Practical Practitioner

By: Pamela Egan, FNP-C CDE

Problems with Metformin not as common as reported

Dear Pam,

I heard on the news that glucophage can be dangerous. Should I stop taking it?

Many diabetes patients are worried about recent media reports that “metformin is dangerous.” The concern is about Metformin (glucophage, glucovance) and lactic acidosis. It isn’t a new concern, but news reports imply that it’s a common problem.

In reality, it’s extremely rare. There are only about three cases of lactic acidosis for every 100,000 patients who take Metformin for one year. It should be noted that more patients have died from hypoglycemia, an adverse effect of insulin and sulfonylureas. Not to mention the long-term effects of coronary artery disease from high insulin levels in the blood.

The key is that high-risk patients should not take Metformin. These are patients with impaired renal function – congestive heart failure that requires drug therapy, liver disease, severe infection or serious dehydration. Metformin should be used with caution in patients over 80 and discontinued temporarily prior to IV radiocontrast or surgery. It should not be used if serum creatinine is 1.5mg/dL for men or 1.4mg/dL for women. The media should present the whole picture instead of attacking the new diabetes drugs that actually preserve the pancreas, health and well-being of diabetic patients.

This article was originally published June 10, 2002 in The St. Tammany News.

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