Study of Diversity of Metformin Related Gastrointestinal Side Effects

Introduction: Digestive disorders represent the most common metformin related side-effects in type 2 diabetics. GI side effects of metformin are not so uncommon rather under reported or wrongly diagnosed as primary gastrointestinal disorder. This study is to estimate metformin related GI side effects in Indian population.

Methodology: This is a retrospective cross sectional study, conducted in tertiary care hospital at Kota. 120 type 2 diabetic patients were included after detailed history, physical examination and inclusion/exclusion criteria, who were on metformin tablet only, for variable duration. All patients were evaluated for gastrointestinal side effects.

Results: Mean age of study group was 52.8±11.9 years with mean weight 72.4±10.3 kg. Mean duration of metformin therapy was 3 years (6 weeks to 6 years) and mean metformin dose was 1000mg (500 mg - 2500 mg). 62 (51.66%) patients presented with GI side effects. These side effects are diarrhea (33), nausea/vomiting (28), pain abdomen (23), flatulence (16), retching (13), dysgeusia (7). On the basis of duration of therapy, most of patients had side effects during initial phase of treatment but some patients also presented after long duration of treatment.

Conclusion: Gastrointestinal side effects being most common side effect of metformin can lead to discontinuation of therapy. So before extensive evaluation of any GI problem in patient on metformin, other methods can be tried like temporary discontinuation, dose titration or proper intake of medicine. These side effects may also occur even after prolonged treatment with metformin.