All three components: Metformin, Phenformin, Buformin have biguanides side effects. But only Metformin is recommended to use as the oral drug for diabetes type 2 because of higher toxicity of two others, Phenformin and Buformin. So, you can see how narrow their use is, besides their “positive effects”.
Coming to side effects, most patients are disturbed from problems with their digestive tract, such as nausea, diarrhea, excessive abdominal gas.
The metallic taste is often referred from the diabetic patients taking metformin. In many cases it becomes disturbing them.
Vitamin B12 and folic acid are very important to protect from heart disease. During the biguanides intake their blood levels are reduced. As you can understand by yourself you are less protected from heart diseases.
The above biguanides side effects maybe couldn't be as serious and harmful as lactic acidosis. If not treated adequately and in time, leads to a coma and the death of the patient who takes it.
It is a body state in which the muscle cells during exercise or working, produce excessive lactic acid, which is put in the blood stream. The liver then can turn it to sugar.
But if liver doesn't work properly, this is not possible. In this way, the lactic acid concentration is increased in the blood stream, and this is very dangerous for the body cells, especially brain cells, which become sleepy and body puts in a coma or even death.
It is true that lactic acidosis happens not every time you use biguanides. But there is a potential risk especially if the patient have kidney diseases (failure) and liver diseases (failure), because of their reduced work of these two organs during diabetes, very important to clear blood stream from lactic acid.
So you must understand that if you have kidney disease or liver disease, you must avoid taking these drugs and better consult your doctor.
In women with polycystic ovaries syndrome, they can reduce the menstruation irregularities, but can increase the probability of unplanned pregnancy, especially in women with endocrine disorders.
Although these drugs seem to be safe, they are not approved from FDA to take them during pregnancy. So, if you're pregnant, and have diabetes type 2, it is better to consult your doctor to stop using them.
Now coming to the other part of the medal. It is true, biguanides can reduce the production of sugar (in form of glucose) from your liver. In this way no added sugar blood levels could result.
Other, it can make your cells to absorb merely the sugar in your blood stream, in way to reduce sugar blood levels making the cells more sensitive to insulin.
The most known drug of this class is Metformin (Glucophage). It can be used alone, but it is more effective if used in combination with other insulin-sensitizer drugs, or insulin itself.
The “positive” sides of metformin are No weight gain and No hypoglycemia. In this way it has a large spectrum of use: in obese diabetic patients, it is also the third options for treating diabetes in children, and in women with polycystic ovaries and insulin resistance.
Although these positive effects, you must keep in mind the above biguanides side effects in order to be healthy.
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Written by Dr.Albana Greca Sejdini, Md, MMedSc
Medically reviewed by Dr.Ruden Cakoni, MD, Endocrinologist