Metformin As A Cause Of Late-onset Chronic Diarrhea.
Abstract Metformin is an effective and commonly administered drug for controlling plasma glucose concentrations in patients with type 2 diabetes mellitus. Gastrointestinal adverse effects such as abdominal pain, nausea, dyspepsia, anorexia, and diarrhea are common and widely accepted when occurring at the start of metformin therapy. Diarrhea occurring long after the dosage titration period is much less well recognized. Our patient began to experience nausea, abdominal cramping, and explosive watery diarrhea that occasionally caused incontinence after several years of stable metformin therapy A trial of metformin discontinuation resolved all gastrointestinal symptoms. A review of the literature revealed two reports that suggest diarrhea occurring long after the start of metformin therapy is relatively common, based on surveys of patients with diabetes. Metformin-induced diarrhea is differentiated from diabetic diarrhea, which is clinically similar, except diabetic diarrhea is rare in patients with type 2 diabetes. Patients with type 2 diabetes who are taking metformin and experience diarrhea deserve a drug-free interval before undergoing expensive and uncomfortable diagnostic tests, even when the dosage has been stable over a long period. Continue reading >>
Metformin Side Effects And How To Deal With Them
Metformin side effects include diabetic neuropathy, brain fog, and digestive issues. You can address them through diet, Vitamin B12, CoQ10, and exercise. Let us understand the drug Metformin in detail and study different forms of metformin, its uses and common metformin side effects along with how to deal with them. Metformin: What Is It Used For? Metformin is an old warhorse in the pharma battle against diabetes. It has been the mainstay in the treatment of Type 2 Diabetes for more than fifty years, often matching or outperforming newer drugs. In fact, many new combination drugs are often created with metformin as one of the main ingredients. Thanks to its long run in the pharmaceutical world, the side effects of Metformin are also well known. The Metformin-PCOS connection has been studied extensively since a majority of health complications associated with PCOS (polycystic ovarian syndrome) are due to hyperinsulinemia (high amounts of insulin in the blood stream). Metformin is known to reduce circulating insulin levels. The use of this drug in women with PCOS has shown highly encouraging results. RELATED: 10 Easy Breakfast Ideas For Diabetics Most Prescribed Names in Metformin Category Include: Fortamet: It is an extended-release formulation that contains metformin hydrochloride. The tablets are designed for once-a-day administration. They deliver either 500 mg or 1000 mg of metformin. The tablet is made using a patented technology called SCOTTM that delivers the active compound slowly and at a constant rate. Glucophage: Glucophage tablets contain metformin hydrochoride. They contain either 500 mg, 850 mg or 1000 mg of the active compound. Glucophage tablets do not contain any special covering and need to be taken multiple times a day until the prescribed dosage is me Continue reading >>
Does Anyone In The Rg Community Know The Mechanism Of Diarrhea Caused By Metformin?
So, apparently Metformin induced diarrhea has a complex but at the same time simple mechanism. It resembles, on a small scale, what we gastroenterologists know as "after bypass surgery dumping syndrome", in which you have a simultaneous osmotic/hipermotility condition. Would it be too much to ask you to provide me w/a reference list in which I could read up on this topic as much as possible? It would be greatly appreciated. As a researcher and clinical gastroenterologist I work w/Metmorfin tolerability, especially diarhrea, that is present between 5-10% of the cases in patients beginning Metformin treatment or in those who are increasing their daily dose. There are also some susceptible ethnic populations such as the mestizo group, which are highly prevalent in most Latin American countries, (Mexico, CA and Pacific Andean Region) who are relatively intolerant to Metformin. As clinicians we usually deal w/this problem by progressively escalating the dose on a weekly basis and in more severe cases by adding on loperamide/psyllum as rescue medication. Now, in order to provide a better and tolerable metformin, first we need to understand what we are dealing with, and second, to work on a different improved delivery system such as NERF "novel extended release fotrmulations" and/or drug combinations. Continue reading >>
How To Ease The Diarrhea Effects Of Metformin
Metformin is the most effective drug used to treat conditions such as polycystic ovarian syndrome and insulin resistance. It is also used to prevent and treat type 2 diabetes. Metformin works by regulating blood-sugar levels. Because of that, it promotes weight loss and can improve fertility. As with most prescription medications, metformin can have problematic side effects. But there is a marked decrease in side effects after the first month of taking metformin. The most common side effect of taking metformin is diarrhea. Instructions Reduce your dose, with the approval of a health-care professional. While diarrhea is most common in the initial weeks of taking metformin, reducing the dose may reduce the frequency, as it allows the body to adjust to the medication. The lowest dosage given is generally 500 mg. If you have started at a higher dose, the doctor may reduce the dosage to lessen side effects. Consider switching to the extended-release version of metformin. Talk to your health-care provider about doing so. As it is a slow-release medication, it may reduce diarrhea, because smaller amounts are absorbed over the day rather than hitting your system all at once. Keep in mind that the extended-release version is more expensive. Reduce consumption of carbohydrates and fat. People who follow a reduced–carbohydrate diet experience less diarrhea than those that do not. A diet that is rich in low-fat protein and low in carbohydrates, fats and sugar is optimal. Take metformin with a meal. It should never be taken on an empty stomach. When metformin is taken on an empty stomach, it reacts with stomach acid and can cause an increase in diarrhea and other gastrointestinal issues. Use over-the-counter medications to treat diarrhea. One such medication is Imodium. The relief Continue reading >>
Late-onset Chronic Severe Painless Diarrhea Secondary To Metformin: Case Report And Literature Review
aRenal Program, Grand River Hospital, Kitchener, Ontario, Canada bDivision of Endocrinology & Metabolism, Department of Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada cCorresponding Author: Selina L. Liu, St. Joseph’s Hospital, 268 Grosvenor St, London, Ontario N6A 4V2, Canada Manuscript accepted for publication December 28, 2015 Short title: Late-Onset Metformin-Associated Diarrhea doi: We present a case of late-onset chronic severe painless diarrhea in an 80-year-old man with type 2 diabetes who was on metformin for 5 years. He underwent multiple laboratory and imaging investigations with no underlying cause found. After detailed medication review, a trial of metformin discontinuation resulted in immediate resolution of symptoms. This case highlights the importance of considering metformin as a cause of new-onset diarrhea in patients even if they had previously tolerated the drug well for years, as its discontinuation can potentially prevent patient inconvenience and discomfort associated with unnecessary investigations. Keywords: Metformin; Diarrhea; Late-onset Metformin is a biguanide antihyperglycemic agent that is currently recommended as the initial agent in most patients with type 2 diabetes, based on its efficacy in lowering blood glucose, known long-term safety, and negligible risk of hypoglycaemia or weight gain . It is generally well tolerated, though it is well known to be associated with gastrointestinal side effects (i.e. diarrhea, abdominal pain, and nausea) that usually occur at initiation of therapy. However, less commonly, metformin may cause late-onset diarrhea in patients who previously tolerated it well. Thus, it is important to recognize metformin as a cause of late-onset diarrhea to potentially Continue reading >>
Can Metformin Cause Severe Diarrhea?
Question Originally asked by Community Member Tracey Can Metformin Cause Severe Diarrhea? My mother has Type 2 diabetes and is suffering with severe diarrhea. This is now making her avoid going out because she’s afraid of needing a bathroom all the time. Can anything be done about this? Answer Yes, metformin can cause severe diarrhea, which is needless, because we can easily avoid it. The problem is that our doctors far too often start us with a dose that is far too high and/or increase the dosage far to soon. Metformin is one of the safest drugs that we have for type 2 diabetes as well as having few side effects. It is one of our most powerful drugs and is one of the least expensive too. Please see my article about it and about how to increase the dosage at Metformin Forever. You should know Answers to your question are meant to provide general health information but should not replace medical advice you receive from a doctor. No answers should be viewed as a diagnosis or recommended treatment for a condition. Continue reading >>
What's The Connection Between Diabetes And Diarrhea?
No one wants to talk about diarrhea. More so, no one wants to experience it. Unfortunately, diarrhea is often the body's natural way of expelling waste in liquid form when a bacterial or viral infection, or parasite is present. However, there are other things that can cause diarrhea for everyone, and some things that can cause diarrhea specifically in those with diabetes. Diabetes and diarrhea There are various things that can cause diarrhea. These include: Large amounts of sugar alcohols, such as sorbitol, that are often used in sugar-free products Some medications, such as metformin, a common medication used to treat diabetes In some cases, such as with illness or the use of sugar alcohols, diarrhea does not last for long. It tends to stop once the illness is over or the person stops using sugar alcohols. With metformin, the symptoms can go away with time. Some people in whom the diarrhea does not resolve may need to stop taking the medication, however. Bowel diseases may cause lasting problems for people with these conditions. Diarrhea and other symptoms can be managed or controlled with lifestyle changes such as stress reduction, and medications as needed. People with type 1 diabetes are at higher risk of celiac disease, and should check for this if long-term diarrhea is a problem for them. A long-term complication associated with diabetes that can lead to long-term diarrhea (and constipation) is called autonomic neuropathy. Autonomic neuropathy occurs when there is damage to the nerves that control how the body works. Autonomic neuropathy can affect the nerves that control all automatic bodily functions such as heart rate, sweating, and bowel function. Since diabetes is the most common cause of autonomic neuropathy, people with long-term diabetes complications stru Continue reading >>
Side Effects Of Metformin: What You Should Know
Metformin is a prescription drug used to treat type 2 diabetes. It belongs to a class of medications called biguanides. People with type 2 diabetes have blood sugar (glucose) levels that rise higher than normal. Metformin doesn’t cure diabetes. Instead, it helps lower your blood sugar levels to a safe range. Metformin needs to be taken long-term. This may make you wonder what side effects it can cause. Metformin can cause mild and serious side effects, which are the same in men and women. Here’s what you need to know about these side effects and when you should call your doctor. Find out: Can metformin be used to treat type 1 diabetes? » Metformin causes some common side effects. These can occur when you first start taking metformin, but usually go away over time. Tell your doctor if any of these symptoms are severe or cause a problem for you. The more common side effects of metformin include: heartburn stomach pain nausea or vomiting bloating gas diarrhea constipation weight loss headache unpleasant metallic taste in mouth Lactic acidosis The most serious side effect metformin can cause is lactic acidosis. In fact, metformin has a boxed warning about this risk. A boxed warning is the most severe warning from the Food and Drug Administration (FDA). Lactic acidosis is a rare but serious problem that can occur due to a buildup of metformin in your body. It’s a medical emergency that must be treated right away in the hospital. See Precautions for factors that raise your risk of lactic acidosis. Call your doctor right away if you have any of the following symptoms of lactic acidosis. If you have trouble breathing, call 911 right away or go to the nearest emergency room. extreme tiredness weakness decreased appetite nausea vomiting trouble breathing dizziness lighthea Continue reading >>
What was your first week on Metformin like? Horrendous? Terrible? Filled with waves of nausea? The sickest you’ve felt in your life? Let’s reminisce for a minute: About a dozen years ago, on December 24, I went to the doctor for a routine physical. Are you envious of my holiday plans? This was in the years before Pinterest, so I was carrying on with regular life activities on Christmas Eve morn rather than bedazzling the cap of an Elf on the Shelf. Anyway, at the Christmas Eve check-up, my physician mentioned that he had read promising things about Metformin being used in women with PCOS. We chatted about Metformin for a bit, talked about other PCOS things, finished up the tests, and then I headed to the pharmacy to pick up the prescription. We had our traditional Christmas Eve dinner of ham, funeral potatoes, salad with asparagus and strawberries; rolls, and other delicious items. Breaking with tradition, this year’s Christmas Eve dinner was followed by Metformin for me. After dinner, we read the Christmas story from the Bible, watched a short film depicting the events in Luke 2, read a new Christmas book, and headed off to bed. That’s when the fun began. In sum: Worst Christmas Ever. Pros: Family, friends, gifts, good music, good food. Cons: Visiting the loo every 15 minutes, constant nausea, wanting to curl up in bed and not wake up for days. Public Service Announcement: Do not start Metformin for the first time on the day prior to a major holiday. My first year on Metformin was pretty rough. I felt like I had morning sickness every single day. I had diarrhea and nausea every morning. When I skipped a few doses hoping for relief, my symptoms would be twice as bad when I re-started. Looking back, I’m actually amazed that I kept taking the medication. If I st Continue reading >>
How To Treat Diabetic Diarrhea?
I have a problem that I never see addressed. I've had type 1 diabetes for 36 years and been diagnosed as having diabetic diarrhea. Numerous tests have ruled out all other gastrointestinal problems. Is there any treatment for this problem? Continue reading >>
The Management Of Diarrhea Caused By Metformin
The CDC estimates that there are 26 million Americans living with diabetes. Roughly 90% of those cases are patients diagnosed with type 2 diabetes. With type 2 diabetes, the body loses the ability to make and use insulin properly. The body needs insulin to absorb sugar from the blood to fuel our cells. Without insulin, sugar stays in the blood and the body is left hungry for energy. Over time the sugar builds up and can damage the eyes, kidneys, nerves and heart. Luckily, with good control of type 2 diabetes, through lifestyle changes and medications, these complications can be prevented or slowed. Metforminis an oral medication used to treat type 2 diabetes. It is the first choice drug for all patients with type 2 diabetes.This medication allows the body to use glucose more efficiently. It is inexpensive, it does not cause weight gain and people with diabetes who take metformin live longer than those who don’t. The most common side effect of metformin is diarrhea. Diarrhea caused by metformin will often go away after the first few weeks of therapy, but sometimes it will not. Luckily, there are ways to decrease this side effect. To avoid or minimize diarrhea the dose should start low and be increased slowly by 500mg per week. It may take a month to increase to the correct dose. Starting on a higher dose or increasing the dose too quickly may cause diarrhea. Another alternative is to take the extended release form of metformin. This formulation tends to have less diarrhea associated with it than the immediate release formulation. The extended release formulation also should be started low and increased slowly. Because of the known benefits of metformin, lowering the dose may also be an alternative for patients if higher doses can’t be tolerated. Additionally, taking Continue reading >>
Diarrhea And Metformin In A Diabetic Clinic
In a questionnaire-based survey of 285 randomly selected diabetic patients, diarrhea was found to occur in 8%; this was found to be similar to that in 150 nondiabetic control patients attending other medical clinics (8%). When the diabetic patients were divided into separate therapeutic groups, metformintreated (with or without sulfonylureas) patients had a markedly greater prevalence of diarrhea (20%) than those not on this drug (6%). A majority of patients with metformin-associated diarrhea had soiling of clothes as a problem, while at least two complained of frank loss of control over their anal sphincter. These patients did not have autonomic neuropathy, and in all who stopped this drug, diarrhea settled within 2–5 days. Only 6% of insulin-dependent diabetic individuals (IDD) had diarrhea, one of whom had explosive nocturnal stools with incontinence and features diagnostic of autonomic neuropathy. Metformin is by far the commonest cause of diarrhea and incontinence in our diabetic clinic, where it is used routinely. In contrast, diarrhea due to autonomic neuropathy is rare. The antibody responses to influenza vaccination of a group of adult diabetic patients were compared with responses in a healthy group of regular volunteer vaccinees. The initial and final geometric mean hemagglutination-inhibiting antibody titers were lower in the patient group, but the relative increase in titers was greater for each of the vaccine components. The percentage of fourfold rises in individual titers was greater in the diabetic group than in the control group. It was concluded that patients with diabetes mellitus responded normally to influenza vaccination. This was confirmed in an additional study. There was no significant difference in the antibody responses of patients treated Continue reading >>
Metformin Wonder Drug
A while back I wrote about why metformin is the number one treatment for Type 2 diabetes. Now new research finds metformin prevents cancer and heart disease and may actually slow aging! Where can I get this stuff? A study from Scotland found that people on metformin had only roughly half the cancer rate of people with diabetes who weren’t on the drug. This is important, because diabetes is associated with higher risks of liver, pancreas, endometrial, colon and rectum, breast, and bladder cancer. Nobody could explain how metformin helped, but then Canadian researchers showed that metformin reduces cell mutations and DNA damage. Since mutations and DNA damage promote both cancer and aging, this is striking news. No one thought we could limit mutations before, but perhaps metformin can do it. A study on mice exposed to cigarette smoke showed that those given metformin had 70% less tumor growth. A small study of humans in Japan showed similar improvements in colorectal cancer outcomes. Metformin is now being studied in clinical trials for breast cancer. The researchers write, “Women with early-stage breast cancer taking metformin for diabetes have higher response rates to [presurgical cancer therapies] than diabetic patients not taking metformin.” They also had better results than people without diabetes. How Does It Work? According to Michael Pollak, MD, professor in McGill’s Medicine and Oncology Departments, metformin is a powerful antioxidant. It slows DNA damage by reducing levels of “reactive oxygen species” (ROS). ROS are produced as byproducts when cells burn glucose. Just as oxygen helps fires burn or metals rust, ROS will oxidize (“burn” or “rust”) the nuclei or other parts of cells. ROS are what the antioxidant vitamins are supposed to block. Continue reading >>
What Can I Use To Slow The Diarrhea That Metformin Causes
what can i use to slow the diarrhea that metformin causes Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. what can i use to slow the diarrhea that metformin causes in my October 31st blood test my A1C went from 6.4 to 6.9 which average out to a daily average of 150. my doctor raised my dosage of metformin from one 500mg extended release pill taken after dinner to one 500mg extended release pill after lunch AND one after dinner. total 1000 mgs a day. since i started taking meformin back in may of this year. every other day i come down with very bad diarrhea. i go 5-6 times in an hour and very watery. i have very bad hemorrhoids,and they tend to break and there is a bit of blood on the tissue paper. this worries me greatly. somedays i feel i cant stop going i am told that some people who take this medication find some relief in the drug "immoduim AD" could you please tell me when you take this drug metformin what you do to manage the diarrhea? what medication helps you manage the effects of having diarrhea. In my experience the diarrhea will go away after about a month. One drug that is available here is imodium & it is very good for stopping it. In my experience the diarrhea will go away after about a month. One drug that is available here is imodium & it is very good for stopping it. I feel your pain. After a year and a 3 months, it is better for me. I use the Pink Stuff. When I was dx in May my endo put me on metformin er 1000 mg at breakfast and dinner, 1mg of glimepiride at breakfast. I had the same problems as you do now. After a month I told my endo and he change my dose to Metformin er 500mg at both breakfast and dinner and glimepiri Continue reading >>
Managing The Metformin Side Effect Of Diarrhea
In working with patients, the metformin side effect of diarrhea can be a real challenge. As a healthcare professional, I understand how beneficial it can be for some patients to be on metformin. It has a lot of great attributes for a diabetes medication. It can help with weight loss as well as not cause hypoglycemia like some other agents. It also comes at a low cost compared to some of the newer agents for diabetes. The major downside with metformin is that it can have a substantial incidence of diarrhea and/or other GI side effects. Managing these appropriately can help keep your patients on metformin and avoid the use of agents that cause weight gain, hypoglycemia, or cost a lot of money. Here’s a few thoughts on how to manage the metformin side effect of diarrhea. Take with food. If patients aren’t doing this and are having GI side effects, I encourage patients to give this a shot prior to calling it quits with metformin. Try the extended release product. The extended release product has a much lower incidence of GI side effects. Reduce the dose. Reducing the total daily dose is a potential option here. We may have to add an additional medication in this situation, but remaining on some metformin can help reduce the need for other medications. Change the timing. If patients are having trouble at a specific time of day, make sure the metformin dose and timing is reviewed. Maybe shifting 500-750 mg to a different time of day could help reduce adverse effects. Change medication. For those patients who continue to have diarrhea despite some of the above changes, sometimes the only thing we can do is change to another medication altogether. Do you have any tips or strategies for helping your patients remain on metformin? Love the blog? Get a free gift simply for foll Continue reading >>