Patient/caregiver was educated on the side effects of using Metformin as follows:
Stomach upset
- Nausea, vomiting, diarrhea, metallic taste in the mouth, and feeling sick to stomach are the most common side effects of using Metformin.
- Taking the medication with a glass of water and some food or snack can help avoid/reduce these unpleasant gastrointestinal symptoms.
Metabolic acidosis
- Gluconeogenesis is a process that normally occurs in the human liver in which glucose is made from nutrition sources other than carbohydrates, such as, proteins and fats. Metformin inhibits the process of gluconeogenesis and reduces the synthesis of glucose from proteins and fats, thus contributing to reducing the blood sugar levels. During this process, metformin contributes to increased synthesis of lactic acid.
- Increased lactic acid production is a rare, but a dangerous side effect of using Metformin. High lactic acid levels in human body induce a state of increased acid ions and metabolic acidosis.
- Be aware of symptoms of metabolic acidosis, such as, rapid shallow breath, increased heart rate, fatigue, headache, confusion, and stomach upset with nausea and vomiting.
- Staying hydrated with intake of fluids as recommended and observing compliance with recommended dietary plan can help prevent development of metabolic acidosis. Also, do not take metformin with alcohol. Both metformin and alcohol can independently contribute to increased acid ion and induce risk for acidosis in the body. Taken together, they can complement each other, to increase this risk significantly.
Hypoglycemia
- Metformin, by increasing the sensitivity for insulin, can result in excessive uptake of glucose by the muscle and lead to improved blood sugar regulation. Also, by reducing absorption of glucose from the food into the blood and reducing synthesis of glucose in the liver from proteins and fats, metformin contributes to improved blood sugar regulation.
- Metformin can contribute to lowering of blood sugars to hypoglycemic levels, especially when combined with other medications for blood sugar control. But metformin used alone, only rarely contributes to lowering of blood sugars to dangerous levels.
- Medications that contribute to severely low blood sugar levels can strongly stimulate the appetite, leading to increased intake and consequent weight gain.
- Since dangerous hypoglycemia with Metformin used alone is not a common problem, Metformin by itself has little effect on stimulation of appetite and weight gain.
