DIABETES MELLITUS-BIGUANIDES

SUMMARY

1. Metformin is the preferred first line drug for T2DM, unless the patient meets a need for immediate insulin.

SIDE EFFECTS
2. Dose-related abdominal pain and diarrhea and propensity for causing lactic acidosis.

3. Contraindicated in renal dysfunction (GFR < 30 cc/min), decompensated CHF, and acute or chronic metabolic acidosis.

4. Contraindicated in contrast procedures or surgery-because both might cause renal failure ⟹ lactic acidosis.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].