Source: Dr. Li of the Department of Obstetrics and Gynecology talks about health
Disclaimer: The copyright of this article belongs to the original author, if there is a source error or infringement of your legitimate rights and interests, you can contact us, we will deal with it in time.
Type 2 diabetes has become a common topic in our lives, and it is like a common occurrence. When it comes to treating diabetes, there is an old brand of drug - metformin, which can be said to be a household name.
If this drug is used well, it is like a "talisman" for diabetics, but if it is not used properly, the consequences are not a joke. We have to keep our eyes open, we can't take it seriously!
1. The core value and mechanism of metformin
Metformin, a drug that not only lowers blood sugar, but also can be used in many ways, and the effect is not inferior to those new first-line drugs, such as SGLT2 inhibitors (commonly known as "gliflozin") and GLP-1 receptor blockers that you may have heard of.
The benefits of metformin are not only in lowering blood sugar, it can also bring cardiovascular protection, and there are even studies that say that people who take metformin for a long time can also prevent dementia, improve metabolism, and prolong life!
However, knowing that metformin is good is not enough. The important thing is that we know how to use it. The first thing is to choose the dosage of medication.
When you first start taking this medicine, your doctor will generally tell you to start with a dose of 500mg and take your time. Don't worry, give the body a process of adaptation. After two weeks, if blood sugar control is not satisfactory, a higher dose may be considered, but the upper limit is 2000 mg.
There is a lesson here, although the effect of lowering blood sugar is better when increasing the dose, your stomach may not be able to stand it and have an uncomfortable reaction.
To find a dose that can control your blood sugar while making your body comfortable, you need to communicate with your doctor to find the right balance.
2. The importance of choosing the correct metformin dose
You may ask, why is the dosage so important? because, although metformin is good, it is also a drug, and the drug has side effects. Especially for those who are new to metformin, the body's acceptance of this drug may vary.
Starting with a large dose may cause you some unnecessary troubles, such as gastrointestinal adverse reactions, which is a problem that many people encounter when taking metformin.
However, if your blood sugar is well controlled, or you have gradually adjusted to the current dose and have not experienced any discomfort, then you may be able to control your blood sugar better by increasing the dose.
Of course, the most important thing in this process is to pay close attention to your body's reaction and maintain close communication with the doctor.
If you find that glycemic control is suboptimal even with tolerated doses of metformin, you may need to consider adding other glucose-lowering drugs.
3. The "2 wants" in the use of metformin
1. Regular monitoring of liver and kidney function
We have to be cautious about this. Metformin is good, but it can cause lactic acidosis, which can be a serious side effect, in the setting of liver and kidney insufficiency.
Therefore, it is particularly important to check the liver and kidney function regularly. This is highlighted in the guidelines of the International Diabetes Federation (IDF) and other authoritative bodies.
Especially for those friends whose liver and kidney function is already a little unsatisfactory, before using metformin, it must be carefully evaluated by a doctor.
2. Pay attention to vitamin B12 supplementation
This is also a headache. Long-term use of metformin may lead to a decrease in the absorption of vitamin B12, and over time, vitamin B12 deficiency may occur, which can lead to various problems such as anemia, neurological problems, etc.
One study showed that about 10%-30% of diabetic patients who used metformin for a long time developed vitamin B12 deficiency. Therefore, it is necessary to check the level of vitamin B12 regularly and supplement it at the right time.
4. "3 Don'ts" when using metformin
1. Don't stop taking the medicine casually
Some friends may take it upon themselves to stop taking the drug for various reasons, such as feeling that their blood sugar is well controlled, or they are worried about side effects.
However, stopping the drug on your own without your doctor's consent may lead to a rebound in blood sugar and even more serious consequences. One study showed that people with diabetes who stopped metformin abruptly had an increased risk of cardiovascular disease.
2. Don't overlook the importance of life conditioning
At this point, we need to remind and remind. Some friends may think that everything will be fine after eating metformin, and they can eat and drink as much as they want. But in reality, although metformin is effective, it is not a substitute for a healthy lifestyle.
A balanced diet and moderate exercise are very important for blood sugar control. Studies have shown that metformin, combined with a healthy lifestyle, can significantly improve the hypoglycemic effect of metformin.
3. Don't rely on metformin alone to lower blood sugar
Although metformin is an important drug for the treatment of diabetes, sometimes metformin alone may not achieve the desired glycemic control goals. At this time, it is necessary to consider the combination of drugs.
Depending on the patient's situation, your doctor may recommend the addition of other types of glucose-lowering drugs, such as SGLT2 inhibitors or GLP-1 receptor agonists, to achieve better blood sugar control. This personalized treatment plan has been supported by a growing number of clinical studies.
5. Understand the potential side effects of metformin
While metformin is considered the drug of choice for the treatment of type 2 diabetes, it is not without side effects. The most common side effects include gastrointestinal reactions such as nausea, diarrhea, bloating, and occasional stomach pain.
For most people, these side effects lessen over time. However, for a small percentage of people, these side effects may persist, severely affecting quality of life.
In addition, although rare, metformin can also cause lactic acidosis, a serious medical emergency that requires immediate treatment.
6. Personalized medication: Not everyone is suitable for metformin
Although metformin is suitable for most people with type 2 diabetes, it is not suitable for everyone. For example, for those with severe kidney disease, severe liver dysfunction, or heart failure, metformin may not be a good option.
In addition, patients who are preparing for imaging tests (using iodine-containing contrast media) also need to temporarily discontinue metformin to avoid potential side effects.
Therefore, before starting metformin, the doctor will assess the patient's overall health to ensure that the medication is suitable for the patient.
7. Drug interactions: the relationship between metformin and other drugs
While metformin is being used, patients may also need to take other medications to treat diabetes or other complications. This requires both physicians and patients to be vigilant for possible drug interactions.
Some medications may affect the effectiveness of metformin and vice versa. For example, certain diuretics and blood pressure medications may increase the risk of lactic acidosis, while certain antibiotics may affect blood sugar levels and require the dose of metformin to be adjusted.
Therefore, when using any new medication, be sure to inform your doctor that you are taking metformin.
8. Handling of emergencies
Although rare, patients should seek medical help immediately if symptoms of lactic acidosis, such as muscle pain, shortness of breath, coma, etc., occur. In such cases, timely diagnosis and treatment are crucial.
Similarly, if a patient needs to temporarily stop metformin for some reason (eg, surgery, severe infection), they should discuss it with their doctor in advance to ensure that their blood sugar is kept within a safe range.
summary
Although metformin is an effective drug for the treatment of type 2 diabetes, there are many details that need to be paid attention to during use.
Understanding the potential side effects of metformin, assessing an individual's suitability for metformin, being aware of drug interactions, and prompt handling of emergencies are all important factors in ensuring that medication is safe and effective.