The DOI matches its Crossref record; 91 of the 91 references it cites were found in a registry or an index.
Understanding and overcoming metformin gastrointestinal intolerance
Abstract
Metformin is the most widely prescribed drug for patients with type 2 diabetes mellitus and the first‐line pharmacological option as supported by multiple international guidelines, yet a rather large proportion of patients cannot tolerate metformin in adequate amounts because of its associated gastrointestinal ( GI ) adverse events ( AEs ). GI AEs typically encountered with metformin therapy include diarrhoea, nausea, flatulence, indigestion, vomiting and abdominal discomfort, with diarrhoea and nausea being the most common. Although starting at a low dose and titrating slowly may help prevent some GI AEs associated with metformin, some patients are unable to tolerate metformin at all and it may also be difficult to convince patients to start metformin again after a bout of GI AEs . Despite this clinical importance, the underlying mechanisms of the GI intolerance associated with metformin are poorly known. In the present review, we discuss: the epidemiology of metformin‐associated GI intolerance and its underlying mechanisms; genotype variability and associated factors affecting metformin GI intolerance, such as comorbidities, co‐medications and bariatric surgery; clinical consequences and therapeutic strategies to overcome metformin GI intolerance. These strategies include appropriate titration of immediate‐release metformin, use of extended‐release metformin, the promise of delayed‐release metformin and gut microbiome modulators, as well as alternative pharmacological therapies when metformin cannot be tolerated at all. Given the available data, all efforts should be made to maintain metformin before considering a shift to another drug therapy.
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1 retracted
Sulphonylurea monotherapy for patients with type 2 diabetes mellitus
Hemmingsen, B., Schroll, J. B., Lund, S. S., Wetterslev, J., Gluud, C. N., Vaag, A. A., Sonne, D. P., Lundstrøm, L. H., & Almdal, T. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009008.pub2 · Cited by 90
RetractedInternational Diabetes Federation 2017
Carracher, A. M., Marathe, P. H., & Close, K. L. (2018) · Journal of Diabetes · doi:10.1111/1753-0407.12644 · Cited by 13,418
Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., Mattheus, M., Devins, T., Johansen, O. E., Woerle, H. J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1504720 · Cited by 12,315
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
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Efficacy and Safety of Nintedanib in Idiopathic Pulmonary Fibrosis
Richeldi, L., du Bois, R. M., Raghu, G., Azuma, A., Brown, K. K., Costabel, U., Cottin, V., Flaherty, K. R., Hansell, D. M., Inoue, Y., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1402584 · Cited by 4,654
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Glycemic durability of rosiglitazone, metformin, or glyburide monotherapy
Kahn, S. E., Haffner, S. M., Heise, M. A., Herman, W. H., Holman, R. R., Jones, N. P., Kravitz, B. G., Lachin, J. M., O'Neill, M. C., Zinman, B., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa066224 · Cited by 2,962
Disentangling type 2 diabetes and metformin treatment signatures in the human gut microbiota
MetaHIT consortium, Forslund, K., Hildebrand, F., Nielsen, T., Falony, G., Le Chatelier, E., Sunagawa, S., Prifti, E., Vieira-Silva, S., Gudmundsdottir, V., et al. (2015) · Nature · doi:10.1038/nature15766 · Cited by 2,116
Cited by
Metformin: update on mechanisms of action and repurposing potential
Foretz, M., Guigas, B., & Viollet, B. (2023) · Nature Reviews Endocrinology · doi:10.1038/s41574-023-00833-4 · Cited by 699
Understanding the glucoregulatory mechanisms of metformin in type 2 diabetes mellitus
Foretz, M., Guigas, B., & Viollet, B. (2019) · Nature Reviews Endocrinology · doi:10.1038/s41574-019-0242-2 · Cited by 686
Shi, Q., Wang, Y., Hao, Q., Vandvik, P. O., Guyatt, G., Li, J., Chen, Z., Xu, S., Shen, Y., Ge, L., et al. (2022) · The Lancet · doi:10.1016/s0140-6736(21)01640-8 · Cited by 279
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Nakatani, Y., Maeda, M., Matsumura, M., Shimizu, R., Banba, N., Aso, Y., Yasu, T., & Harasawa, H. (2017) · Diabetes & Metabolism · doi:10.1016/j.diabet.2017.05.009 · Cited by 126
Metadata
- Authors
- Bonnet, F., & Scheen, A.
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2017-02-22
- Volume
- 19
- Issue
- 4
- Pages
- 473-481
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2567000504
- Cited by
- 256
- References
- 91
- FWCI
- 9.24
- Type
- journal article
- Language
- en
- Open access
- closed
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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