Podcast
Questions and Answers
What is the main mechanism by which Metformin helps manage type 2 diabetes?
What is the main mechanism by which Metformin helps manage type 2 diabetes?
What is the recommended initial dosage of Metformin for adults?
What is the recommended initial dosage of Metformin for adults?
Which of the following side effects is most commonly associated with Metformin?
Which of the following side effects is most commonly associated with Metformin?
What percentage reduction in A1C levels can Metformin achieve in drug-naïve patients?
What percentage reduction in A1C levels can Metformin achieve in drug-naïve patients?
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Why is Metformin considered a first-line therapy for type 2 diabetes?
Why is Metformin considered a first-line therapy for type 2 diabetes?
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Study Notes
Biguanides: Metformin
- Oral medication for type 2 diabetes
- Action:
- Lowers hepatic glucose production
- Increases insulin sensitivity in muscle tissues, allowing for increased glucose uptake
- First-line treatment for type 2 diabetes (unless contraindicated or intolerable)
- Initiating therapy:
- Start with a low dose (500 mg) with the largest meal
- Increase dose gradually (500 mg increments) over several weeks
- Advantages:
- Reduces A1C levels by 1.5%–2%
- Reduces fasting plasma glucose (FPG) levels by 60–80 mg/dL in patients with initially high A1C
- Lowers triglycerides (TG) and LDL-C by ~8%–15%
- May modestly increase HDL-C by 2%
- Does not cause weight gain; may lead to modest weight loss (2–3 kg)
- Low risk of hypoglycemia as it doesn't directly stimulate insulin secretion
- Adverse effects:
- Frequent gastrointestinal (GI) side effects (diarrhea, abdominal discomfort, upset stomach)
- Dose-dependent, usually transient, and mild
- Minimized by slow dose titration and taking with meals
- Extended-release metformin may slightly lessen GI effects; no significant difference compared to immediate-release regarding GI side effects.
- Metallic taste
- May lower vitamin B12 levels (annual B12 measurements recommended)
- Contraindications:
- Renal insufficiency (eGFR) - Metformin is excreted by the kidneys and builds up in kidney problems.
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Description
This quiz covers the oral medication Metformin used for type 2 diabetes. It highlights its mechanism of action, advantages, dosing recommendations, and potential adverse effects. Test your knowledge on this first-line treatment for diabetes management.
