Metformin is an oral hypoglycemic agent under the family of biguanides. It is taken by mouth usually at a frequency of one to three times a day, for the immediate release form. On the other hand, the extended release form is taken once in the evening with meal.

By Robert P. Tracy

The action of this drug is to help regulate blood glucose by preventing glucose production by the liver. It also helps increase the muscles’ and fats’ sensitivity to insulin to increase their uptake of glucose. This way, a controlled amount of glucose can be attained without increasing the insulin produced by the pancreas.

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This drug is known to be the first line of treatment for diabetes mellitus type 2. It is especially beneficial for overweight and obese people because unlike other anti-diabetic drugs, Metformin does not prompt significant weight gain. It can also help lower one’s LDL and triglycerides — both contribute to the development of complications of this disease like cardiovascular problems, which are actually the leading cause of death among people with this condition.

According to studies made involving Metformin and other anti-diabetic drugs, Metformin reduces diabetic complications by up to 30% compared to insulin and sulfonylureas (another type of oral hypoglycemic agent). Also, unlike other drugs used to treat this disease, Metformin does not produce hypoglycemia especially if taken singly to treat affected people.

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However, even with these benefits, Metformin still has the tendency to produce side effects. Although these side effects are relatively rare, they may prove bothersome and may prompt the discontinuation of the therapy. If given some time though, most of the medication’s side effects will eventually go away on their own. Those that do not can easily be treated at home or by a medical provider.

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Most of the accompanying side effects are mild including nausea, vomiting, bloating, loss of appetite, gas, and diarrhea. Often, decreasing the dosage of the drug is enough to get rid of these problems. It is then important to inform your physician about such problems to help you avoid or lessen these side effects.

A more serious side effect of this drug may also occur, however rarely. It is called lactic acidosis, the presence of too much lactic acid in the blood. Blood tests will typically show the presence of lactic acid above 5 mmol/L, which results to the decrease in blood pH, below 7.35. This is a type of metabolic acidosis which requires immediate medical attention.

Lactate is produced when the cells start producing glucose anaerobically. The chemical is directly produced from pyruvate, a substance derived from glucose after being broken down. If the production of lactate surpasses consumption and the buffers become exhausted, accumulation of lactate in the blood occurs.

Most cases of lactic acidosis occur in patients who are already exhibiting significant health problems like multi-organ malfunction. Patients who are at higher risk for lactic acidosis are sufferers with heart, kidney and liver problems. Patients with systemic infection and folks with advanced age are also part of the list. If you have these problems or have a history, it is important to inform your physician in order for him to take necessary precautions for your case.

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