Metformin: The First-Line Medication for Type 2 Diabetes
What is Metformin?
Metformin is a biguanide used as the first-line treatment for type 2 diabetes. It improves the body’s response to insulin and lowers blood sugar levels. Metformin is often combined with other medications and lifestyle exercises to manage diabetes more effectively. Metformin is also used in females with Polycystic ovarian syndrome (PCOS), Ovarian hyperstimulation. At times it is often prescribed to initiate weight loss in patients of excessive weight gain due to antipsychotic usage (Off-label use).
How Metformin Works
Metformin is a anti-hyperglycemic agent that improves glucose tolerance in patients with type 2 diabetes mellitus lowering both basal and postparandial plasma glucose. It also decreases hepatic glucose production, decreases glucose absorption, improves insulin sensitivity in muscle cells and fat cells. It doesn’t change insulin secretion, while fasting insulin levels and day long plasma insulin response may decrease.
When to Use Metformin
● Type 2 Diabetes: Metformin is prescribed to help lower blood sugar levels and improve insulin sensitivity in type 2 diabetic patients.
● Polycystic Ovary Syndrome (PCOS): It is also used to help manage insulin resistance associated with PCOS.
Dosage
● Adult Dose: Typically, 500 mg to 2,000 mg per day, taken with meals to reduce gastrointestinal side effects. Maximum dose is 2250 mg/day given in divided doses.
● Pediatric Dose: For children aged 10 and older, starting with 500 mg once or twice daily. Maximum dose is 2000 mg/day.
Side Effects
● Common Effects: Nausea, diarrhea, and stomach upset.
● Serious Adverse Effects: Lactic acidosis (rare but serious), vitamin B12 deficiency, and kidney dysfunction with prolonged use.
Common Indian brands: Glyciphage, Gluconorm.