Currently, the group biguanide for use is restricted to metformin, as having low risk of lactic acidosis.
Mechanism of action Metformin exerts its influence on carbohydrate by acting on hepatocytes (inhibition of gluconeogenesis), increased sensitivity of peripheral tissues to insulin (especially striated muscle, to a lesser extent – of adipose tissue), slowing of glucose absorption in the intestine ( as a result of possible side effects such as diarrhea).
Pluses * Good hypoglycaemic effect comparable to sulfonylureas. Monotherapy with metformin reduces HbA1C about 1,5-1,8% * Metformin is accompanied by a moderate weight loss by reducing body fat. In addition, metformin decreases appetite few (slight anorectic effect). * Metformin (in contrast to sulfonylureas) does not reduce blood glucose levels in healthy people and patients with type 2 diabetes after an overnight fast (no risk of hypoglycemia). * With prolonged use of metformin has a positive effect on lipid metabolism: inhibits lipogenesis, lipolysis is activated. In some cases, metformin causes a decrease in triglycerides, cholesterol and low density lipoprotein (LDL). * Metformin also increases the activity of platelet hemostasis.
Cons * Lactic acidosis (build up of lactic acid). Despite the potentially fatal lactic acidosis, a condition under treatment with metformin there is an extremely rare (less than one case per 100,000 treated patients). Early symptoms of lactic acidosis include nausea, vomiting, diarrhea, drop in body temperature, abdominal pain, muscle, and in the future there may be a shortness of breath, dizziness, impaired consciousness and the development of coma.
Statement * Metformin is the drug of choice for people with prediabetes, accompanied by fasting hyperglycemia and normal glucose levels after meals, which indirectly indicates insulin resistance. * Metformin is indicated for type 2 diabetes as monotherapy and in combination, especially with sekretogenami (when the latter do not provide complete correction of hyperglycemia) and insulin (with insulin). Contraindications and side effects Contraindications include: * all acute conditions requiring insulin therapy (surgery and trauma, acute myocardial infarction or acute cerebrovascular accident); * pregnancy and breastfeeding; * severe liver damage and / or kidney disease; * the presence of lactic acidosis or conditions that may contribute to the development of lactic acidosis: hypoxic diseases (anemia, chronic heart failure, respiratory failure, dehydration, chronic alcoholism), acute urinary tract infection or bronchopulmonary infection, compliance with a hypocaloric diet (less than 1000 kcal / day.) persons over 60 years, performing heavy physical work.
Metformin often causes side effects than drugs sulfonylureas (20% vs. 4%). Above all, this side reaction on the part of the gastrointestinal tract: a metallic taste in the mouth (due to the slowing of glucose absorption in the intestines), dyspeptic symptoms, etc. It is believed that glyukofazh more refined than Siofor and less likely to cause diarrhea. From a metabolism: rarely – lactic acidosis (requires treatment), long-term treatment – Hypovitaminosis B12 (Malabsorption). Occasionally there are allergic reactions – skin rash.
Metformin Side Effects are rare and it is usually well tolerated.have a look on Latest News and Info about Side Effects of Metformin..