Although metformin generally does not induce hypoglycemia, it can also induce some gastrointestinal reactions. It is best not to use metformin in patients with hepatic and renal insufficiency, so as to avoid drug accumulation and aggravate the damage to the body.
What should I pay attention to when taking metformin? 1, taken under the guidance of a doctor: taking metformin drugs must be taken under the guidance of a doctor, and the contraindications of metformin should also be noted, such as patients with metformin allergy, patients with diabetic ketoacidosis, patients with liver and renal insufficiency, pregnant women and lactating women.
2. Start from a small dose: Metformin should be taken from a small dose, the minimum dose is 0.25g, three times a day, and blood sugar should be monitored, and the dose should be adjusted according to the blood sugar situation. The dose of metformin should also be adjusted under the guidance of a doctor, and the maximum dose should not exceed 2 grams per day.
3, after meals: Metformin should be taken during or after meals, which can reduce the stimulation of metformin on the gastrointestinal tract. Food in the gastrointestinal tract after meals can reduce the direct stimulation of metformin on the gastrointestinal tract, protect the gastrointestinal tract and reduce adverse reactions.
4. Avoid drinking alcohol when taking biguanides: Avoid drinking alcohol when taking biguanides. Alcohol is harmful to the liver. Drinking alcohol when taking metformin will inhibit gluconeogenesis and lead to hypoglycemia.
5. Long-term use of metformin requires appropriate supplementation of vitamin B 12: Long-term use of metformin will reduce the absorption of vitamin B 12, leading to its deficiency, so patients who take metformin for a long time need appropriate supplementation of vitamin B 12.
When do I need to stop using metformin? Most diabetics need drugs to lower their blood sugar, and metformin is also the first choice for many diabetics. Diabetic patients need to take medicine for life, but they need to stop taking medicine under some special circumstances. Let's have a look.
1, abnormal liver and kidney function, need to stop using.
Although metformin is not metabolized by the liver, about 90% of it is excreted by the kidney. For diabetic patients, metformin has little hepatorenal toxicity. However, when liver and kidney function is abnormal, we should consider stopping using metformin, because if we continue to use metformin when liver and kidney function is abnormal, it will easily lead to lactic acid poisoning in the body.
Whether metformin should be stopped is based on serum creatinine, male: serum creatinine ≥1.5 mg/dl; Female: Serum creatinine ≥ 1.4mg/dl. Or abnormal creatinine clearance rate.
2, coronary angiography needs to stop using metformin.
Coronary angiography is necessary for patients with coronary heart disease to see the cardiovascular situation clearly. Before coronary angiography, if they take metformin, they need to stop taking it for three days before coronary angiography. Because during coronary angiography, it is necessary to inject a contrast agent into the patient, which contains iodine, which is excreted from the kidney like metformin.
If metformin and iodine are used together, it will increase the burden on the kidney, and metformin excretion will be disordered, which is easy to accumulate poisoning. Therefore, it is necessary to stop using metformin for 3 days before using iodine contrast agent. Although some experts believe that the excretion of metformin by people with normal renal function will not be affected by iodine, it is best to stop taking the drug for 3 days for their own health.
3. Unbearable adverse reactions
When there are intolerable adverse reactions after taking metformin, it is necessary to stop using it and replace it with other drugs. For example, if allergic reaction or severe gastrointestinal reaction occurs, it is necessary to consider stopping taking drugs and replacing other hypoglycemic drugs to control blood sugar.
4, pregnancy needs to stop using metformin.
There is no clear research result on the effect of metformin on pregnant women. For safety reasons, if diabetic patients find themselves pregnant while taking metformin, they need to stop taking metformin and use other insulin which is relatively safe for pregnant women to control blood sugar under the guidance of doctors.
5. Vitamin B 12 is seriously deficient.
Long-term use of metformin may reduce the level of vitamin B 12, because metformin can change the peristalsis of small intestine, stimulate the overgrowth of intestinal bacteria and competitively inhibit the absorption of vitamin B 12. Patients who take metformin for a long time should be tested for vitamin B 12 level once a year, and if it is deficient, it should be supplemented appropriately. If the deficiency is serious and a series of symptoms appear, it is necessary to consider stopping the drug.
In addition, patients with some serious diseases, such as severe trauma, severe heart failure or infection. At this time, it is best to stop using metformin. Some patients with early diabetes can stabilize their blood sugar at a certain level after taking metformin for a period of time. At this time, you can gradually reduce the amount and intervene through diet control, exercise, weight loss and lifestyle change. Blood sugar is stable and there is no sign of rebound. You can consider stopping metformin, but it needs to be done under the guidance of a doctor and closely monitor blood sugar.