Metformin

Question 1

Hb1ac target for type 2 diabetic (single mono therapy/ lifestyle)

Answer 1

48 mmol/l

Question 2

Metformin MOA

Answer 2

Lowers blood glucose by reducing hepatic glucose synthesis (gluconeogenesis), lowering glucose absorption in the intestine and improving insulin sensitivity by enhancing peripheral glucose uptake

Question 3

Metformin SE

Answer 3

GI upset (usually transient)
Abdominal pain
Taste alteration
Decreased appetite

Question 4

Metformin and Lactic acidosis

Answer 4

Seek emergency medical attention if symptoms such as breathlessness, muscular cramps, stomach discomfort, hypothermia or asthenia develop
Discontinue if lactic acidosis develops

Question 5

Metformin cautions

Answer 5

Lactic acidosis
Chronic stable HF
Dehydration
AKI
Decreased tissue perfusion

Question 6

Metformin in diabetes and breastfeeding

Answer 6

Ok

Question 7

After childbirth should patient with gestational diabetes continue metformin

Answer 7

No

Question 8

Renal impairment and metformin

Answer 8

Avoid if eGFR is below 30ml/min

Question 9

Metformin and hepatic impairment

Answer 9

Discontinue if tissue hypoxia likely

Question 10

What vitamin disturbance can metformin cause

Answer 10

B12

Question 11

Monitoring during metformin treatment

Answer 11

Renal function before and annually