Type 2: Biguanides - metformin

Question 1

What is the first line treatment for type 2 diabetes

Answer 1

Metformin

Question 2

What is the MOA

Answer 2

Works by increasing peripheral utilization of glucose

Question 3

Does it cause hypoglycaemia?

Answer 3

No

Question 4

How should dose be increased?

Answer 4

Slowly to prevent side effects (OD-BD-TDS)

Question 5

If normal treatment is not tolerated, what should be done?

Answer 5

Offer MR

Question 6

What can metformin also treat?

Answer 6

Polycystic ovary syndrome

Question 7

Should it be taken with food?

Answer 7

Yes, with or after food

Question 8

Can it be used in pregnancy?

Answer 8

Yes

Question 9

Does it cause weight loss or weight gain

Answer 9

Weight loss

Question 10

What are some side effects of it?

Answer 10

GI side effects

Abdominal pain

Appetite decreased

Taste altered

Lactic acidosis

VIT B12 deficiency

Nausea

Question 11

What egfr should it be stopped in

Answer 11

Below 30 because renal failure increases risks of lactic acidosis

Question 12

Signs of lactic acidosis

Answer 12

-Dyspnoea (difficult/laboured breathing)

• Muscle cramps
• Abdominal pain

-Hypothermia

• Asthenia (weakness/lack of energy)