Metformin And Dka

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Metformin In Type 1 Diabetes

Is this a good or bad idea? The article by Meyer et al. (1) revives a debate regarding the appropriateness of metformin use for people with type 1 diabetes. Given the potential for coexisting lactic acidosis and diabetic ketoacidosis, how can one justify its use? Indeed, there was little reason to expect a benefit in patients who were studied: nonobese type 1 diabetic subjects with HbA1c <9.0% who were taking ∼0.7 units · kg insulin−1 · day−1. A modest average reduction of daily insulin requirements, 4.3 units, as compared with an increase of 1.7 units for placebo, does not seem to be worth the trade-off of increased risk for severe hypoglycemia (19 events in metformin group vs. 8 events in placebo group). There was no differential effect in terms of HbA1c. Only 7 of 31 patients (23%) treated with metformin responded in terms of a significant (20%) reduction in insulin requirement. Furthermore, it is likely that the incidence of hypoglycemia would be much greater if more aggressive metabolic targets of HbA1c had been applied. Despite the failure to observe diabetic ketoacidosis, the limited number and short period of observation does not permit the conclusion that metformin Continue reading >>

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Popular Questions

  1. Kingleonidas

    Metformin and DKA>>

    Just wondering, I have read that taking metformin without food can lead to dka, or does this usually pertain to people who eat absolutely nothing or very little all day?
    I am going to start my 850mg three times a day at about 4-5am, 9-10am, then again at the end of the day when I go to bed.
    Has anyone had a problem with metformin and dka?

  2. MarkM

    no, metformin won't cause dka. its main action is to inhibit glycogenolysis. only insufficient insulin will cause dka. metformin can cause lactic acidosis, but it is not the same thing as ketoacidosis (dka).

  3. Ken S

    Studies have also shown that the risk of getting lactic acidosis with or without taking metformin is about the same. This is an extremely rare affliction that only really seems to affect patients with serious preexisting health problems. It's really not an issue to be concerned about.
    As for DKA, metformin is contradicted in cases where patients are experiencing symptoms of DKA, and therefore it may be surmised that it may worsen this condition, although it does not seem to cause it.

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