Metformin
Recent news regarding Metformin ((1,1-dimethylbiguanide hydrochloride focuses on its potential benefits beyond diabetes management, particularly in reducing the risk of long COVID-19, new insights into its mechanism of action (including a brain pathway), and a study suggesting it may blunt the benefits of exercise in some areas.
About Metformin
Metformin is a widely used oral medication for managing type 2 diabetes, particularly in individuals who are overweight or obese. It helps the body use its own insulin more effectively and lowers blood sugar levels. It is also prescribed "off-label" for other conditions like Polycystic Ovary Syndrome (PCOS).
How Metformin Works
Metformin is the only drug in the biguanide class available today. It primarily lowers blood sugar through several mechanisms:
- Decreasing glucose production in the liver.
- Increasing the body's sensitivity to insulin, which helps body cells absorb more glucose from the blood.
- Slowing the absorption of glucose from the food you eat in the intestines.
It usually does not cause hypoglycemia (abnormally low blood sugar) when taken alone, a benefit over some other diabetes medications.
Common Uses
The primary use of metformin is for type 2 diabetes management, but healthcare providers may prescribe it for other conditions as well:
- Type 2 Diabetes: First-line treatment to manage blood glucose levels when diet and exercise are insufficient.
- Prediabetes: May be prescribed to help prevent or delay the onset of type 2 diabetes in high-risk individuals.
- Polycystic Ovary Syndrome (PCOS): Used off-label to help regulate menstrual cycles, improve ovulation, and manage insulin resistance.
- Gestational Diabetes: Sometimes used to control blood sugar during pregnancy.
Side Effects
Metformin is generally well-tolerated, but side effects can occur. They often improve over the first few weeks of treatment.
- Common Side Effects: Gastrointestinal issues like diarrhea, nausea, vomiting, gas, stomach pain, and a metallic taste in the mouth.
Serious (but Rare) Side Effects:
- Lactic Acidosis: A dangerous buildup of lactic acid in the blood. Symptoms can include unusual muscle pain, trouble breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired. This risk is higher in people with kidney or liver disease, severe infection, or those who consume excessive alcohol.
- Vitamin B12 Deficiency: Long-term use can lead to lower levels of vitamin B12, so doctors may monitor levels and recommend supplements.
- Allergic Reactions: Seek emergency help if you experience hives, difficulty breathing, or swelling of the face, lips, tongue, or throat.
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