Metformin is a conventional drug for treating type 2 diabetes mellitus, which can improve glucose utilization and insulin sensitivity. Metformin is regarded as the first-line drug for diabetes treatment in most diabetes medication guidelines, such as the guidelines of Diabetes Association in China.
Metformin can reduce the absorption rate and total amount of glucose in intestine, inhibit the decomposition of glycogen and reduce the input of glycogen in liver, thus reducing the total amount of glucose entering the blood. Metformin can also increase the sensitivity of surrounding tissues to insulin, make insulin active and play a role in lowering blood sugar.
Metformin can also activate AMPK enzyme, which is responsible for controlling the amount of glucose converted into blood sugar. Activating this enzyme will make the body consume more glucose, thus lowering the blood sugar level.
Another function is that metformin will gather in the intestinal tract after washing hands, so that the intestinal tissue can quickly ferment a large amount of glucose into lactic acid and reduce the peak blood sugar after meals. These lactic acids will enter the liver with the blood, and when the blood sugar drops, they will re-enter the liver and become glucose through the treatment of the liver, which will be used by the body to maintain the stability of blood sugar. That is, there will be no hypoglycemia.
1, suitable for patients with type 2 diabetes, especially obese and overweight patients with type 2 diabetes.
2. It is suitable for patients who use an oral hypoglycemic drug alone or insulin alone, and the effect of controlling blood sugar is poor or ineffective. Metformin can be considered in combination.
3. Patients with impaired glucose tolerance can choose metformin.
Although metformin is a first-line hypoglycemic drug for type 2 diabetes, it is not suitable for all patients with type 2 diabetes. The following people are not suitable.
1, patients with moderate renal insufficiency: When the renal function is damaged and the glomerular filtration rate is below 45, it is necessary to stop taking drugs. Because metformin is easy to accumulate poisoning.
2. Those who are allergic to metformin are forbidden: Some people are allergic to metformin, and these people cannot use metformin drugs.
3. It is not recommended for pregnant women: Metformin is classified as Class B in FDA pregnancy, and usually Class B drugs can be considered for use during pregnancy, but the 20 17 version of China Guidelines for the Prevention and Treatment of Type 2 Diabetes is not recommended for use during pregnancy. Therefore, pregnant women should not use metformin.
4. Patients with special diseases can't use metformin: The use of metformin in the case will lead to life-threatening side effects due to metabolic disorders, so some serious special diseases can't use metformin, such as severe trauma, major surgery, acute and chronic metabolic acidosis, diabetic ketoacidosis, and those who receive intravascular iodinated contrast media need to stop taking metformin.
In addition, metformin should not be used in the state of drunkenness or in the state of serious deficiency of vitamin B 12.