Metformin (medication): uses, side effects, and information.

We explain the effects of one of the most popular anti-diabetic medications.

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

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

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 plant Galega officinalis, whose anti-glycemic properties have been known since the early 20th century.

Despite the usefulness of biguanides, their use as an anti-diabetic medication was initially overshadowed by the commercialization of insulin.. It was introduced in France in 1957 and approved for medical use in the USA 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 of how metformin works is not yet clear, we know that this blood glucose lowering effect is produced by:

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

These mechanisms cause a patent decrease in the hyperglycemic levels of the patients who take itwithout increasing insulin production or increasing the weight of the patients taking it, the latter being a common effect of other medications used to treat diabetes.

Uses

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

It is taken orally and should be taken with meals to minimize side effects such as:

• Nausea
• Vomiting
• Abdominal pain
• Flatulence
• Diarrhea

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

Side effects

There are several side effects of metformin, some of which are very serious although of rare incidence. Grouped according to their rarity, they would be:

1. Very frequent side effects

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

2. Frequent side effects

One in ten people taking metformin will experience alterations in their sense of taste during treatment with this medication.

3. Rare side effects

It is estimated that 1 in 10,000 people taking metformin may have an altered liver function.The main visible symptom is yellowing of the skin and/or eyes. Also in this range we would find skin rashes, with redness or itching.

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

The main initial symptoms of lactic acidosis are not specific, but are usually unexplained fatigue and muscle weakness, as well as severe cramps. At particular risk for lactic acidosis are those with impaired renal function, for whom the use of metformin is not recommended because of the inherent risk of lactic acidosis.

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

In addition, although it is not yet conclusively proven and more research is needed to confirm or deny this fact, metformin's ability to increase the risk of heart attacks in people taking it is being studied.

Contraindications

The use of metformin is not indicated for people with liver or kidney problems, people suffering from severe infections, or people who are taking metformin. or diseases related to reduced oxygen supply, such as heart disease. On the other hand, dehydration and the consumption of alcohol in large quantities can increase the risk of lactic acidosis.

Although metformin does not cause hypoglycemia on its own, if taken in conjunction with other diabetes medications, there is a risk of hypoglycemia, too low blood sugar levels. Hypoglycemia manifests itself 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 discontinued if we are going to undergo major surgery or diagnostic tests with iodine-containing contrasts.