Metformin Side Effects and Why They Occur

Metformin is one of the medications that, despite the passage of time (in use for 60 years), is still a recommended option for the treatment of Diabetes. Metformin is a biguanide drug used to control Type 2 Diabetes because it can lower blood glucose, lower levels of bad cholesterol or LDL and circulating triglycerides in the blood, promote weight loss and help prevent cardiovascular disease associated with Diabetes. History of Metforminr Galician officinalis also known as goat rue was used in the medieval times to reduce frequent urination and as a remedy in plague epidemics. In the late 1800s, it was seen to be rich in guanidine and its structure was confirmed in 1923. However, guanidine was too toxic for clinical and agricultural use. Later works by Parturier and Hugonot in 1937 confirmed the antidiabetic properties of Galician officinalis. In 1957 Metformin was studied for antidiabetic properties in Paris and Phenformin was studied that same year in the United States. In 1977 phenformin and metformin were removed from the market due to the increased number of deaths noticed with the use of phenformin due to lactic acidosis. Sadly the pharmacokinetic differences between phenformin and metformin were not considered at that time. In 1968 and 1977 metformin was found to have similar efficacy as sulfonylureas. In 1995 metformin’s advantage was rediscovered and it entered the market eventually becoming the first drug of choice for all type 2 diabetes patients in 2012. What Are the Benefits of Metformin? The main function of metformin is to reduce the production of glucose in the liver, it helps muscle tissue to make better use of glucose as well as the effect of insulin produced in the body. In addition, other benefits of this drug have been discovered that are not necessarily linked to Diabetes, but with problems such as obesity: it helps reduce cholesterol and triglycerides levels, as well as regulate appetite and in some cases which serve to lower weight. Metformin is a very good choice of drug for overweight diabetes patients who can’t control their diabetes and weight with dieting alone. This is because it helps reduce morbidity associated with excessive weight gain and cardiovascular problems in diabetes. Sulfonylureas are not much of a choice in overweight diabetics because they cause weight gain. What Happens in Your Body When You Take Metformin? 1. Metformin is absorbed after taking 1 or 2 tablets in the gastrointestinal tract, mainly in the small intestine. 2. It travels through the blood to all tissues. 3. Reduces blood sugar levels when it reaches the liver, since metformin slows the rate of liver glucose production. 4. The liver increases the intake of glucose from the bloodstream to convert it into an energy reserve. 5. It decreases the levels of free fatty acids which contributes to improving the functioning of the pancreas in the secretion of insulin. 6. It helps in the binding of insulin with its cellular receptors and it increases the sensitivity of cells to insulin, which favors the entry of sugar from food into cells. 7. Allows muscles and fat cells to pick up and use glucose better. 8. Reduces tiredness, thirst, and excessive hunger, as well as the constant urge to urinate caused by diabetes this because there is no excess blood glucose. 10. Metformin is removed after 8 to 12 hours, so another dose should be taken. However, metformin needs the presence of insulin to elicit its antihyperglycemic effect. How does Metformin Help You Lose Weight? Metformin has been scientifically known not to be associated with weight gain and hence is the drug of choice in overweight patients as sulfonylureas are seen to cause weight gain. Metformin has also been claimed by some people to cause lose weight and has been taken by some non-diabetic people for these effects. These are the reasons why metformin may promote weight loss: • It reduces blood sugar levels, when it reaches the liver, as it slows down the rate of production of hepatic glucose. • It allows muscles and fat cells to better capture and use glucose. • Metformin decreases insulin resistance, which means that the patient will be less eager for food, especially carbohydrates, thus reducing the consumption of this type of food and therefore low weight. • It also reduces the absorption of glucose by the intestines. All this will lead to increased utilization and reduction of blood sugar and reduce the amount of calories stored in the body from carbohydrates. However, this does not happen by magic, because you also need a proper diet. Likewise, it can only be consumed by prescription and under strict medical supervision. Since undesirable metformin side effects could also arise. Metformin Side Effects Metformin is majorly used to treat diabetes. However, like all medicines, metformin may have certain side effects that may affect each person differently, although they are not very common. It should be noted that some side effects are beneficial while others are adverse. Some of the side effects are more common as they affect one in ten people who take it. These include nausea, diarrhea, vomiting, abdominal pain and loss of appetite (anorexia). Another less common adverse effect as it affects one in every hundred people is a variability in the sense of taste, generally a metallic taste. One beneficial side effect of metformin is weight loss which has made it useful for obese diabetic patients and even some non-diabetic obese people. Unusual Reactions When Taking Metforminr Other effects, very rare (occurring in 1 in 10,000 people): elevated levels of lactic acid in the blood which is called lactic acidosis. Others are skin reactions, irritation, and itching, difficulty absorbing vitami B-12 (taking long-term metformin). If you have taken metformin and begin to experience difficulty breathing, lethargy, dizziness, and confusion, you should consult your doctor as soon as possible, as these are symptoms of lactic acidosis, a serious and potentially fatal condition that, although rarely, may be caused by metformin. Although this condition is more common in other biguanides like phenformin and buformin which led to their withdrawal from the market. What makes lactic acidosis less common in metformin is its pharmacokinetic profile which makes it easily excreted by the kidney mostly unchanged, unlike other biguanides which go through the liver first and cause extreme lactic acid build up. Other Uses of Metforminr Hyperinsulinism (excessive insulin production) is thought to play a role in abnormal androgens production seen in polycystic ovary syndrome (PCOS). Hyperinsulinism can be caused by negative feedback caused by resistant cells. Resistance to insulin or any hormone by the body cells will send signals to the brain to release more of those hormones which can lead to over-secretion. Metformin increases the sensitivity of the body cells to insulin hence sending signals to the brain not to produce more insulin than necessary. This helps in reducing excess androgen production and thereby helps treat PCOS. Taking metformin with clomiphene has been found to be useful in the treatment of PCOS and increasing fertility and possibly reducing the chances of spontaneous abortions during pregnancy in women with PCOS.