Metformin
Mechanism
Decreases hepatic glucose production, decreases intestinal glucose absorption, and improves insulin sensitivity.
Uses
- Type 2 diabetes mellitus
- Improving glycemic control with diet and exercise
Common effects
- Diarrhea
- Nausea
- Abdominal discomfort
- Reduced vitamin B12 over time
Serious risks
- Metformin associated lactic acidosis
- Risk accumulation with renal impairment
- Contrast and procedure related risk
Monitoring
- A1C and glucose
- Estimated glomerular filtration rate
- Vitamin B12 during long term treatment
- Tolerance and adherence
Counseling
- Take with food when directed
- Extended release products should be swallowed intact
- Limit excessive alcohol
- Tell the care team before contrast studies or procedures