Diabetes is a major health problem, affecting over 23 million Americans, according to the American Diabetes Association. Type 2 diabetes accounts for approximately 90 to 95 percent of the cases and is characterized by insulin resistance resulting in elevated blood sugar levels. Metformin is one medication intended to help people with type 2 diabetes control their blood glucose levels.
Indications
Metformin is an oral diabetes medication indicated to control blood glucose (sugar) levels in individuals with type 2 diabetes. It is not intended for individuals with type 1 diabetes. Metformin is available in tablet form and can be used by both children and adults. The drug can be used alone or in combination with other drugs to control the amount of glucose in the blood.
Side Effects
It is important to monitor changes in blood sugar levels while taking metformin and to know the symptoms associated with hyperglycemia (high blood sugar levels) and hypoglycemia (low blood sugar levels). Less serious side effects associated with metformin include headache, weakness and mild cases of nausea, diarrhea and vomiting. Severe side effects can occur, and medical attention should be sought if they arise. These include severe hypo- or hyperglycemia, swelling or rapid weight gain, fever and flu-like symptoms, or lactic acidosis, a dangerous condition in which too much acid is in the blood and tissues of the body.
Dosage and Administration
Metformin is available as a tablet and as an extended-release tablet to be administered orally. The tablet should not be chewed, crushed or split open. It is most often prescribed to be taken two to three times per day with meals. The extended-release tablet is taken once per day with an evening meal. It is common to start with a low dose of the medication, which is gradually increased every one to two weeks to determine the therapeutic dosage needed.
Warning
Lactic acidosis, a serious and life-threatening condition, can arise while taking metformin and is more likely in individuals with congestive heart failure or in older adults. Medical attention should be sought if the signs and symptoms of lactic acidosis arise, which include malaise, increased sleepiness and slow heart rate, cold feeling, shortness of breath, fainting or stomach pain. Individuals with kidney disease or failure should not take metformin, nor should those allergic to any substance in the drug. Individuals with liver disease or a history of heart disease should inform their doctor before taking metformin.
Mechanism of Action
Metformin belongs to a class of medications referred to as antihyperglycemic agents. It lowers both basal--minimum healthy level--and postprandial--or after meal--blood glucose levels. It works by decreasing the amount of glucose produced by the liver, by decreasing the absorption of glucose in the intestines and by increasing the sensitivity of insulin, so the body uses the sugar from food more effectively.
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