In the course of daily diabetes treatment, I often encounter patients who ask the question: Doctor, will this medicine harm the liver and kidneys? In the face of such questions, I will take great pains to explain the safety of the drug and eliminate their concerns about its use. Indeed, the reality is that many patients are wary of Western oral hypoglycemic drugs, and once they take the drug, they are afraid that one day their liver and kidneys will be damaged. So some patients are keen to seek the propaganda of “no liver, no kidney” prescription; blood sugar fluctuations are not well controlled, resulting in aggravation of the disease. So is it true that long-term use of glucose-lowering drugs can lead to liver and kidney damage, as the legend goes? It is often said that “medicine is three parts poisonous”, as long as the drug there are certain side effects, even Chinese medicine is no exception, but the patient should not exaggerate the adverse effects of drugs. As a matter of fact, all the regular oral hypoglycemic drugs in clinical use are drugs that have been selected at various levels and confirmed to be safe and effective on the basis of repeated animal experiments and years of clinical verification. Therefore, patients do not have to worry too much, as long as they take them under the guidance of doctors and within the allowed dose, the side effects of drugs can be avoided, and generally do not cause adverse reactions to the liver and kidneys. We take the most common metformin for example: folklore says that long-term use of metformin drugs will make the patient’s liver and kidney function slowly fail. The fact is that it is the first-line drug in domestic and international guidelines for the treatment of type 2 diabetes, and it is precisely the best drug to control high blood sugar and improve insulin resistance. Metformin, derived from the plant goat bean, was synthesized in Ireland in 1922 and has been widely used for 94 years. It was the first drug proven to prevent diabetes and is the first oral hypoglycemic drug approved for use in adolescents with type 2 diabetes. Metformin is not only highly regarded as a glucose-lowering drug, but recent studies have proven that metformin has no liver or kidney damage, and also has cardiovascular protection, anti-tumor and anti-aging effects. However, if the patient has liver and kidney insufficiency, metformin should be disabled and replaced with insulin therapy. This is because when renal insufficiency, metformin excretion through the kidneys is blocked, which can easily cause drug accumulation and induce lactic acidosis. As we all know, after entering the body, most of the drugs have to be metabolized by the liver and then excreted by the kidneys. If the patient’s liver and kidney function is normal, it can ensure that the drugs are metabolized and excreted normally in the liver and kidneys, and will not be affected by the accumulation of drugs on the liver and kidney function, some diabetic patients have abnormal liver and kidney function, mostly due to their own blood sugar, blood pressure, lipids and other metabolic indicators of poor control, and the drugs are not related. In fact, the damage of long-term hyperglycemia on liver and kidney function far exceeds the impact of glucose-lowering drugs on the liver and kidneys, and the benefits of glucose-lowering drugs to patients far exceed its adverse effects. It is said that medicine is a double-edged sword, but often mastering its dosage and indications, medicine will become a powerful weapon in your hands not only to harm your body but also to cut off the demon of high sugar. The lifelong treatment of diabetes is a thorny path, inevitably accompanied by hardships and bumps in the road, but as long as you follow the doctor’s instructions and use your medication wisely, your health will be guaranteed and the harvest will be full of thorns into flowers!