Metformin is the first line medication and the safest choice for people
who have type 2 diabetes. But there are plenty of websites that will try
to convince you otherwise.
Online myths and misinformation would not bother me except I know how important
this drug can be for people who need to lower their glucose level. With
type 2 diabetes, patients have insulin resistance, which causes the body’s
blood sugar levels to soar and force the pancreas to produce more insulin.
Metformin lowers blood sugar in several ways, but primarily by decreasing
insulin resistance. That is why my colleagues and I work with patients
to combat rumors with data.
Among the most common misconceptions is that metformin can damage your
kidneys, liver or heart. Many patients believe that they developed renal
failure (dialysis dependent) because they took metformin for too long.
There is no evidence to back up these claims. Metformin has been available
for over 30 years, and its side effects have been very well studied. The
most common side effects are nausea, bloating and diarrhea, which usually
resolves after 1 to 2 weeks.
Why do myths persist? Social media.
As with any drug, FDA approval came with some restrictions. In metformin’s
case, the drug is contraindicated for people with high creatinine levels,
for fear that these people would develop lactic acidosis, which is a condition
where the body has excess level of lactate and leads to low pH in the
bloodstream. Symptoms of lactic acidosis may include anorexia, nausea,
vomiting, confusion, abdominal pain and thirst. If the condition is not
treated in timely matter, lactic acidosis could potentially be fatal.
Lactic acidosis continues to stoke fears, especially online, that metformin
is dangerous. In truth, research has shown that the likelihood of developing
lactic acidosis from metformin is very rare. An article published in New
England Journal in 1998 reported that among one million patients on metformin,
there were only 47 reports of lactic acidosis.
For pre-diabetic patients, metformin can prevent or delay the onset of
type 2 diabetes mellitus by decreasing insulin resistance and helping
to lower blood sugar levels. It is important to note that the first line
of treatment for pre-diabetes is lifestyle modification – diet,
exercise and smoking cessation. If you’re unable to control your
blood sugar with these modifications, medication is usually recommended.
And while there are newer classes of drugs on the market today, metformin
is the safest and most well-known.
If you have type 2 diabetes mellitus, your doctor will likely prescribe
you metformin as the first-line medication. As you learn how to manage
diabetes and read about various medications and supplements, make sure
to focus on reputable medical sites, with information by trusted medical
professionals.
Metformin is not dangerous. But myths and misinformation can be.
Dr. Jinsun Choi is an endocrinologist at Hoag Medical Group Irvine – Sand Canyon.