There are 7 special effects of metformin that diabetic people often face
At the end of 2019, the American Diabetes Association (ADA) released the Diabetes Diagnosis and Treatment Guidelines 2020, and jointly released the updated version of the Consensus 2019 for Type 2 Diabetes Hyperglycemia Management with the European Diabetes Research Society (EASD). Metformin, as a first-line medication, is recommended if there are no contraindications or intolerance, metformin should be preferred. Prior to this, due to the excellent performance of some new drugs in experimental studies, there was a tendency to replace metformin as the first choice. It now appears that metformin is still the drug of choice.
Crucial Effects of Metformin on Diabetic people
Many doctors and patients have concerns when using metformin, especially after seeing a lot of contraindications listed in the instructions. In fact, in many special cases, metformin can still be used.
If there is no kidney disease, even if there is a physiological decline in renal function in elderly patients, it is safe to take metformin, and the low risk of hypoglycemia is particularly valuable for elderly patients. Older patients only need to monitor kidney function regularly (once every 3 to 6 months), and they need to stop metformin when severe renal insufficiency occurs.
2. Young age
Many children and adolescents are now suffering from type 2
diabetes. If simple lifestyle interventions are ineffective and blood glucose
levels do not need to start insulin therapy, children 10 years of age and older
may consider using metformin, which is currently not recommended for children
under 10 years of age.
3. Heart failure
Heart failure can cause tissue hypoxia, and the use of
metformin may be a potential risk. In fact, metformin itself does not cause or
exacerbate heart failure.
|Adjust Metformin per the diabetes Risk|
On the contrary, it may be related to the reduced risk of heart failure and death in patients with diabetes. Therefore, metformin can be used in patients with stable heart failure, but only for patients with acute and unstable heart failure.
4. Liver disease
Metformin is not metabolized by the liver and has no liver
toxicity. Studies have also shown that metformin is beneficial for the
treatment of liver diseases, especially in the presence of insulin resistance
However, when the liver function is seriously impaired, the body's ability to clear lactic acid decreases significantly, so it is recommended that patients with serum transaminase exceeding 3 times the upper limit of normal or with severe liver dysfunction should avoid using metformin.
Metformin itself has no damage to the kidneys, and more studies have shown that metformin may have kidney protective effects. However, in order to avoid lactic acidosis, it is recommended that metformin need to be reduced when the renal function is mild-moderately decreased G3a phase, and metformin is disabled when the renal function is moderately-severely decreased (G3b phase) or worse. The ADA guidelines are broader, and it is considered safe to use metformin in the G3b phase.
Although studies have shown that long-term use of metformin can cause vitamin B12 to decline, there are also studies that have found that metformin can improve vitamin B12 metabolism in cells. Therefore, long-term use of metformin does not require routine supplementation of vitamin B12, vitamin B12 levels can be measured once a year, if lack of replenishment, even anemia patients do not have to refuse metformin for this reason.
Studies have shown that gastrointestinal reactions caused by
metformin mostly appear in the early stage of treatment (the vast majority
occur in the first 10 weeks), and most patients can gradually tolerate or
disappear as the treatment time prolongs.
Recent domestic studies also found
that the incidence of gastrointestinal adverse events did not increase with
Therefore, patients with gastrointestinal diseases can also try to start with small doses and gradually increase the dosage, as well as choose enteric-coated capsules (such as Junlida), sustained release and other dosage forms to reduce gastrointestinal adverse reactions.