The three major hazards of Metformin can be fatal if you ignore Any
Metformin is the first-line medication recommended in the guidelines for the prevention and treatment of type 2 diabetes. Not only can it improve insulin resistance and lower blood sugar, it can also prevent macrovascular and microvascular disease caused by diabetes, improve blood lipid metabolism, and reduce the chance of cardiovascular complications. Most people with diabetes need to take it for a long time. However, there are three issues that Metformin must pay attention to, otherwise it may cause harm or even threaten life at any time.
1. Long-term use of metformin will cause the loss of vitamin B12 and accelerate the occurrence of diabetic neuropathy
Vitamin B12 is an important substance that maintains the normal state of the body's hematopoietic function and can effectively prevent pernicious anemia. It can also exist in the form of coenzymes to regulate sugar metabolism. At the same time, it is also an essential vitamin for the nervous system.
For diabetics, the lack of vitamin B12 will not only affect
the regulation of blood sugar, but also accelerate neuropathy and cause a
variety of diabetic complications early. For example, diabetic peripheral
neuropathy (lower limb numbness, pain, itching, etc.), diabetic cardiovascular
disease (painless myocardial ischemia, painless myocardial infarction, etc.),
diabetic foot (old rotten foot), etc.
Therefore, patients taking Metformin for a long time should add vitamin B12 appropriately. Vitamin B12 is abundant in meat, animal liver, fish, shellfish and eggs.
2. Very few patients taking metformin will induce lactic acidosis
Lactic acidosis is a very rare but very dangerous complication of diabetic patients. The clinical manifestations are vomiting, abdominal pain, and mental disorder. Once it occurs, the mortality rate is as high as 50%.
Lactic acid is a substance produced when glucose is
metabolized under anaerobic conditions in cells. Under normal circumstances,
most of the lactic acid can be converted into glucose again by the liver's
xenobiosis, providing energy for the human body.
A small amount of lactic acid
can be excreted by the kidney through metabolism. Metformin itself has the
effect of inhibiting gluconeogenesis to glucose. It will cause the increase of
lactic acid content in the body.
If the patient has a serious loss of kidney function and lactic acid is difficult to metabolize through urination, it will accumulate too much in the human body and cause lactic acidosis. Therefore, patients with severe liver and kidney dysfunction are clinically prohibited from using metformin to prevent lactic acidosis.
3. Taking Metformin under three circumstances can easily cause hypoglycemia
Metformin itself does not cause hypoglycemia, but it can induce hypoglycemia in three situations, causing the patient's life to be dangerous.
1) After a lot of exercise, did not add enough calories in time;
2) Combination with sulfonylurea drugs or insulin may cause hypoglycemia;
3) After drinking alcohol, alcohol can stimulate insulin secretion, and it will reach a peak in 2-3 hours, which is the same as the peak period of the effect of hypoglycemic drugs. The two peaks are superimposed, which can easily cause hypoglycemia coma. This situation is often most easily overlooked by patients, and should be paid more attention to.
Although there may be the above risks, a large number of studies have shown that metformin is generally well tolerated, has high safety, and does not damage the liver and kidneys. It is still the drug of choice for diabetes control worldwide. Patients should be taken reasonably under the guidance of a doctor to obtain better treatment results.
Education: MBBS, MD
Occupation: Medical Doctor
Specialization: Community Medicine, General Surgery, Natural Treatment
Experience: 18 Years as a Medical Practitioner
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