How Well do You Know Your Own Meds?
This week we were prompted to look at how much our family members, friends, coworkers, etc. know about drugs. For the last couple years my father has been hovering around the pre-diabetic range in terms of his fasting blood glucose and A1C. He recently started taking Metformin so I decided to chat with him to see what he knows about it.
With my father being an engineer, he is very analytical in his thinking. He seems to actually enjoy taking his blood glucose after meals because he likes to interpret the data and analyze how his meal affected his blood glucose. He has also become interested in how adding a glass or two of wine or beer to his meal affects his blood glucose.
When asked how metformin works he was able to give me a generalized explanation of type II diabetes and how metformin works to counteract these effects by increasing the sensitivity of insulin receptors in certain tissues. We spoke about how metformin also regulates blood glucose by reducing glucose production by the liver and partially reducing absorption of glucose in the GI tract.
We also spoke about possible adverse effects from taking metformin. He noted that he sometimes gets an upset stomach when he drinks wine with metformin but otherwise hasn’t had any issues. He had vaguely remembered something about the risk of lactic acidosis and also knew it is not advisable to drink heavily when on metformin but wasn’t quite sure how these two factors were related. I explained that metformin can inhibit the breakdown of lactic acid and in rare cases can lead to lactic acidosis if it accumulates to toxic levels. We went over the early signs of lactic acidosis (hyperventilation, myalgia, malaise, unusual somnolence) and also discussed how alcohol can contribute to the risk of lactic acidosis as it also inhibits the breakdown of lactic acid.
Although my father likes to drink a glass or two of wine with dinner and is fascinated with how alcohol drops his blood glucose levels, he understands that drinking heavily while on metformin is not advisable. We also talked about how drinking alcohol in general can contribute to the development of type II diabetes by desensitizing insulin receptors. Even though metformin seems help regulate his blood glucose levels and keep him in the pre-diabetic range we talked about how important it is to still continue to try to manage his blood glucose as much as possible through diet and exercise. As with anything, a glass of wine or dessert is okay but do it in moderation!
