Metformin (medication): uses, side effects and information

Diabetes is the ninth global cause of death and currently has no cure. It is estimated that currently 1 in 11 adults worldwide suffer from diabetes, a number that will reach 590 million affected by 2035. Of all of them, more than 85% have type 2 diabetes.

Metformin is the most prescribed medication to treat type 2 diabetes., which occurs because the body is not producing enough insulin and/or has developed a tolerance to the effects of insulin, due to constant exposure to high levels of it.

In this article we will discuss what metformin is, how and what it is used for, as well as its possible side effects derived from its consumption.

What is metformin?

Metformin is an antidiabetic medication used to lower blood glucose levels. It belongs to the family of biguanides, medications derived from the Galega officinalis plant, whose anti-glycemic properties have been known since the beginning of the 20th century.

Despite the utility of biguanides, its use as a diabetes medication initially took a back seat due to the commercialization of insulin

. It was introduced in France in 1957 and approved for medical use in the US in 1995. It is currently the most widely used medication in the treatment of type 2 diabetes.

How does it work?

Metformin lowers blood glucose levels. Although the exact mechanism by which metformin works is not yet clear, we do know that this blood glucose lowering effect is produced by:

• Decreased hepatic glucose release
• Enhanced glucose uptake by muscle cells
• Enhanced glucose uptake in erythrocytes
• Inhibition of intestinal glucose absorption
• Changes in the gut microbiota

These mechanisms cause a patent decrease in the hyperglycemic levels of the patients who take it., without increasing the production of insulin or increasing the weight of the patients who take it, the latter being a common effect of other medications used to treat diabetes.

Applications

Currently, as we have discussed, metformin is mainly used to treat type 2 diabetes. Even so, there are medical professionals who prescribe it to curb obesity in patients, whether they are diabetic or not. This use of metformin is controversial, due to the side effects that this medication can generate.

Its consumption is orally, and should be taken with meals to minimize side effects such as:

• Nausea
• Threw up
• Abdominal pain
• Flatulence
• Diarrhea

Daily doses of metformin greater than 2g should be avoided.. When starting treatment, it is recommended to start with the lowest doses possible and gradually increase them according to the patient's needs.

Side effects

The side effects of metformin are various, some of them very serious, although they are rare. Grouped according to their rarity, they would be:

1. Very common side effects

We would find the previously mentioned side effects that decrease as our body gets used to the treatment and we take the daily dose in conjunction with meals. Again, these would be vomiting, nausea, diarrhea, loss of appetite, and abdominal pain.

2. Common Side Effects

One in ten people taking metformin will experience taste disturbances during treatment with this medication.

3. Rare Side Effects

It is estimated that 1 in 10,000 people taking metformin may have impaired liver function, whose main visible symptom is yellow skin and/or eyes. Also in this range we would find skin rashes, with redness or itching.

As rare but serious side effects, we would find lactic acidosis -an increase in lactic acid in the blood that is potentially lethal if left untreated-, as well as a drastic decrease in vitamin B12 levels, necessary for proper functioning of the nervous system.

The main initial symptoms of lactic acidosis are not specific, but are usually unexplained tiredness and muscle weakness, as well as severe cramps. People with decreased kidney function are especially at risk of lactic acidosis, for which the use of metformin is not recommended due to the inherent risk of suffering from lactic acidosis.

On the other hand, decreased levels of vitamin B12 cause a multitude of symptoms if this deficiency is severe. we would find depression cases, personality disorders, memory problems, gastrointestinal problems, muscle weakness and vision loss.

Also, although it is not yet conclusively proven and more research is needed to confirm or denying this fact, the ability of metformin to increase the risk of heart attacks in people taking it is being studied they take.

contraindications

Taking metformin is not indicated for people with liver or kidney problems, who suffer from serious infections or diseases related to reduced oxygen supply, eg cardiac. On the other hand, dehydration and the consumption of alcohol in large quantities can increase the risk of suffering from lactic acidosis.

Although metformin does not cause hypoglycemia on its own, if it is taken in conjunction with other medications for treatment of diabetes we run the risk of hypoglycemia, too low blood sugar levels blood. Hypoglycemia manifests with weakness, dizziness, sweating, increased heart rate, and impaired vision and concentration.

If we suffer from symptoms of hypoglycemia, the consumption of sugary foods can provide temporary relief.

Metformin should also be stopped if we are going to undergo major surgical procedures or diagnostic tests with iodine-containing contrasts.