Facts and fallacies about metformin

As one of the medications frequently prescribed for metformin, many of my patients have already heard about this drug when I mention it during clinic visits. Unfortunately, sometimes the information they come across is inaccurate or “fake news.”

One such misleading article says that metformin in bad for you and that it is no longer being prescribed by doctors. Contrary to the article, I still prescribe metformin on a regular basis for my patients, a medication that continues to save lives by helping control diabetes. Many of these articles end with a sales pitch at the end, selling some so-called “miracle” drug for diabetes which is not proven to work, and may even be harmful.

Many patients ask, “Doc, ‘di ba nakakasira ‘yan ng kidney?” The truth is that metformin does not damage the kidneys; it’s uncontrolled diabetes that can cause that. But when the kidneys are not functioning well, metformin can accumulate in the body and this can lead to toxic effects. Patients with worsening kidney function are taken off metformin because of the possibility of toxicity, and this has led to the common misconception that the metformin may have been the reason for the kidney failure. Neither does metformin cause liver damage or cancer.

Photograph courtesy of PEXELS/SORA SHIMAZAKI
One of the common side effects of taking metformin is an upset stomach.

Metformin has been in use since the 1950s and after proper diet and exercise, it is one of the first medications prescribed for patients with Type 2 diabetes mellitus, where patients cannot use insulin properly. Metformin helps your body make better use of the insulin produced by the pancreas, and regulates the release of stored glucose from organs like the liver. Metformin can also be used in combination with other oral medications and insulin for better diabetes control.

When starting metformin, common side effects are stomach upset, nausea, and soft bowel movements. These symptoms usually go away after a few days, but if they persist let your doctor know so you can be advised on how to adjust your medication. One way to reduce these symptoms is to start with a low dose, with a gradual increase in the dose over days to weeks. Taking the medication after a meal can also help. It is also very rare to have low blood glucose with just metformin.

photograph courtesy of DIABETES TALK
METFORMIN is a medication usually prescribed for people with diabetes.

Only take metformin if it has been prescribed for you by your doctor, and keep taking your medication regularly. Metformin should not be used if you have advanced kidney or liver disease, or in instances of dehydration or severe illness that requires hospitalization. Doctors request for lab tests be done regularly (usually every three months) to monitor not only your diabetes control, but also liver and kidney function to ensure that metformin is still safe for you to take.
When it comes to your health don’t believe everything you read or hear. Talk to your doctor to confirm that you are taking medication that is right and safe for you.

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