Under the guidance of his family, he accepted the fact that he was ill, however, after taking the hypoglycemic drug metformin prescribed by the doctor, he found that his stomach was a little uncomfortable, and sometimes he would be nauseated and vomited

This more or less brought some trouble

He couldn't help but wonder: was this because of eating metformin, or was there a problem with his stomach?

Eating metformin, will cause gastrointestinal reactions?

Senior sugar friends know that metformin is a classic antidiabetic drug, its first successful synthesis has a history of 100 years, the clinic has a history of more than 60 years, is the first line of choice and the whole process of treatment of type 2 diabetes, has a reliable short-term and long-term hypoglycemic effect, if there is no contraindication, should always be retained in the treatment plan of diabetes [1].

What makes countless sugar friends more praised is that metformin itself has no liver, kidney toxicity, does not hurt the liver and kidneys, it enters the human body, through the gastrointestinal absorption for blood circulation, does not go through liver metabolism, so there is no liver toxicity, will not cause liver damage

However, metformin, which is so friendly to sugar friends, also has shortcomings - it can cause some gastrointestinal adverse reactions

Clinically, about 20% to 30% of patients have gastrointestinal discomfort symptoms after taking metformin [2], mainly manifested as nausea, diarrhea, vomiting, bloating and abdominal pain

Why does eating metformin make the gastrointestinal tract "anxious"?

Studies have confirmed that metformin can lead to the occurrence

But sugar friends do not need to worry too much, normal taking a safe dose will not cause any damage to the body, nor will it cause complications

In addition, we should also remind everyone that since autumn is the season of high incidence of gastrointestinal diseases, the alternation of hot and cold is also easy to bring about various gastrointestinal diseases, and sugar friends should pay more attention to

Learn 3 tricks, eat "guanide" less trouble every day

If sugar friends eat "guanidine" for a period of time, gastrointestinal reactions or repeated, may wish to try the following three tricks, can effectively reduce gastrointestinal reactions -

1.

The minimum effective dose of metformin is 500 mg/day, the optimal effective dose is 2000 mg/day, and the maximum recommended dose for adults is 2550 mg/day, and its efficacy is positively correlated

2.

Metformin into the digestive tract, in the stomach can be dissolved quickly, high concentration of metformin hydrochloride adhesion to the digestive tract mucosa caused irritation, easy to produce nausea, vomiting and other gastrointestinal discomfort, in the meal process or after the meal will not affect the absorption of drugs, and can reduce gastrointestinal adverse reactions

3.

Metformin extended-release tablets are drug dosage forms prepared using slow and controlled-release technologies, and are currently divided into

Taking metformin proto-drug sustained-release tablets as an example, after it is taken orally into the gastrointestinal tract, it is slowly dissolved and released in the gastrointestinal tract, which has better gastrointestinal tolerance, and is taken once a day, which is convenient and convenient, not easy to miss, and can improve the patient's medication compliance
.

A retrospective U.
S.
study of metformin-based extended-release tablets showed that starting metformin-based extended-release tablets reduced the incidence of gastrointestinal adverse events by 50 percent and the incidence of diarrheal events by 75 percent [4].

Therefore, when taking metformin ordinary tablets, if there are repeated gastrointestinal adverse reactions, it is recommended to change to metformin extended-release tablets under the guidance of a doctor, and take it once a day with dinner, which can significantly reduce gastrointestinal discomfort
.

Finally, we should also remind you that when there is a gastrointestinal discomfort after taking metformin, do not stop the drug without authorization, which will not only lead to blood sugar fluctuations, aggravate the condition, but also may cause acute complications
.
If you really want to stop metformin due to gastrointestinal adverse reactions, you should also consult a professional doctor for advice and stop or change the dressing under his guidance
.

Editor: Chen Yue

Drawing: CT

Produced by: China Family Doctor Magazine

Academic guidance Xu Wenming

The First Affiliated Hospital of Sun Yat-sen University, Director of Secretion in Huangpu Campus

Deputy Chief Physician Doctor of Medicine Master Supervisor

Member of the Standing Committee of the Endocrinology Branch of Guangdong Health Management Association

Member of endocrinology branch of Guangdong Medical Doctor Association

Member of Osteoporosis Management Branch of Guangdong Medical Industry Association

Standing Committee Member of Multidisciplinary Diagnosis and Treatment Committee of Fatty Liver Disease of Guangdong Health Management Branch

Member of Diabetes Management Branch of Guangdong Medical Industry Association

He has been engaged in clinical and scientific research of endocrine metabolic diseases for nearly 20 years, and his main research direction is type 2 diabetes mellitus and its macrovascular complications

References:

[1] Mu Yiming, Ji Linong, Li Chunlin, et al.
Expert Consensus on Clinical Application of Metformin (2018 Edition).
Chinese Journal of Diabetes,2019,027(003):161-173.

[2] Delgado K,Chamberlain JJ,Shubrook JH,Skolnik N,Trujillo J.
Pharmacologic Approaches to Glycemic Treatment of Type 2 Diabetes:Synopsis of the 2020 American Diabetes Association’s Standards of Medical Care in Diabetes Clinical Guideline.
Ann Intern Med,2020 Sep 1.

ZHANG Jianhong.
Coping strategies for gastrointestinal reactions caused by metformin[J].
Physician Online,2020,10(30):1.

[4] Blonde L,Dailey GE,Jabbour SA,Reasner CA,Mills DJ.
Gastrointestinal tolerability of extended-release metformin tablets compared to immediate-release metformin tablets:results of a retrospective cohort study.
Current medical research and opinion.
2004; 20(4):565-572.