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Question of the Week | Reluctant to Start Metformin due to Side Effects

Question of the Week Diabetes Education Services

LS is reluctant to start on metformin because they heard it can cause diarrhea and kidney problems. You reassure LS that metformin doesn’t harm the kidneys and can actually improve gut health.

Based on the most recent evidence, which of the following is true?

 

  1. Hold metformin if the GFR is less than 45 and the person has an occasional alcoholic beverage.
  2. Metformin increases the growth of bacteria like Akkermansia muciniphila.
  3. Most people with metformin experience diarrhea, so make sure to increase fiber intake when starting.
  4. Start vitamin B12 therapy and iron supplements with initiation of metformin.

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