Metformin Hypoglycemia Risk

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Postmarketing cases of Metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset of Metformin-associated lactic acidosis is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Metformin-associated lactic acidosis was characterized by elevated blood lactate levels (>5 mmol/Liter), anion gap acidosis (without evidence of ketonuria or ketonemia), an increased lactate/pyruvate ratio; and Metformin plasma levels generally >5 mcg/mL (see PRECAUTIONS). Risk factors for Metformin-associated lactic acidosis include renal impairment, concomitant use of certain drugs (e.g. carbonic anhydrase inhibitors such as topiramate), age 65 years old or greater, having a radiological study with contrast, surgery and other procedures, hypoxic states (e.g., acute congestive heart failure), excessive alcohol intake, and hepatic impairment. Steps to reduce the risk of and manage Metformin-associated lactic acidosis in these high risk groups are provided (see DOSAGE AND ADMINISTRATION, CONTRAINDICATIONS, and PRECAUTIONS). If Metformin-associated lactic aci Continue reading >>

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Popular Questions

  1. JV

    I'm confused. At my yearly appt, my fasting glucose was 130. Last year it was 125. So my Dr has prescribed med, given me a blood tester and set me up with a dietitian. I've checked my blood for 3 mornings and the highest it's been is 109. After meals it's 135. From what I read, those are pretty normal levels. Do I really have a pre diabetes?

  2. mollythed

    Yes, the fasting glucose numbers do show diabetes. As a matter of fact, if last year's number had been just one point higher, at 126, your doctor would be saying you had full-blown diabetes. It really doesn't take too much thought, or too much careful watching of what we eat when we first begin to show signs of diabetes to bring our numbers back down to the normal range.
    If you didn't have prediabetes, your numbers would be down below 100 first thing in the morning, and down much closer to 100 a couple hours after a meal.
    There is a gradual increase in the damage we are doing to ourselves when blood glucose levels begin to rise.The kind of damage to blood vessel, and the damage that is done to nerves when blood vessels are starting to fail, begins to show up before we are diagnosed with diabetes. It even gradually begins before prediabetes. Our goal shouldn't be just to keep blood glucose low enough to scrape by some arbitrary point that describes diabetes or prediabetes, but to keep blood glucose levels consistently down in the normal range, or as close as we can, no matter where we start out,. That gives us the best results in the long run.

  3. JV

    Thank you so much for the explanation. There's so much to learn but I'm going to do my best to be healthy.

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