Metformin Flashcards

1
Q

Does Metformin cause hypoglycaemia and weight gain?

A

No.

Sulphonylureas (Gliclozide) cause does.

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2
Q

What other two conditions is Metformin used in apart from T2DM?

A
  1. PCOS
  2. Non-alcoholic fatty liver disease.
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3
Q

What is the mechanism of action of Metformin?

A
  1. Increases insulin sensitivity
  2. Decreases hepatic gluconeogenesis
  3. Reduces gastrointestinal absorption of carbohydrates.
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4
Q

What are some adverse effects of Metformin?

A
  • GI upset iscommon - about 20% of patients.
  • Reduced B12 absorption.
  • Lactic acidosis with severe liver or renal disease (rare but common exam question.)
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5
Q

What are some contraindications for using Metformin?

A
  1. CKD
    • If creatinine >130umol/l or eGFR <45ml/min it should be reviewed.
    • Stop if >150 umol/l or eGFR <30ml/min.
  2. Lactic acidosis can occur when there are periods of tissue hypoxia. (e.g. MI, sepsis, AKI, severe dehydration)
  3. Iodine-containing x-ray contrast media - stop on the day of the procedure and 48 hours afterwards.
  4. Alcohol abuse - a relative contraindication.
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