Metformin in Women With Diabetes

During pregnancy, women can face many health complications, including diabetes, which can endanger the health of the unborn child. To counter this gestational diabetes and type 2 diabetes, a drug called Metformin is prescribed. This article will examine this drug in detail, including its benefits, side effects, and how it is particularly tied to gestational diabetes.

What is Metformin?

A prescription drug for treating type 2 diabetes, Metformin is available as a tablet or oral solution. It features two variations, immediate-release and extended-release, with the latter available as branded drugs called Fortamet and Glumetza. Both versions are sold as generic drugs, which costs less than their branded counterparts.

What is Metformin Used for?

While Metformin is primarily used to treat type 2 diabetes, it also has multiple uses for other conditions such as prediabetes, polycystic ovarian syndrome (PCOS), gestational diabetes, and rapid weight gain brought about by antipsychotic drugs such as olanzapine. However, it must be noted that these auxiliary uses are not FDA approved.
Metformin tablets can be also used in conjunction with other blood-sugar medications such as Jentadueto and Invokamet.

How does Metformin Work?

Metformin helps to revive the body’s natural response to insulin by reducing the amount of blood sugar produced by the liver. It also helps reduce the absorption of blood sugar by other major organs such as the stomach and intestines.

How much does Metformin Lower Blood Sugar?

Studies have shown that Metformin medicine can lower the presence of sugar in haemoglobin proteins by about one percent. This is measured via a diagnostic test called Hemoglobin A1C and offers a three-month average of the body’s blood sugar levels. The ideal scenario for diabetic patients is to lower haemoglobin sugar levels by seven percent.

What are the Risks of taking Metformin?

The drug can cause a potentially life-threatening condition called lactic acidosis, where lactic acid is in the bloodstream. Symptoms include muscle pain, difficulty breathing and fatigue. One should seek immediate medical attention if one encounters these symptoms. To prevent further risk avoid combining Metformin with drugs like ranolazine and cimetidine. Furthermore, one should also limit their alcohol intake as it is also a catalyst for lactic acidosis.

It can also drop blood sugar levels severely, causing extreme hunger, nausea, fatigue, dizziness and blurred vision. If left untreated, low blood sugar can lead to seizures and loss of consciousness.

Use of Metformin During Pregnancy

• Gestational Obesity- Random trials of Metformin during pregnancy have shown to slightly reduce gestational weight gain in obese women with normal blood glucose levels.
• Gestational Diabetes- Apart from insulin and proper diet, Metformin has shown a clear effect in controlling hyperglycemic conditions in pregnant women suffering from gestational diabetes.
• Polycystic Ovary Syndrome- Metformin ingestion in pregnant women who have PCOS reduces miscarriage incidents significantly, even dropping down to zero if the drug is administered through all 3 trimesters.

Side Effects of Metformin

• Lactic acidosis- As previously mentioned, it is a serious albeit rare side effect of taking Metformin, likely to happen to patients suffering from kidney or liver disease, congestive heart failure and other associated conditions.
• Vitamin B12 deficiency - B12 deficiency can numbness in the extremities and a drastic drop in red blood cells.
• Hypoglycemia - Unprecedented drop in blood sugar levels. Generally occurs when Metformin is combined with other diabetic control drugs such as insulin.

How to Reduce Side Effects of Metformin?

• Start With A Low Dose- It is always recommended to start with a small dose, allowing the body to acclimatize to the new drug.
• Take It With Food- Although Metformin tablets or oral solutions can be consumed in a fasted state, it is better to consume them after ingesting food.
• Opt For Extended-Release Options - Rather than taking immediate-release tablets, which release the entire drug in the bloodstream at once, it’s prudent to opt for the extended-released one if possible. Incidents of diarrhoea and nausea reduce significantly among users who took the latter version.

How to treat low blood sugar?

Since hypoglycemia is a constant risk among diabetic patients using Metformin, it’s vital to know about a few remedies to treat low blood sugar on the spot. For mild cases, ingesting glucose tablets or a glucose gel is a perfect way to stabilize sugar levels. Alternatively, one can also consume juice, soda, non-fat milk, honey, sugar or candy to treat the condition.

How does Metformin Treat Diabetes?

• Increases insulin sensitivity- Diabetic patients develop insulin resistance due to the abundance of sugar, and Metformin increases insulin sensitivity, helping the hormone to better perform its functions.
• Lowers sugar absorption- Metformin blocks some amount of sugar from entering the intestines, thereby lowering its concentration in the blood.
• Lowers sugar production- Metformin reduces the amount of natural sugar produced by the liver to keep blood sugar levels under control.

In Conclusion

To sum it up, Metformin is a highly useful drug for treating myriad diseases ranging from diabetes to PCOS, provided the side effects are kept in check.

References

1. Hyer S, Balani J, Shehata H. (2018). Metformin in Pregnancy: Mechanisms and Clinical Applications. NCBI
2. Kumar P, Khan K. (2012). Effects of metformin use in pregnant patients with polycystic ovary syndrome. NCBI
3. Ye, F. Hui-Xia, Y. (2020). Metformin in Pregnancy with Diabetes—Opinions from Several Latest Guidelines. MFM