Metformin is a biguanide glucose-lowering drug. The drug helps people with type 2 diabetes and prediabetes lower their blood sugar levels in three ways:
- Inhibiting hepatic glucose production.
- Enhances the body’s sensitivity to insulin, which means that the drug allows muscles to better use insulin to promote glucose utilization and thus lower blood sugar levels.
- Inhibits the absorption of glucose from food in the intestine.
In summary, this drug can lower glycated hemoglobin (HbA1c) levels (the “average” of blood glucose control over several months) and also delay the progression of prediabetes to diabetes.
What are the metformin drugs?
Doctors usually use it as a first-line drug for type 2 diabetes. There are several metformin preparations available, and there are also tablets that combine metformin with another drug, including:
- Glipizide and metformin;
- Glibenclamide and metformin;
- pioglitazone and metformin;
- Riglitazone and metformin;
- Saxagliptin and metformin;
- Saxagliptin and metformin.
What are the adverse effects?
If you are taking a glucose-lowering medicine or combining metformin with other glucose-lowering medicines or insulin, consult your doctor about the possibility of hypoglycemia. If you are currently taking only metformin, you may not experience a hypoglycemic reaction.
The coating of the extended-release tablet may also be found in one’s stool; do not worry if you find this; the drug has been absorbed by the body and no additional dosing is needed.
The following intestinal problems may be induced by metformin drugs, but usually resolve within a few weeks.
- Distention;
- Gastrointestinal distention;
- Diarrhea;
- Stomach upset;
- Loss of appetite.
These adverse reactions may reappear if your doctor increases the dosage of the drug. Taking it with food can help reduce the incidence of adverse reactions to metformin.
In the past, doctors often avoided prescribing these drugs to patients with kidney disease, but the current view is that they are generally safe to take in patients with mild to moderate kidney disease.
Long-term use of metformin can significantly reduce the amount of vitamin B12 in the body. Your doctor may recommend checking your vitamin B12 levels, especially if you have anemia or nerve damage in your hands and feet (peripheral neuropathy).
A large study suggests that long-term metformin use may be associated with an increased risk of developing Alzheimer’s disease and Parkinson’s disease. However, more research is needed to clarify the relationship.
Lactic acidosis
People taking metformin may have a buildup of lactic acid in their blood. This is less common, but has an increased likelihood of occurring in the following conditions:
- Have kidney or liver disease;
- drinking large amounts of alcohol;
- Having severe congestive heart failure;
- Being unwell with fever, diarrhea or vomiting;
- Dehydration.
Contact your doctor immediately if the following symptoms are present, indicating a serious condition:
- Hardness in breathing;
- General weakness or muscle aches;
- Stomach pain or abdominal cramps;
- Chills;
- A change in heart rhythm;
- Dizziness or fainting.
Before surgery, X-rays, or various scans
If you are going to have surgery, or need to have an injection of contrast for tests such as X-rays, let your healthcare provider know that you are taking metformin. In this case, it may be necessary to stop taking the drug for a few days so that the procedure or test is not interfered with, but you need to consult your doctor first about how to control your blood sugar during the time you are off the drug.