Abstract
Metformin, a biguanide, is the preferred first-line oral blood glucose-lowering agent to manage patients with type 2 diabetes. Metformin is widely utilised, while phenformin, another biguanide, has been discontinued due to the high risk of lactic acidosis. This side effect lined with biguanides in general has impacted the use of metformin. Metformin is renally excreted, and its toxicity has been implicated as a cause of lactic acidosis, so its use in patients with kidney impairment has been limited. Lactic acidosis is rarely seen in patients with type 2 diabetes with an incidence of 6/100,000 patient-years, a risk similar in metformin-treated and non-treated patients. Metformin retains some glycaemia-independent clinical effects such as weight loss, anti-inflammatory properties and antifibrotic and confers cardio-renal protection. Because of its characteristics, metformin is utilised in patients with GFR down to 30 ml/min. With the development of new renoprotective agents such as SGLT2 inhibitors, the use of metformin will play a more important role in diabetes control.
| Original language | English |
|---|---|
| Title of host publication | Diabetes and Kidney Disease, Second Edition |
| Publisher | Springer International Publishing |
| Pages | 521-531 |
| Number of pages | 11 |
| ISBN (Electronic) | 9783030860202 |
| ISBN (Print) | 9783030860196 |
| DOIs | |
| Publication status | Published - 1 Jan 2022 |
Keywords
- Acidosis
- Diabetes
- Kidney
- Lactate
- Metformin
