The drug metformin is not recommended for people with
kidney disease. For this reason, some people think that metformin causes kidney disease. But new evidence
suggests that metformin might actually protect the kidneys.
For many people with type 2 diabetes , metformin is a very
effective drug. In everyone, the liver is a sort of "mother" organ. When blood
glucose (BG) levels go down, the liver releases some glucose into the blood to
make sure all the other organs get enough glucose energy to work properly.
When you eat and your BG levels start going up, the liver
is supposed to stop pushing all this glucose out into the bloodstream.
But for some reason, in people with type 2 diabetes, like
an oversolitous mother, the liver doesn't stop feeding the bloodstream after
meals. "Eat eat!" I can hear it say to a bloodstream already stuffed with
glucose. And this continued release of glucose into the bloodstream after
meals is one reason people with type 2 go high after me...
I received an interesting question by e-mail recently, which brought up several good points to review. The author asked: "Can a patient use metformin after a heart attack (after 12 years of using metformin) assuming the patient has good renal function? My question is if metformin should be avoided forever after an acute myocardial infarction or just temporarily withheld after the heart attack in a patient with an adequate renal and liver function (also without congestive heart failure or hypersensitivity to metformin)." I answered: "According to the USPI (the "label") for Glucophage brand of metformin, GLUCOPHAGE and GLUCOPHAGE XR are contraindicated [should not be used] in patients with: Renal disease or renal dysfunction (e.g., as suggested by serum creatinine levels =1.5 mg/dL [males], =1.4 mg/dL [females] or abnormal creatinine clearance) which may also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicem...
Metformin as well as every other prescription drug has a "label" (in the US, called a "United States package insert" or USPI, and in Europe called the "Summary of Product Characteristics" or SPC). The label spells out what governmental agencies authorize drug companies to say about the good and bad of their prescription drugs. Labels vary from country to country depending on local laws, but the label seems always to contains a section concerning the use of the medication in pregnancy.
Drug companies and the regulators negotiate every word in a label for a new medication, as getting additional good information into the label is viewed as a marketing advantage (and vice versa for bad information). For older drugs such as metformin, which are available as generics and which are sold by several companies, there frequently is less financial incentive to update the label, and labeling may be similar or identical across all the generic versions of the drug.
Recently, the on-lin...
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