Metformin diabetes: application features

Description Medicine

Metformin belongs to a hypoglycemic agent and is useful in diabetes, a pre-diabetic condition. The active ingredient of the drug is metformin (Group biguanide). Its action is aimed at supporting the sugar level that is acceptable for the functioning of nerve cells in the brain and other tissue types.

Metformin is produced in the form of oral tablets with a shell and without it. The drug in the film coating is from normal and extended release rate of the active ingredient. Prolonged form allows you to drink the drug less often or in smaller doses, reduces the frequency of dyspepsia and other unwanted effects.

Indications and the expected effect of Medicine

Assigned metformin in type 2 diabetes. This insulin-dependent form of diabetes disease in which tissues receptors lose their sensitivity to insulin, but the hormone produced by the pancreas continues. This causes a strong increase in the concentration of glucose, obesity, in humans often worsens circulation due to vascular blockage or breakage of the walls.

Doctors also practice the use of Metformin:

• for therapy / prevention of type 1 diabetes;
• hyperglycemia (elevated glucose);
• in the case of pre-diabetes;
• with insulin-dependent form of diabetes (I-type disease).

In monotherapy medication taken in the first phase antihyperglycemic therapy. Metformin include integrated circuits, if hyperglycemia can not be corrected, the patient begins to gain weight, develop atherosclerosis or other complication of diabetes. It is combined with 1-3 drugs: insulin preparations of thiazolidinediones, dipeptidyl peptidase-4 or DPP-4 inhibitor, glyukanopodobnym peptide-1 or antagonist of GLP-1 receptors, means sulfonylureas.

Expected effects of Metformin for diabetes:

• reduces postprandial (after a meal growing), basal (fasting) blood sugar levels;
• It does not enhance insulin secretion;
• It does not cause drop in the level of glucose energy starvation cells;
• It stabilizes the body weight, but it happens and a moderate decrease in weight (weight loss does not begin until a week from the beginning of treatment);
• reduces the production of glucose by the liver;
• increases glucose uptake in the muscle fibers;
• slowing glucose absorption through the intestinal wall;
• It stimulates glycogen synthase enzyme than activates glycogen production;
• It accelerates the transport of glucose by increasing its carrying capacities;
• lowers cholesterol levels;
• reduces the content of neutral fat (triglyceride);
• It reduces the concentration of the atherogenic lipoprotein class (LDL or "bad" cholesterol);
• It suppresses the feeling of hunger by stimulating nutritional satiety center;
• can not remove dry mouth, increased urination, and other symptoms of hyperglycemia.

Attention! Metformin doctors prescribe for patients older than 10 years with hyperglycemia in the absence of the effectiveness of the methods of diet therapy, exercise therapy, correction of sulfonylurea agents. Suppose pills healthy people to lose weight, subject to caution measures.

course duration

Doctors recommend the prevention or diabetes medication Metformin drink long courses. Often, he was appointed for life. The drug may be periodically replaced by other antidiabetic drugs, if there was a risk of lactic acidosis, megaloblastic anemia, anorexia nervosa or other complications from receiving metformin substance.

Dosages for the correction of hyperglycaemia

Normal levels of sugar on an empty stomach in adults or adolescents is 3,3-5,5 mmol / l. During pregnancy, the figure is 6.3 mmol / l. With increasing level of physician recommends receiving glucose-lowering agents. Metformin Dosage in diabetes is dependent on glucose concentration, but is selected in the range 500-3000 mg / day.

The recommended amount of substance metformin people with diabetes under the age of 60 years old for:

• an initial dose in the primary course - 500-850 mg 1-2 p / day.
• starting dose through 1-2 weeks of - 850 mg-1 g 1-2 p / day.;
• maintenance therapy - 850 mg-1 g 2-3 p / day..

People with diabetes over 60 years the daily rate of the drug is only 1000 mg, because patients of this age are the two risk groups. They often by Metformin developing lactic acidosis or appear asymptomatic dysfunction of the kidneys and liver.

The reception for the prevention of diabetes

In order to prevent prescribed Metformin persons at risk of escalation / 1-2 type of diabetes. After initiation of the disease probability decreased to 31%.

The medicine will help people who:

• was diagnosed with pre-diabetes;
• impaired response to insulin hormone for the exponent 7,8-11,0 glucose mmol / l;
• is the deviation of the glucose level when measured under fasted 6.1-6.9 mmol / l;
• glycated hemoglobin is HbA1c 5,7-6,4%;
• age between 18-60 years of age and body mass index above 30-35 kg / m² (Start of obesity);
• a history of gestational diabetes is made (diabetes in pregnancy).

For the prevention of diabetes doctors prescribe metformin to drink every 12 hours long course of treatment. The dosage is chosen taking into account the severity of the disease and the presence of obesity. Usually, people at risk for a prescribed time to drink 250-850 mg metformin.

Features reception Medicine

Metformin drink at one time with a meal (immediately before / along / immediately after a meal). Desirable to use a protein products, since fiber absorption of the drug degrades. A tablet is swallowed without chewing, washed down with 150-200 ml of water. Failure to do so increases the intensity of dyspepsia and breach the release rate of therapeutic substances. Milling conventional or sustained-release tablets can cause hypoglycemic crisis.

The dosage of Metformin in the case of the primary applications is increased only in the absence of expressed gastrointestinal reactions to the drug. If you raise your standards once appeared diarrhea, pain or vomiting, the drug again drink of 0.5-0.85 g 1-2 p. / Day. After 2 weeks of recommended daily dosage increased again to 850 mg-1 g In the case of adverse effects for the second time the doctor is looking for an alternative glucose-lowering medication.

To reduce the likelihood of dyspepsia metformin in a daily dose of 500-850 mg of the above divided by 2-3 times. Take recommended on schedule: at the same time, maintaining an equivalent interval.

On a note! Studies metformin substance revealed that the effect of the daily dose of 3000 mg and 2000 mg differ slightly. However, a daily intake of 3 g of the drug often causes indigestion than eating 2 grams metformine.

Properties receiving depot tablet

Metformin Long prescribed to patients with diabetes, already taking the medication with conventional release agents. This form of funds will be properly taken daily with dinner 1 time / 24 hours. Tablets drink in a single dose of 1000-2550 mg. Prolonged effect allows you to control glucose throughout the day. If such a scheme does not give the expected results, the daily dosage of 1700-2550 divided in half and drink with breakfast and dinner. If absent hypoglycemic effect continues recommend patient in type 2 diabetes take Metformin normal release rate.

state of the body control

When metformin from diabetes for life or long-term constant need to do blood, urine. In the primary application of the agent twice a month consult with the endocrinologist. If necessary, the doctor adjusts the dose.

What and how much time exploring:

• kidney function - yearly or quarterly basis;
• liver function - 1 time / year;
• Fasting plasma glucose - 1 time / 90 days;
• glomerular filtration - monthly;
• glycosylated hemoglobin - on a quarterly basis;
• level in capillary blood sugar - daily or after sleeping with the recommended frequency of doctor;
• the concentration of vitamin B₁₂ - 1 time / year;
• lactate levels in plasma - 2-3 times / year, or in the presence of lactic acidosis symptoms.

In disorders exchange amount of Metformin is reduced to the minimum effective dose. In the case of increasing the concentration of lactate drug overturned.

Interaction of drugs

With a combined drug therapy of diabetes endocrinologist adjusts the daily requirement of Metformin. In the case of a combination with diuretics, hormonal agents, sympathomimetics, calcium antagonists and a number of other medicaments attenuated effect metformine. Enhances the properties of the substance β-blockers, insulin, sulfonylurea, NSAIDs, oxytetracycline and some other means. The combination with cimetidine increases the risk of lactic acidosis due to the extension of metformine excretion.

Side effects Medicine

In humans, diabetic patients with concurrent renal dysfunction observed metformin accumulation in tissues. This increases the risk of coma, predkomatoznogo state or hypoglycemic shock.

Side effects of substance metformin:

• vomiting;
• bloating;
• nausea;
• pain in the intestines, the stomach;
• palpitations;
• diarrhea;
• anorexia (loss of appetite);
• changes in taste;
• feeling of metallic taste;
• lactic acidosis;
• megaloblastic anemia due to malabsorption of vitamins B₉, B₁₂;
• itching of the skin, peeling, rash.

Attention! Lactic acidosis may also be indicative of Metformin overdose. To conduct body cleansing hemodialysis administered symptomatic therapy agent.

Contraindications receiving Medicine

It is forbidden for children under 10 years with diabetes taking Metformin. Mothers can not breastfeed while taking the drug. Pregnant pills prescribed only in the case of the greater good of the woman than the risk to the fetus. It is contraindicated in case of intolerance substances.

Metformin also can not drink when:

• dehydration;
• renal failure;
• difunktsii liver;
• pathologies causing hypoxia;
• alcoholism, all conditions caused by alcohol consumption (metformin incompatible with ethanol);
• infectious pathologies;
• ketoacidosis with diabetes;
• hypoglycemic Stroke;
• metabolic / lactic acidosis;
• severe trauma.

Metformin is contraindicated in people who follow a diet with caloric content of not more than 1000 kcal. Temporarily stop taking tablets for 2 days prior to surgery or diagnostics with a / infusion-governmental iodine-containing agents.

Medications to replace

There are more than 20 direct analogues Metformin shown in diabetes. The easiest way to find Gliformin Prolong, Glucophage, Diaformin, Metfogammu, Siofor, Sofamet, Formetin. Pharmacies their minimum value at the end of October 2018 is 27-190 rubles.

Metformin drug substitution with other hypoglycemic agent must be taken on the recommendation of the attending endocrinologist. The doctor evaluates the type of diabetes, complications of the disease and the characteristics suitable for the treatment of drugs.

sources:

Vidal: https://www.vidal.ru/drugs/metformin-5
GRLS: https://grls.rosminzdrav.ru/Grls_View_v2.aspx? routingGuid = ac45cb5c-4394-42ca-8479-a60a7a67e0b0 & t =

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