Metformin Contraindications

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Metformin In The Treatment Of Adults With Type 2 Diabetes Mellitus

INTRODUCTION Two classes of oral hypoglycemic drugs directly improve insulin action: biguanides (only metformin is currently available) and thiazolidinediones (TZDs). In the absence of contraindications, metformin is considered the first choice for oral treatment of type 2 diabetes (table 1). A 2006 consensus statement from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), updated regularly, proposed that metformin therapy (in the absence of contraindications) be initiated, concurrent with lifestyle intervention, at the time of diabetes diagnosis [1-3]. The pharmacology, efficacy, and side effects of metformin for the treatment of diabetes will be reviewed here. A general discussion of initial treatment of type 2 diabetes and the role of metformin in the prevention of diabetes, in the treatment of polycystic ovary syndrome, and in gestational diabetes are reviewed separately. 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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