Metformin, a commonly prescribed drug for diabetes, is known for its significant impact on blood sugar management and affordability – aka it is effective, efficient, and inexpensive. Normally, this would be a big win for a medication. However, despite these advantages, there is a growing trend of individuals discontinuing its use. This is largely due to the side effects that it can sometimes cause, as well as a general lack of education around the drug and its side effects. This is what you should know, so you can decide with the guidance of a healthcare professional what is right for you.
The Digestive Dilemma: Side Effects of Metformin
One of the primary reasons individuals stop taking metformin is the gastrointestinal side effects it can cause. Symptoms such as diarrhea and flatulence are fairly common. As anyone can imagine, these side effects are challenging, uncomfortable, and often embarrassing. It can make it difficult to leave the house or lead to anxiety about being in public situations. After all, the last thing anyone wants is to start suffering from severe flatulence or worse while on a long bus ride, at a concert, or even everyday places like the grocery store. Despite metformin’s effectiveness in managing diabetes, this symptom alone may lead to people discontinuing their treatment.
Other Common side effects of metformin
Not all side effects of this medication are permanent. In many cases, metformin may cause some side effects that diminish over time. These side effects include the gas and diarrhea, as well as heartburn, stomach pain, nausea or vomiting, bloating, constipation, weight loss, headache, and a metallic taste in your mouth. Taking metformin with a meal can help reduce the chances of experiencing these side effects. Of course, depending on the severity of these symptoms and how long they do last, it can be quite a hindrance towards doctors getting their patients to hang in long enough for those symptoms to pass.
These common side effects are not the only side effects of metformin, however. There are other side effects that have begun to cause quite a lot of concern among some diabetes patients. Some are so worried that they are even beginning to refuse to take the medication altogether, for fear of these potential side effects. This, of course, puts them at risk for mismanaged diabetes and all of the problems that come along with that.
Lactic acidosis
One of the most serious side effects of metformin is lactic acidosis, although it is rare. Lactic acidosis is characterized by a dangerous buildup of metformin in the body leading to a pH imbalance. Our bodies have a very delicate pH system that if changed by even a decimal point or two, can have some pretty serious consequences. Symptoms of lactic acidosis can include extreme tiredness, weakness, decreased appetite, nausea, vomiting, trouble breathing, dizziness, lightheadedness, muscle pain, and more. This is not a side effect to be taken lightly: Lactic acidosis is a medical emergency. It requires immediate treatment in a hospital setting, so if you believe you are experiencing it, get to the hospital as soon as you possibly can.
Anemia
Vitamin B12 is a very important micronutrient for our health. It is involved with countless processes in the body, particularly with energy and cognitive function. Metformin can lower the levels of vitamin B12 in the body, which in rare cases can lead to anemia. Anemia can cause plenty of health problems on its own accord. Symptoms of anemia include tiredness, dizziness, and lightheadedness. While there are plenty of healthy food sources of vitamin B12, those with low levels may need to discuss supplement options with their healthcare provider. In severe cases, injections may be required.
Hypoglycemia
Hypoglycemia refers to low blood sugar, usually levels low enough that you will begin to experience other, potentially dangerous symptoms. While hypoglycemia is not a common side effect of metformin on its own, combining metformin with an unhealthy diet, strenuous exercise, excessive alcohol intake, or other diabetes medications can increase the risk of low blood sugar. Symptoms of hypoglycemia can include weakness, tiredness, nausea, vomiting, stomach pain, dizziness, and an unusually fast or slow heartbeat. This is why open communication, honesty, and careful monitoring with your healthcare provider are so important. If you have diabetes, simply taking medication to control your blood sugar isn’t enough. You need to follow your medical team’s instructions in terms of diet, exercise, and lifestyle. Be open and honest with your lifestyle habits, as well as be sure to show them all medications you are already taking, including both prescription and over-the-counter medications.
Side effects during pregnancy
One of the biggest concerns among diabetes patients are the potential effects of metformin on babies still developing in the womb. Some research has come out stating a potential relationship between the drug, the development of a man’s sperm, and that this may induce genital birth defects in their sons. Other research, however, has found that this is not the case. Experts still say, however, that metformin is generally considered safe to take during pregnancy, either alone or with insulin. While it crosses the placenta, there is no significant research to suggest increased rates of fetal development issues. However, it may result in a fetus being small for its gestational age, so caution is advised if there are concerns about adequate fetal nutrition. Women with polycystic ovary syndrome (PCOS) may benefit from metformin use during pregnancy, but it’s essential to consult with a healthcare provider for individual recommendations. As always, if you are at all unsure, seek out a second opinion before making any decisions.
Improving Patient Adherence: Insights from Health Professionals
Health experts emphasize the importance of tailored approaches to improve patient adherence to metformin. There are many different versions of metformin that can be chosen and adapted for individual patient needs. From prescribing the extended-release version to educating patients on dosage and timing, healthcare providers play a significant role in optimizing the medication experience. If doctors want their patients to adhere to their instructions, they must both educate the patient properly on their condition and their treatment plan, as well as help tailor their plan so that they have the best experience possible. Working with their patients and not against them will help the patient feel seen and heard, increasing patient trust and adherence to protocols.
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Educational Gaps and Treatment Preferences
As already mentioned, there is a significant lack of patient education and limited awareness about metformin’s benefits. Both of these contribute to its underutilization. While metformin is often recommended as the first line of defense in diabetes management, the lack of comprehensive education around its usage is leading to low adherence rates. Medical professionals must remember that in the age of the internet, many patients are doing research on their own. If a patient comes to their doctor saying that they read online that metformin causes birth defects in babies, the doctor should be willing to review that article with their patient and help to educate that patient as to why this article may or may not just be media fear mongering. Doctors also must remember that medication technology and research is ongoing, and medications and treatments are constantly being reviewed, renewed, and replaced by better alternatives. Enhancing patient understanding and engagement, as well as staying on top of new research, is crucial in promoting long-term medication compliance.
The Role of Cost and Treatment Options
Cost considerations and treatment preferences also influence individuals’ decisions regarding metformin. While the medication is known for its affordability, some patients may opt for alternative drugs due to side effects or personal preferences. Healthcare providers must consider individual needs and explore diverse treatment options to ensure optimal outcomes for patients with diabetes. The bottom line is that if a patient has the means and wishes to explore other alternatives, the doctor should advise and guide as they see fit. Exploring other diabetes treatments better than the patient not controlling their diabetes at all.
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Addressing the Complexities of Metformin Adherence
The challenges associated with metformin adherence highlight the multifaceted nature of diabetes management. For patients, it isn’t easy. Side effects are not fun and can even be quite frightening for many. For doctors, it can be frustrating to constantly feel that patients trust sensationalized media who have seemingly misunderstood or exaggerated new research. By addressing the side effects, enhancing patient education, and exploring tailored treatment approaches, healthcare providers can support individuals in effectively utilizing metformin for improved health outcomes. Recognizing the individualized nature of diabetes care is crucial in promoting medication adherence and empowering patients to take control of their health journey.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
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