Metformin

Introduction:

Metformin is also known as a biguanide that reduces blood glucose levels by reducing the amount of glucose generated by the liver and increasing insulin absorption by muscle tissue. Metformin has traditionally been used to treat high blood sugar in people with type 2 diabetes, but a new study suggests that it could be used to treat a variety of other illnesses.

Marcio Griebeler, MD, an endocrinologist at the Cleveland Clinic in Ohio, explains, “It’s primarily a medicine for the treatment of diabetes.” “Several studies have shown that metformin helps reduce long-term diabetic consequences such as cardiovascular events and mortality, myocardial infarction, heart failure, arterial revascularization, stroke, and death.”(Luo et al., 2020)

According to the Mayo Clinic, metformin was first made available in the United States in 1995, and it is now the most often prescribed medicine to treat type 2 diabetes worldwide, according to a report published in JAMA Insights in April 2019. According to a JAMA report published in March 2017, diabetes healthcare professionals regard metformin to be “the medicine of choice for initial treatment of type 2 diabetes.”(Flory & Lipska, 2019) 

Health benefits:

Metformin is treated high blood sugar, but researchers have discovered that it offers a slew of other health benefits for those with type 2 diabetes, including:

Cancer: While using metformin, participants had a 62 per cent lower risk of pancreatic cancer, according to a study published in Gastroenterology. The treatment could also help inhibit the spread of cancer cells in the colon, breast, ovarian, prostate, and lung, according to the study, possibly due to its antioxidant effect.(Li et al., 2009)

Colon cancer: Metformin has been demonstrated to be beneficial in the prevention and treatment of colorectal cancer in multiple studies. Diabetic patients with colorectal cancer who take metformin have a higher overall survival rate(Kheirandish et al., 2018).

Prostate cancer: Metformin, when combined with standard chemotherapy, decreased cancer progression in rats with prostate cancer, according to a new study. This could suggest that metformin can help with androgen restriction medications like Lupron in the treatment of prostate cancer in people.(Liu et al., 2018)

Ovarian cancer: Metformin has been demonstrated to have anti-tumour properties when used to treat ovarian cancer.

Enhance gut bacteria: Metformin has been found to have an effect on the gut microbiota, which live in our intestines, according to recent research. Many people feel that metformin aids weight loss by modifying the composition of gut bacteria.(8 Surprising Benefits of Metformin Besides Treating Diabetes – GoodRx, n.d.)

Dementia: According to a study, metformin can lessen the incidence of dementia, which patients with type 2 diabetes are at risk of developing. Alzheimer’s disease is the most common type of dementia, accounting for 60 to 80 per cent of cases.(Cheng et al., 2014)

Heart Issues: A study performed showed that Metformin helps protect against coronary events and heart failure; Griebeler adds, “Metformin can also improve [one’s] cholesterol profile.” As per the Centers for Disease Control and Prevention (CDC), diabetics are two times more chances to die than non-diabetic. (Nesti & Natali, 2017) 

Macular Degeneration as a Result of Age (AMD) Metformin has the ability to improve your vision. According to the National Eye Institute, diabetic treatment may reduce the incidence of AMD by 58 per cent. AMD, a common cause of blindness among adults aged 50 and older. Metformin, but not other drugs (such as DPP-4 inhibitors, SSRIs, antidepressants, and statins), was found to be related to a lower risk of AMD development in the study(Brown et al., 2019).

Improves male fertility:Males with diabetes who take metformin have better sperm motility and reproductive function. In addition, incubation of sperm with metformin following cryopreservation improves their ability to fertilize eggs (freezing during sperm donation).(Ferreira et al., 2015)

Improves female fertility: Adding metformin to clomiphene improves the likelihood of women with unexplained infertility conceiving in patients with polycystic ovarian syndrome (PCOS) conceiving when compared to clomiphene alone.(Clomiphene Prices, Coupons & Savings Tips – GoodRx, n.d.)

Without diabetes: Osteoarthritis Metformin can assist persons with obesity and osteoarthritis, according to a study The researchers discovered that taking metformin reduced the probability of needing a total knee replacement, which is a possible complication of this health condition., https://pubmed.ncbi.nlm.nih.gov/31126352/

Alzheimer’s disease is a destructive brain disease that affects people Metformin improved executive function skills, learning. According to a study involving 20 participants without type 2 diabetes. However, because the randomized, controlled experiment was brief (only eight weeks) and small (only 21 participants), more research is required. (Koenig et al., 2017)

Obesity According to the Mayo Clinic, metformin has been demonstrated to help patients with type 2 diabetes lose weight, so researchers wanted to test if the results were the same in people who didn’t have diabetes. “Some study has shown that putting people on metformin who don’t have diabetes but are overweight helps them lose weight(Type 2 Diabetes: 8 Steps to Weight-Loss Success | Everyday Health, n.d.).

Metformin was given to 154 patients who did not have diabetes for six months a study Researchers discovered that the medicine helped overweight and obese persons with insulin resistance by boosting their sensitivity to the hormone. Participants in the study shed an average of roughly 13 pounds (lbs). But insulin resistance raises the chance of gaining weight.(Ning et al., 2018)

Arthritis: Metformin can protect bones and reduce inflammation, according to a study published in Reviews.(Rajaei et al., 2018)

PCOS According to a study, metformin can help stimulate ovulation in nonobese women with PCOS, which, like type 2 diabetes, involves insulin resistance. “Diabetes does not cause PCOS, but those who have PCOS are more likely to get diabetes,” Besser explains. She’s treated folks with PCOS with metformin, and a handful of them became pregnant after starting the medication. Metformin can also help women with PCOS get pregnant, according to the Mayo Clinic(Johnson, 2014).

Side-effects

1.Metformin must be used on a long-term basis. This may make you think about the possible adverse effects. Metformin can have both mild and severe adverse effects in both men and women. 

2. Metformin has a number of adverse effects. These can happen when you first start taking metformin, but they generally pass. If any of these symptoms are bothersome or severe, consult your doctor.

3. The following are some of the more prevalent metformin adverse effects:Heartburn, stomach ache, vomiting or nausea, Bloating, Gas, Diarrhoea, Constipation, slimming down, Headache, a metallic taste in the tongue

4. When patients first start taking metformin, nausea, vomiting, and diarrhea are some of the most prevalent side effects. These issues normally fade away with time. Metformin can be taken with a meal to lessen these side effects.

Serious effects:

Lactic acidosis:

Lactic acidosis is the most significant yet rare adverse effect of metformin. Metformin, in fact, comes with a “boxed” — often known as a “black box” — warning regarding this danger. The Food and Drug Administration (FDA) gives a boxed warning as the most severe warning.

Lactic acidosis is an uncommon but serious condition that can develop as a result of a buildup of metformin in your system. It’s a medical emergency that requires immediate hospitalization, extreme exhaustion, weakness, reduced appetite, nausea, vomiting, difficulty breathing, and dizziness, a rapid or slow heart rate, lightheadedness, muscular ache that is cold, stomach ache with any of these other symptoms such as flushing or rapid reddening and warmth in your skin

Anaemia: 

Metformin can lower the vitamin B-12 levels in your body. Anaemia can occur in uncommon instances. If you don’t get enough vitamin B-12 or calcium in your diet, you’re more likely to have very low levels of vitamin B-12.

If you stop using metformin or take vitamin B-12 supplements, your vitamin B-12 levels may improve. Do not discontinue taking metformin without first consulting your physician.

The following are some of the more prevalent anaemia symptoms:

Tiredness, dizziness \slightheadedness

Make an appointment with your doctor to get your red blood cell levels checked if you suspect you have anaemia.

Hypoglycemia:

Metformin does not produce hypoglycemia or low blood sugar levels when taken alone. If you use metformin with the following medications, you may experience hypoglycemia.

A bad diet and a lot of physical activity

Other diabetes meds if you drink a lot of alcohol

Weakness, tiredness, nausea, vomiting, indigestion, dizziness, lightheadedness, a heartbeat that is excessively rapid or slow(Metformin Side Effects: Common and Severe, n.d.)

PRECAUTIONS:

While using metformin, a number of variables increase your chance of developing lactic acidosis. If any of these variables impact you, talk to your doctor before using this medication.

Heart failure:

Don’t take Metformin if you have acute heart failure or have recently suffered a heart attack. It’s possible that your heart isn’t sending enough blood to your kidneys. This would prevent your kidneys from properly eliminating metformin from your body, increasing the risk of lactic acidosis.

Kidney failure:

Metformin is excreted from your body through your kidneys. You’ll have higher levels of metformin in your system if your kidneys aren’t functioning properly. Lactic acidosis becomes more likely as a result of this.

Your doctor may prescribe a lower dose of metformin if you have mild or moderate kidney problems.

Metformin may not be good for you if you have serious kidney problems or are 80 years or older. Your kidney function will most likely be tested before you start taking metformin and then once a year.

If you have serious liver problems, you should avoid taking metformin. Lactic acid is removed from your body by your liver.

Lactic acid accumulation could occur if you have severe liver problems. Lactic acid accumulation increases your chances of developing lactic acidosis. Metformin also increases your risk, so it’s not a good idea to take it if you have liver problems.

Alcohol consumption:

Hypoglycemia is more likely if you drink alcohol while taking metformin because of the fact that it raises your body’s lactic acid levels.

While using metformin, you should avoid drinking a lot of alcohol. Long-term drinking and binge drinking are examples of this. If you drink alcohol, talk to your doctor about how much is safe for you to consume while taking metformin.(Metformin and Alcohol: Are They Safe to Mix?, n.d.),