Metformin is a medication that is commonly prescribed to help control blood sugar or glucose levels in individuals with type 2 diabetes. The Mayo Clinic underlines that metformin has three primary actions that benefit patients with adult-onset or type 2 diabetes. This medication slows the absorption of food carbohydrates from the intestines to decrease the blood glucose levels. Secondly, it reduces gluconeogenesis or the production of glucose by the liver, which also lowers blood glucose. Thirdly, metformin helps to improve the sensitivity of the cells of the body to the hormone insulin, which is essential to ferry glucose from the blood to the tissues and muscles. As with all medications, metformin can cause side effects, some of which may be severe in rare cases.
Low Blood Sugar
Metformin can cause hypoglycemia or low blood glucose, as noted at Drugs.com. This usually occurs in cases where the individual has taken too much metformin, is eating too little, drinking alcohol or is exercising excessively. It may be also occur if metformin is taken with another diabetes medication. It is important to recognize and treat symptoms as severe hypoglycemia can lead to fainting, loss of consciousness, coma and even death. Symptoms will vary between individuals but may include dizziness, lightheadedness, weakness, drowsiness, tiredness, anxiety, nervousness, blurred vision, cold sweats, nausea, vomiting, nightmares, restless sleep and slurred speech.
Lactic Acidosis
Long-term use of metformin or too much medication can cause lactic acidosis, a condition in which the pH or acidity of the blood becomes too low. This rare metabolic complication is rare but fatal in almost 50 percent of patients that have lactic acidosis according to the site MedSafe.gov. Diabetic patients that also have heart, liver or kidney disease are at higher risk for this potentially deadly side effect. Symptoms of lactic acidosis are usually severe and occur rapidly and may include fast, shallow breathing, a slow, irregular pulse, a feeling of weakness, unusual sleepiness, muscle pain, severe muscle pain and cramping, diarrhea and severe vomiting. Lactic acidosis requires immediate medical attention at an emergency room.
Vitamin B12 Deficiency
The medication metformin can interfere with a chemical in the stomach called intrinsic factor that is essential for the body to absorb vitamin B12 from food. This causes B12 malabsorption that can pose a significant health risk over time. The Mayo Clinic underlines that vitamin B12 is an essential nutrient that has several functions in the body including DNA and red blood cell synthesis and healthy cell development. Severe vitamin B12 deficiencies can lead to megaloblastic anemia, which occurs when the bone marrow does not have an adequate supply of vitamin B12 to produce normal, healthy red blood cells. Individuals who already have low B12 and folic acid levels are at higher risk of a vitamin B12 deficiency due to metformin.
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