oral hypoglycaemics (metformin)

Question 1

Indications of metformin?

Answer 1

diabetes, polycystic ovary syndrome

Question 2

Contraindications of metformin?

Answer 2

acute metabolic acidosis

Question 3

First and second line treatment with oral hypoglycaemics

Answer 3

metformin is first line treatment for type 2 diabetes in children and adults, second line treatment for adults is DPP-4 inhibitors, sulfonylureas or pioglitazone

Question 4

What is the mechanism of action of metformin?

Answer 4

increases the transport capacity of all membrane glucose transporters. reduces hepatic glucose production by inhibiting gluconeogenesis and glycogenolysis. works in the muscle, increasing insulin sensitivity improving peripheral glucose uptake and utilisation. delays intestinal glucose absorption

Question 5

Common side effects of metformin?

Answer 5

abdominal pain, anorexia, nausea, vomiting, diarrhoea, taste disturbance

Question 6

Monitoring requirements for metformin?

Answer 6

determine renal function before and monitor annually

Question 7

Treatment cessation of metformin

Answer 7

none

Question 8

Patient and carer advice for metformin

Answer 8

should be taken with food. inform of the risk of lactic acidosis and advise to seek medical attention if they experience symptoms such as dyspnoea, muscle cramps, abdominal pain, hypothermia or asthenia