Usage of metformin in patients with type 2 diabetes mellitus
Abstract
Metformin is an old drug which is widely prescribed for the treatment of type 2 diabetes mellitus (T2DM). It is recommended as the first line oral anti-hyperglycaemic agent in Australia, United States and most European countries. It reduces haemoglobin A1c (HbA1c) by 10-20 mmol/mol (approximately 1-2%), and does not cause weight gain or hypoglycaemia. Metformin is well tolerated in most patients and has potential clinical advantages in patients with cardiovascular disease. The clinical conundrum facing practitioners while prescribing metformin is the potential risk of lactic acidosis, which although rare is often fatal. The current official product information recommends that metformin should be avoided or the dosages adjusted in patients with coexisting conditions that are likely to increase the risk of lactic acidosis. The safe use of metformin is still under debate, which may confuse practitioners when prescribing. Thus we aimed to provide more evidence regarding the current prescribing pattern and usage of metformin in Australia, and to explore the safety of metformin, especially its association with lactic acidosis. To achieve this aim, a number of complementary studies were conducted. We evaluated the prescribing pattern of metformin in patients who were admitted to a local hospital. The main finding of this study was that metformin was often being prescribed 'inappropriately' with regards to the restrictions listed in the official product information, in terms of…
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