels seen in diabetics have been linked to metformin use in some cases, possibly as a result of reduced folic acid absorption. Symptomatic folate deficiency is unlikely to occur with metformin, but people with diabetes may need folic acid supplements to reduce hyperhomocysteinemia.
  • MagnesiumMagnesium: Based on secondary sources, depletion of magnesium may occur with use of diabetic medications.
  • ThiaminThiamin: Based on secondary sources, metformin may reduce thiamine activity.
  • Vitamin B12Vitamin B12: Based on human evidence, metformin may reduce serum vitamin B12 levels (15521233). Secondary sources cite rare reports of megaloblastic anemia in individuals taking metformin for five years or more. Based on a case report, hyperhomocysteinemia was reported with metformin-induced B12 deficiency (17908667). Secondary sources also mention that reduced serum levels of vitamin B12 occur in up to 30% of individuals taking metformin on a regular basis. However, clinically significant deficiency is not likely to develop if dietary intake of vitamin B12 is adequate. Based on human evidence, deficiency may be corrected with vitamin B12 supplements even if metformin is continued (17908667, 17420435, 16495296).