Metformin exerts its therapeutic effects primarily by:
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Reducing hepatic gluconeogenesis – thereby decreasing excessive glucose production by the liver.
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Enhancing peripheral insulin sensitivity – improving glucose uptake in muscle and adipose tissues.
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Delaying intestinal glucose absorption – contributing to postprandial glucose regulation.
Unlike sulfonylureas, metformin is weight-neutral and carries a low risk of hypoglycemia, making it a preferred choice for long-term diabetes management. It is also associated with cardiovascular benefits, including potential reductions in LDL cholesterol and triglycerides.
Who Can Take It?
- Adults: Usually start with 500 or 850 mg taken 2 or 3 times daily, with meals. The dose can be increased gradually based on blood sugar results, with a maximum of 3 grams per day.
- Children and Teens (10 years and older): Can also use metformin, starting with 500 or 850 mg once daily and adjusting the dose over time, up to 2 grams daily.
- Elderly: Must be monitored closely because of possible decreased kidney function.
Important Precautions:
Metformin is not suitable for everyone. It should not be used if someone has severe kidney problems, liver issues, or certain types of metabolic acidosis. It’s also contraindicated in cases of recent heart attack, shock, or severe infections that could impair kidney or heart function.
Patients with dehydration, alcohol abuse, or who are planning surgery should stop using it temporarily. Regular checkups of kidney function are essential to prevent serious side effects like lactic acidosis—a rare but dangerous condition.
Possible Side Effects:
Most people tolerate metformin well, but some may experience stomach upset, nausea, or diarrhea when starting treatment. Serious side effects are rare but can include lactic acidosis, which requires immediate medical attention.
Drug Interactions:
Metformin can interact with other medicines, especially those affecting kidney function or blood sugar levels. Patients should tell their healthcare providers about all medicines they take.
