However, elderly patients are more likely to have age-related kidney problems, which may require caution in patients receiving metformin. This medicine is not recommended in patients 80 years of age and older who have kidney problems.
Precautions – Older patients also are at increased risk for developing conditions other than diabetes that reduce kidney function further or cause lactic acidosis (eg, acute infections, myocardial infarction [MI], stroke, cardiac failure,). Therefore, metformin should be used with caution in older patients.
Why Shouldn't You Stop Taking Metformin? Metformin works by decreasing the amount of sugar your liver releases into your blood, making your body more sensitive to insulin's effects. If you suddenly discontinue use, it can lead to dangerously high blood sugar levels.
A doctor will often use certain criteria to determine whether it is safe for an individual to stop taking metformin. These criteria include: having a fasting or pre-meal blood glucose level of 80–130 milligrams per deciliter (mg/dL) having a random or after-meal blood glucose level of under 180 mg/dL.
Metformin doesn't work for everyone. Precose, Januvia, Victoza, Glucotrol XL, and Actos are some metformin alternatives.
More serious side effects are rare. They include severe allergic reactions and a condition called lactic acidosis, a buildup of lactic acid in the bloodstream. The risk for this is higher among people with significant kidney disease, so doctors tend to avoid prescribing metformin for them.
The UK study by Imfeld et al. showed an increased risk of dementia associated with metformin use (odds ratio 1.71, 95% confidence interval 1.12-2.60) by using a matched case-control design including 7086 incident cases of Alzheimer's disease and 7086 controls without dementia [10].
This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.
Do not stop taking metformin without talking to your doctor. If you stop taking metformin suddenly, your blood sugar levels will go up and your diabetes will get worse.
The kidneys process and clear the medication out of your system through your urine. If your kidneys don't function properly, there's concern that metformin can build up in your system and cause a condition called lactic acidosis. Lactic acidosis is when there's a dangerous amount of lactic acid in the body.
1. How long does it take metformin to work? Metformin is a long-term medication. While not everyone with diabetes needs to take medication forever, many people will continue taking metformin for life.
Among individuals with diabetes, long-term treatment with metformin may reduce the risk of cognitive decline. Further studies should establish the role of hyperglycemia and insulin resistance, and the protective role of metformin in the risk of cognitive decline and dementia.
They noted that in observational studies there was a significant association of exposure to metformin with the risk of cancer death, all malignancies, liver, colorectal, pancreas, stomach, and esophagus.
Metformin is an oral medication used to treat type 2 diabetes that is generally well tolerated. GI upset, especially diarrhea, is the most common side effect. This typically decreases over time. Although rare, lactic acidosis, hypoglycemia, and vitamin B12 deficiency can occur.
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.
In some people, metformin leads to poor absorption of vitamin B12. That can lead to a vitamin B12 deficiency, though this only occurs after long-term medication use. Taking metformin might also lead to loss of appetite, which could cause a small amount of weight loss.
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.
People with type 2 diabetes (the most common form) are twice as likely to develop liver or pancreatic cancer. They also run a higher-than-normal risk of developing colon, bladder and breast cancer.
Emerging research shows that the diabetes drug metformin, used in type 2 diabetes treatment, has the potential to inhibit aging by activating AMPK-mediated pathways that promote youthful functioning at the cellular level—making it a potential healthy aging drug.
Recently, Samira et. reported no increase in the risk of acute kidney injury in patients receiving metformin compared to those without metformin treatment by baseline eGFR [11]. However, in the present study, continuous metformin therapy was shown to worsen renal function in patients with DM and moderate CKD.
Coming off medication in diabetes remission
Some people are able to stop taking diabetes medication like metformin, by putting their diabetes into remission. This means that blood sugar levels are in the non-diabetes range without needing any medication.
14 , 15 Metformin administration ameliorates diabetes by affecting glucose absorption, but long‐term metformin administration is associated with side effects, such as muscle atrophy. Metformin administration might induce muscle atrophy.
Therefore, glycemic control in diabetic patients is vital for bone health. Metformin, a widely used antidiabetic drug, has been shown to improve bone quality and decrease the risk of fractures in patients with diabetes in addition to glycemic control and improving insulin sensitivity.
Cruciferous Vegetables
Vegetables that belong to the cabbage family such as cauliflower, Brussels, broccoli, and sprouts should never be consumed raw. These vegetables contain sugar that is difficult to digest. Eating these vegetables raw may lead to a number of gastronomical problems.