Under certain conditions, too much metformin can cause lactic acidosis. The symptoms of lactic acidosis are severe and quick to appear, and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure.
Long-term side effects
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
It can have gastrointestinal side effects like bloating and diarrhea in quite a few people apart from the very small risk of lactic acidosis.
Metformin helps lower how much sugar gets absorbed through your intestines, which means that less sugar makes it to your bloodstream. It lowers sugar production. You get sugar from the foods you eat, but did you know that your body naturally produces sugar, too? Most of this happens in the liver.
The American Diabetes Association (ADA) also recommends metformin for some people with prediabetes. Generally, if you're prescribed metformin, you'll be on it long term. That could be many decades, unless you experience complications or changes to your health that require you to stop taking it.
Summary. Metformin is a common drug for the treatment of diabetes. If you successfully manage your diabetes to remission, it's possible to stop taking metformin. Lifestyle and dietary changes can help you manage your blood sugar levels and possibly reach diabetes remission.
Metformin does cause side effects in some people, but many of these are mild, and are associated with taking the medicine for the first time. Nausea and gastric distress such as stomach pain, gas, bloating, and diarrhea are somewhat common among people starting up on metformin.
Metformin—a safe and inexpensive glucose-lowering drug—is sometimes used to treat non-diabetic people with polycystic ovarian syndrome, for aiding weight loss, and for some people with impaired glucose tolerance, partly on the basis of its purported cardiovascular benefits.
Side effects
Nausea, vomiting, stomach upset, diarrhea, weakness, or a metallic taste in the mouth may occur. Metformin usually does not cause hypoglycemia; however, low blood sugar may occur if this drug is used with other anti-diabetic drugs.
Outside of their work, other scientists are hailing metformin as a wonder drug not only because of its effect on Type 2 diabetes, but because of its emerging prominence in cancer research and potential influence in the lungs of those diagnosed with tuberculosis.
Metformin and weight loss
In a much larger trial in over 4,000 people with type 2 diabetes, it was found metformin use was associated with a 2.4 kg (roughly 5.3 lbs) weight loss over a four-year period. There are a few ways that metformin might impact weight. One is that the medication can reduce your appetite.
Current evidence suggests that the weight change associated with metformin is more likely to be due to decreased caloric intake versus increases in energy expenditure. Metformin appears to impact appetite regulation both directly and indirectly due to its gastrointestinal side effects.
How to check if metformin is working. A medical provider can run a few tests to see how metformin is affecting your health: Blood work can check if your glucose, insulin, and HbA1C levels are in range. If they are, the medication is working.
As seen in Table 2, 40 patients (53.3%) had GI side effects with persistent use of metformin tablet for 7.8 years in average (range, 1–30 years), including epigastric and abdominal pain, nausea, vomiting, diarrhea, and bloating.
There are many reports that metformin can result in some sleep problems, especially insomnia. On the other hand, metformin is proven to be useful for preventing sleep apnea. The exact relationship between metformin and sleep problems is still not clear, and further studies for a more clear understanding are warranted.
Recent studies have also found that metformin has a positive effect on cardiovascular protection [8,9,10,11,12]. Metformin also lowers risk factors for cardiovascular disease such as blood fats [13,14,15], body weight and blood pressure.
Declining renal function prohibits many medications for fear of potential side effects from lower renal clearance. As such, it is recommended that metformin should be discontinued when the eGFR falls to 30 ml/minute/1.73 m2 or below [3], in anticipation of a higher risk of lactic acidosis.
Many antihyperglycemic drugs can increase the risk of heart failure. However, it is commonly believed that metformin - the first-line treatment for type 2 diabetes - reduces the risk of and improves the clinical course of heart failure. It is estimated that 20-25% of patients taking metformin have heart failure.
This medicine is not recommended in patients 80 years of age and older who have kidney problems.
Conclusion: Metformin does not appear to cause or exacerbate liver injury and, indeed, is often beneficial in patients with nonalcoholic fatty liver disease. Nonalcoholic fatty liver frequently presents with transaminase elevations but should not be considered a contraindication to metformin use.
Metformin is a synthetic derivative of galegine and/or guanidine, natural products found in the herbal medicine Galega officinalis that was used in medieval Europe.
Insulin remains the most effective therapy to lower glucose, particularly in comparison to most oral medicines for type 2 (including metformin).
Missing doses of oral diabetes medications frequently can lead to serious health complications, some of which may require hospitalization. This also increases the overall cost of your treatment. Potential complications include nerve damage, as well as eye, kidney, or heart disease.