Metformin helps with type 2 diabetes

Metformin is used to treat  type 2 diabetes  . Thanks to years of experience, metformin is a reliable active ingredient for lowering the elevated blood sugar level in diabetes mellitus. This active ingredient is now also recommended for certain types of menstrual disorders. But there are some contraindications and side effects to consider so that metformin can be taken safely.  Metformin is completely unsuitable for patients with  type 1 diabetes .

effects of metformin

Metformin lowers blood sugar levels and improves how the body uses sugar. In addition, this active ingredient shuts down the body’s own sugar production and hinders the absorption of sugar from the intestine into the blood. It is suitable for patients with type 2 diabetes when other therapeutic approaches have been exhausted.

Above all, overweight patients, in whom dietary measures and exercise have no effect, can benefit from the effect of this active ingredient. Experience shows that many sufferers lose weight when they first start taking metformin.

Metformin, which belongs to the biguanide group, is one of the longest-established  antidiabetics  and is extremely reliable. It is often used alone at first and combined with other medications only if unsuccessful. In addition, metformin is said to have heart and vascular protective properties.

A major advantage over other blood sugar-lowering drugs is the low risk of hypoglycaemia.

Metformin in PCOS

Another area of ​​application for metformin is cycle disorders in the context of  polycystic ovarian syndrome ( PCOS ),  which is often associated with diabetes mellitus. Metformin can be used to treat cycle disorders as well as high blood sugar levels, but it is not yet approved for this use in Germany. The costs for metformin must therefore normally be borne by the patient themselves in the context of off-label use.

Metformin during pregnancy and lactation

Diabetes patients who are taking metformin and want to have children or who are already pregnant should  discontinue metformin  and switch to  insulin  . Metformin therapy can only be continued during pregnancy in exceptional cases. The same applies to diabetes that only occurs during pregnancy ( gestational diabetes ).

There are no restrictions for breastfeeding mothers and metformin can be taken after consultation with the attending physician.

Metformin dosage

Metformin is a prescription drug. It is best to discuss which dosage is suitable with your doctor. It is available in the form of film-coated tablets and is therefore taken orally, preferably before or with meals. Metformin is offered in dose increments of 500, 850, and 1000 milligrams. You can find more information on the package leaflet.

Metformin side effects

The most common side effects of metformin are  gastrointestinal symptoms:  nausea , vomiting,  diarrhea  and abdominal pain are among the side effects that occur very frequently. Also worth noting are  taste changes,  such as a metallic taste in the mouth, which together with the former side effects can cause loss of appetite.

Lactic acidosis is very rare but extremely dangerous  .  An overdose of metformin or an overload of the kidneys leads to an accumulation of the active substance in the body, which leads to a derailment of the acid-base balance. The symptoms of lactic acidosis are very similar to the normal side effects of metformin: nausea with vomiting. This is often accompanied by other gastrointestinal complaints, muscle pain, cramps and accelerated breathing. In this case, a doctor should be consulted immediately.

Contraindications of metformin

Some  chronic conditions  prohibit the use of metformin because they either impair its metabolism or increase the risk of lactic acidosis.

This is the case with  cardiac insufficiency , any disease affecting lung function ( COPD ,  asthma ), liver dysfunction and impaired kidney function. According to recent studies, however, those affected with moderately impaired kidney function (grade 3b) can be treated with metformin in consultation with their doctor.

Circumstances that put a strain on the kidneys should always be a reason to reconsider taking metformin. Such circumstances can be, for example, severe vomiting, diarrhea or severe infections.

Metformin should also be discontinued during pregnancy and switched to another preparation. Insulin syringes are a good example.

When combined with  alcohol  , metformin carries an extremely high risk of lactic acidosis. Alcohol consumption should therefore be avoided or minimized.

metformin and surgeries

Another special feature of metformin is the handling in the case of  general or spinal anesthesia  , for example during an  operation.  Metformin must be stopped two days before the procedure and kidney function checked before restarting. The same applies to X-ray examinations with iodinated contrast media. Metformin must not be taken before the test and for up to 48 hours after it. Here, too, a clarification of the kidney function is required after the examination.

Interactions of metformin

When combined with some other medications, the effectiveness of metformin is reduced. Examples include corticosteroids ( cortisone ), water tablets (diuretics) and some medications for asthma (beta sympathomimetics). The blood sugar-lowering effect of metformin is increased by antihypertensive drugs such as ACE inhibitors.

Medications containing alcohol (e.g. some cough medicines) and iodinated contrast media carry the risk of lactic acidosis in combination with metformin and should therefore be taken with caution. In the case of the contrast medium, metformin even has to be discontinued for a while.

Metformin: This is important to note

Metformin is a good drug for the treatment of type 2 diabetes and can permanently and reliably lower blood sugar levels if a few special features are taken into account:

• Metformin is suitable for patients with type 2 diabetes in whom diet and exercise measures have not shown any effect.
• Its advantage lies in the low risk of hypoglycaemia.
• Since metformin is eliminated by the kidneys, renal function should be checked at least annually.
• Metformin must be discontinued prior to operations and X-ray examinations with administration of contrast medium. Before taking it again, kidney function must be checked.
• Important contraindications are pregnancy and increased alcohol consumption.