Metformin is a drug widely used in United States to control the increasing blood sugar levels in type 2 diabetic patients. Despite being such a good drug FDA has rejected prescribing metformin to patients with even mild kidney disease due to high chance of lactic acidosis. Lactic acidosis is a serious condition in which body accumulates too much lactic acid that is fatal. Hence doctors usually stop prescribing metformin to diabetic patients who are older, as the kidney function starts to decline with increasing age but this would lead to uncontrolled diabetes. Alternative drugs for metformin though available are not generic, expensive and have side effects.
However a systematic review article published by Dr. Inzucchi and his colleagues from Yale, the University of Texas Southwestern Medical Center, and Aston University in the U.K is now questioning the adverse impact of metformin on type 2 diabetes patients with kidney disorders. The review was carefully made from 65 out of 818 chosen articles published between the years 1950 to 2014 in reputed journals. The selected journals, were chosen based on various aspects like pharmacokinetic/metabolic studies, large case series, retrospective studies, meta-analyses, and a clinical trial and with a focus on the impact of metformin in diabetic patients with mild to moderate kidney disorders. Dr. Inzucchi said “Metformin could be safely used as long as the kindey function is stable and not severely impaired as there is zero evidence of risk from the study”.
The review suggests that adverse effects of metformin in patients with mild and moderate kidney disorders were extremely low as compared to those who did not take metformin. However the review findings are not applicable to patients with severe kidney disease. Also Dr. Inzucchi suggests that the dosage of metformin is to be determined based on the severity of kidney disease. The research team is currently trying to petition the FDA to update its guidelines by assembling over a 100 signatures from diabetes experts throughout the country.
The original article can be read at: http://www.ncbi.nlm.nih.gov/pubmed/25536258
Disclaimer: This article does not reflect any personal views of the authors/editors