Metformin

3 important questions on Metformin

How is Metformin able to lower plasma glucose levels in patients with diabetes type 2?

Metformin improves glycemic control by decreasing hepatic glucose production (gluconeogenesis), increasing peripheral glucose uptake and utilisation in skeletal muscle, and reducing intestinal absorption of glucose.

Why are patients with impaired renal/hepatic function that are treated with Metformin at risk of lactic acidosis?

Since Metformin decreases gluconeogenesis, which causes accumulation of lactic acid, patients with impaired renal/hepatic function may not be able to remove the lactic acid adequately from the body, which my lead to lactic acidosis.

What causes the arise of side-effects (nausea/vomiting/diarrhea) of Metformin?

Metformin structurally resembles an agonist for the 5-HT3-receptor, of which the activation leads to nausea/vomiting/diarrhea.

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