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Metformin is a popular prescription drug used as a first-line treatment for type 2 diabetes and is sometimes prescribed off-label for conditions such as prediabetes and polycystic ovary syndrome (PCOS). It is usually taken orally in tablet form once or twice daily.
Metformin helps people manage their blood sugar levels. It is thought to work by decreasing glucose release from the liver and increasing muscle insulin sensitivity. It has also been proven to help you lose weight.
This article investigates the safety profile of metformin and its relationship with diabetes.
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How does metformin work?
Metformin is taken as an oral tablet once or twice a day and is a type of drug called a biguanide. These drugs are used to treat high blood sugar and are most often used in patients with prediabetes, gestational diabetes (a type of diabetes that develops during pregnancy), and type 2 diabetes.
This drug reduces the amount of sugar produced by the liver and reduces absorption of sugar in the intestines, allowing individual cells in the body to consume more sugar and use it more efficiently.
These three physiological changes reduce the amount of sugar (in the form of glucose) circulating in the blood.
As a result, the average person taking metformin will check their HbA1c, a measure of blood sugar control over the past two to three months. decrease by about a percentage pointblood sugar levels drop significantly.
Who should not take metformin?
It is important to know that not everyone should take metformin.
If you have kidney problems, your health care provider should monitor your kidney function while you are taking metformin. People with severe kidney disease or People over 80 years old with kidney problems It is generally recommended not to take the drug.
People with liver disease or congestive heart failure may also be advised not to take the drug.
Metformin has not undergone rigorous clinical trials in pregnant and lactating women or children, so it is generally used with caution in these populations.
Metformin is not approved by the FDA for use in patients with type 1 diabetes.According to research, this drug May help increase insulin sensitivity Its efficacy in improving glycemic control or meaningfully improving other health outcomes in patients with type 1 diabetes has not been established.
Some people still take metformin for weight loss to treat type 1 diabetes.
See below for more information. Metformin for type 1 diabetes: advantages and disadvantages and Metformin and weight loss: Can pills help you lose weight?
People with a known allergy to metformin or any of its ingredients should not take the drug.
Similarly, people who experience a condition called lactic acidosis while taking metformin are usually advised not to take metformin again.
For more information, see: Can metformin cause lactic acidosis?
Metformin can interact with many other prescription drugs, so it’s important to talk to your doctor about any other medicines you’re taking before getting a prescription.
See below for more information. Everything you need to know about metformin.
What are the risks of taking metformin?
Although metformin is generally considered to be a safe drug, it is important to know that like any drug it can have side effects and risks.
Although rare, one of the most serious risks of taking metformin is a condition called lactic acidosis, which involves the rapid accumulation of lactic acid in the blood.
Established through clinical research Metformin-induced lactic acidosis occurs in only about 6 cases per 100,000 people taking this drug per year. However, although rare, this condition can be fatal if not treated promptly.
Symptoms of lactic acidosis include abdominal pain, muscle spasms, difficulty breathing, and fatigue.
Another potential risk of taking metformin is that it can cause a decrease in vitamin B12 levels.
Prolonged vitamin B12 deficiency can lead to anemia, which can lead to neurological problems, weakness, and fatigue.
Study of 1,111 patients with type 2 diabetes They found that the risk of vitamin B12 deficiency was highest in people who took metformin for more than six months and took more than 1,500 milligrams (mg) of the drug daily.
By eating a rich diet, Good source of vitamin B12 You can protect yourself from this potential side effect by consuming foods such as animal liver and kidney, clams, beef, sardines, fortified cereals, and taking vitamin B12 supplements as recommended by your health care provider.
Metformin also has other side effects that are less dangerous.
The most common side effects include:
Most gastrointestinal side effects go away over time and can be reduced or completely avoided by starting with a low dose and increasing the dose over time. Switching to an extended-release (XR or ER) version of the drug can also help reduce these side effects.
If side effects persist or if you experience serious side effects, it is important to contact your doctor or other health care provider.
How long can I take Metformin?
It is not established how long you can take metformin. Metformin is considered a long-term treatment for the management of prediabetes and type 2 diabetes.
However, the effects of metformin in regulating blood sugar levels May decrease slightly over time. As a result, for people who have been taking metformin for many years, their health care team may occasionally review and adjust the dosage as necessary to ensure optimal treatment effectiveness.
Metformin therapy is individualized for each person, and your long-term treatment plan will depend on your response, treatment goals, and whether you experience side effects from the drug.
Metformin is useful because it can be used alone or in combination with other drugs.
See below for more information. Metformin combination drug for type 2 diabetes.
It is important to note that metformin does not treat diabetes, but is intended to help manage blood sugar levels, which can prevent complications of diabetes and reduce the burden of diabetes.
When taking metformin, it is important to monitor your blood sugar levels as directed by your doctor or health care professional. This may include finger prick blood sugar testing, wearing a continuous glucose monitor (CGM), and/or having his HbA1c blood tested periodically.
This ensures that your metformin continues to work as prescribed and helps you know if you need to change your dose over time.
Once you stop taking metformin after consulting with your medical team, it remains in your system for about 4 days.
See below for more information. How long does metformin stay in the body? and Stopping Metformin: When and How Can You Stop Taking Metformin?.
Does metformin put a strain on the kidneys?
Metformin is excreted from the body through the kidneys and excreted in the urine. If your kidneys aren’t working properly, metformin can build up in your bloodstream and increase your risk of lactic acidosis.
For this reason, people with severe renal impairment or kidney disease are generally advised to avoid taking metformin. People with mild kidney disease should have their kidney function monitored while taking the drug if their doctor determines they are candidates for metformin therapy.
People with existing kidney disease Kidney health may be further compromised By taking metformin.
However, there is no need to worry if your kidney function is healthy. There is no evidence that metformin adversely affects healthy kidneys.
Does metformin put a strain on the heart?
Metformin is not known to have any negative effects on the heart. It is important to consult your doctor before taking metformin if you have a history of heart disease, but the drug is generally considered safe for the cardiovascular system.
Current research is not clear Although there are questions about whether metformin prevents heart failure, it has been established that it is generally safe for people with a variety of heart conditions.
However, as always, we recommend that you discuss all other symptoms with your doctor or care team before starting treatment with metformin.
Safety of metformin for diabetic patients
Overall, metformin is considered a very safe drug for people with prediabetes and type 2 diabetes.
The drug’s benefits in helping manage blood sugar levels and reducing the risk of complications from diabetes generally outweigh the relatively small risk of serious side effects.
Common side effects, such as abdominal or stomach discomfort, are usually temporary and can be managed or eliminated by starting with a small dose and gradually increasing the dose over time.
See below for more information. Metformin Dosing Guide (Minimum and Maximum Dosage).
You should work closely with your doctor or other health care provider to continuously monitor your blood sugar levels, report and discuss any side effects, and adjust your treatment plan as necessary.
Sharing any concerns you have with your health care provider will help your care team ensure that you receive the most appropriate care.
By asking about side effects and discussing other symptoms and medications before starting metformin treatment, people with diabetes can feel confident that a treatment plan that includes a daily metformin prescription is safe.
See below for more information. Metformin side effects: common and serious side effects.
FAQ
Is it safe to take metformin every day?
yes. The maximum recommended dose for immediate-release metformin oral tablets is 2,550 mg per day. (Do not take more metformin than prescribed.)
If you are taking more than 2,000 mg of metformin per day, it may be helpful to split it into 2 to 3 smaller doses throughout the day to minimize the risk of gastrointestinal side effects . However, always consult your prescriber before changing your medication regimen.
At what HbA1c level should I start metformin?
The recommended HbA1c for metformin use depends on many factors. However, in general, metformin may be recommended if the fasting blood glucose level is greater than 100 mg/dL and the 2-hour postprandial blood glucose level is between 140 and 199 mg/dL.
Metformin may also be recommended if your HbA1c is consistently above 5.7%.
What is the brand name of metformin?
Brand names for metformin include Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet, and Riomet ER.
final thoughts
Metformin is widely used to manage blood sugar levels in people with prediabetes and type 2 diabetes and is a generally safe drug.
Although it has great benefits in terms of blood sugar control and potential weight loss, it is not suitable for everyone, especially those with kidney or liver problems, so its use must be carefully monitored.
Although serious side effects, such as lactic acidosis, are rare, it is important for users to be aware of them and to discuss any concerns or symptoms with their healthcare provider.
Metformin’s safety and effectiveness make it an important component in diabetes management, but like any drug, its use must be tailored to the individual’s specific health needs and condition.
Regular monitoring and open communication with your healthcare provider is essential to ensure the best results for patients taking metformin.
