Are you on Metformin for DM or PCOS. In this article I will walk you through six scenarios where your Doctor has to stop Metformin! Coming up!

 Let us look at the most common diabetes complications. Some of these complications caused by diabetes may make your healthcare provider stop Metformin. So please make sure your blood sugars are being well monitored and you are taking control of your blood sugars. It’s not my body or your heathcare provider’s  body it is your body. Take care of it.

  • Diabetes is sometimes called a silent disease because you don’t feel it, but unfortunately it can affect so many organs in your body.

  • You are twice as likely to have a stroke or a heart attack. One of the reasons is because diabetes can raise your triglycerides ( a type of fat) as well as your “bad cholesterol” called LDL and decrease your good cholesterol called HDL.
  • You are at an increased risk for eye problems and even blindness. The vessels in your eye, in particular your retina can get damaged. This is called diabetic retinopathy and you will have to follow up regularly with your eye doctor. Your eye lens can get cloudy, also known as cataracts. You are also at an increased risk for glaucoma, where the eye pressure in your eye increases.
  • Diabetes causes your blood sugars to go up and this can damage your kidneys. Especially, if you are older you are at an increased risk as the kidney functions worsens with age. This type of chronic kidney disease caused by diabetes can lead to kidney failure. Very bad kidney disease (we  refer to this a stage 5 kidney disease) might require dialysis to filter your blood.
  • Your nerves can also get damaged. You might be experiencing numbness, tingling or even pain especially in your hands or feet. This is called diabetic neuropathy.
  • Damage to the vessels especially in your feet can lead to circulation problems with an increased risk for pain, difficulty walking, infection and in very severe cases amputations of digits and limbs.
  • Another complication can be gum disease leading to increased risk of infection. The increased amount of sugar in your saliva can be helpful for bacteria to grown in your mouth. There is higher risk for tooth plaque, caries and tooth loss.
  • Other complications to think about are an increased risk for depression as the disease progresses and with advancing disease because of damage to the nerves and reduced blood flow to the vessel’s you have bladder problems such bladder incontinence and sexual problems such as erectile dysfunction.

Going back to the first question of this article I going to list six  conditions or scenarios  where your healthcare provider  will have to stop giving you Metformin.

All the following conditions can predispose you to a condition called LACTIC ACIDOSIS when there is too much acid in your body.

 

Stethoscope on a table with words Lactic acidosis

Lactic acidosis

  1. If your kidney function becomes worse your Doctor will stop giving you Metformin. He or she will look at a value called GFR (glomerular filtration rate). If that value is less than 30ml/min/1.7 m2  Metformin will be discontinued. I typically use a higher value as I also see a lot of elderly patients and I stop it at a GFR of 45 or below. Between 30-and 45 some Doctors reduce the dose of Metformin by half, but no more than 1000mg /day.
  2. If you are abusing alcohol your Doctor will be stop Metformin, so stay away from those temptations.
  3. If you have progressive liver disease or liver cirrhosis Metformin will be stopped. However, Fatty liver disease is not seen as a contraindication unless your liver disease progresses.
  4. Now the question about using Metformin and heart failure can become tricky. If your heart failure is well managed and stable you do not have to stop the drug. However, in situations of acute heart failure or unstable heart failure you will have to stop Metformin.
  5. If in the past you have had a history of lactic acidosis, when there was too much acid in your blood (you would know) … you cannot use Metformin.
  6. Other situations your Doctor can’t use Metformin are situations where there is decreased blood flow to your tissues such as sepsis, or prolonged low blood pressure and hemodynamic instability… that just means your BP and circulation is unstable. Those kinds of patients are usually quite sick and in the ICU.

Did you know that Metformin can cause B12 deficiency, click here  to find out more.

Question of the Day?

Are you on Metformin and do you know what your GFR is?

Have a good day and Think your Health.If you want to see the complete video click here.

 

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