Mechanism of Metformin:
It is a medication used to lower or reduce blood glucose levels. So, it is not only used for diabetic patients but can also be used for other patient populations as well including patients with polycystic ovary syndrome. It lowers blood glucose levels by several mechanisms.
One of them is by inhibiting gluconeogenesis in the liver. Another one is by inhibiting glucose uptake from the gastrointestinal system, and then another one is by increasing insulin sensitivity. So by these three mechanisms, it can reduce blood glucose levels. Now the problem here is that Metformin may cause a variety of mild and or severe side effects.
Side effects from Metformin use:
The continuous use of the medication can cause: following side effects:
- Flatulence.- use of medicine increase gas and bloating.
- Constipation - this is going to be less common than diarrhea but it can happen in certain patients Nausea and vomiting.
- Abdominal pain
- Lactic acidosis
- Fatigue
- Headaches
- Respiratory distress-upper respiratory tract infections include respiratory tract infections above the larynx so which means that these are going to be infections in the nose and in the throat.
- Myalgia - it is muscle aches and pains.
- Heartburn and dyspepsia
- Diaphoresis-which is excessive sweating.
- Muscle weakness - also known as asthenia.
- Acid reflux in epigastric pain and chest discomfort may also occur.
- Orthostatic hypotension means that if someone is going from sitting down to standing up very quickly they can have a drop in their blood pressure, which can cause them to feel dizzy.
- Taste changes - oftentimes a patient will describe a metallic taste in the mouth when they're on Metformin or they may also have a sensation or taste of acid or sour taste in their mouth which may be related to the heartburn.
- Rhinitis- it is an inflammation of the nose and this can lead to a runny nose and nasal congestion. But this is a rare or uncommon side effect.
- Diarrhea-It occurs in a dose-dependent manner - so oftentimes, Metformin is start at a lower dose, patients will get diarrhea, and then diarrhea will subside, that side effect will go away, and then the patient's primary care provider will increase the dose of Metformin to a higher dose, and then the patient will get diarrhea again and then that diarrhea will subside until the therapeutic dose is reached.
Long-term side effect of Metformin:
Vitamin b-12 deficiency is associated with long-term use of Metformin so a lot of times patients will get on Metformin for their diabetes control, and they'll be on it for a long period of time. But the longer they are on Metformin the more chances that they will become vitamin b12 deficient. So because of this, they are susceptible to getting signs and symptoms of vitamin b12 deficiency these include macrocytic anemia, anemia, where the red blood cells are bigger in size, fatigue, and depression, which are some symptoms that can occur with vitamin b12 deficiency.
There are some neurological symptoms from vitamin b12 deficiency including peripheral neuropathy. Neurological symptoms from vitamin b12 deficiency are very important to recognize because they can become irreversible if this is not treat properly. So these neurological symptoms include peripheral neuropathy but some other symptoms as well including postural stability, two-point discrimination issues, and some other symptoms as well.
In very rare circumstances especially when Metformin is use with other diabetes medications or after excessive alcohol consumption, a person may experience hypoglycemia.
How is most likely to develop the side effect of metformin?
Metformin causes side effects in those patients who have:
- Liver disease,
- Kidney disease,
- Heart disease,
- Myocardial infarction,
- A heavy alcohol consumer,
- Have a previous allergic reaction to Metformin.