What are the efficacy and side effects of Metformin Extended-Release Tablets?

Generally, the therapeutic effects of metformin sustained-release tablets include lowering blood glucose, improving insulin sensitivity, regulating lipid metabolism, reducing body weight, and delaying the progression of diabetes complications. Adverse effects may include gastrointestinal discomfort, lactic acidosis, vitamin B12 deficiency, taste disturbances, and skin allergies. It is recommended to use this medication under medical supervision. Detailed analysis is as follows:

Ⅰ. Therapeutic Effects of Metformin Sustained-Release Tablets

1. Lowering Blood Glucose

Metformin sustained-release tablets reduce hepatic glucose output and inhibit the process of gluconeogenesis, thereby lowering fasting blood glucose levels and bringing patients' blood glucose values closer to the normal range.

2. Improving Insulin Sensitivity

This medication enhances insulin sensitivity in peripheral tissues, increases insulin-mediated glucose uptake and utilization, allowing body cells to better utilize glucose in the bloodstream, thus lowering postprandial blood glucose levels.

3. Regulating Lipid Metabolism

The drug helps reduce triglycerides and low-density lipoprotein cholesterol levels, while increasing high-density lipoprotein cholesterol levels. It has a certain beneficial effect on lipid abnormalities and reduces the risk of cardiovascular diseases.

4. Reducing Body Weight

For overweight or obese patients with type 2 diabetes, metformin sustained-release tablets can aid in weight reduction. It suppresses appetite, reduces food intake, increases fat oxidation and energy expenditure, thereby promoting fat loss and achieving a certain weight-loss effect.

5. Delaying the Progression of Diabetes Complications

Prolonged hyperglycemia can lead to various diabetes complications, such as diabetic nephropathy, retinopathy, and neuropathy. Metformin sustained-release tablets effectively control blood glucose levels, reduce damage to blood vessels and nerves caused by hyperglycemia, delay the onset and progression of chronic diabetes complications, improve patients' quality of life, and prolong their lifespan.

Ⅱ. Adverse Effects of Metformin Sustained-Release Tablets

1. Gastrointestinal Discomfort

This medication may directly irritate the gastrointestinal mucosa, disrupt the mucosal barrier, trigger inflammatory responses, and stimulate gastrointestinal nerve endings, leading to symptoms such as nausea and vomiting. Additionally, it may affect the normal peristaltic rhythm of the intestines, accelerate intestinal transit, cause insufficient retention time of food in the intestines, and result in inadequate water absorption, thus causing diarrhea.

2. Lactic Acidosis

Metformin sustained-release tablets may inhibit mitochondrial respiratory chain complex I, impair cellular respiration, and prevent pyruvate from entering the tricarboxylic acid cycle for aerobic oxidation, leading to its conversion into lactic acid. Additionally, the drug may reduce the metabolic clearance of lactic acid in the liver and muscles. These dual effects result in the accumulation of lactic acid in the blood, causing lactic acidosis, which may present with symptoms such as fatigue, rapid breathing, and abdominal pain.

3. Vitamin B12 Deficiency

Metformin sustained-release tablets may interfere with the absorption of the vitamin B12-intrinsic factor complex in the terminal ileum. The drug alters the intestinal microenvironment and may inhibit the function of transport proteins or receptors involved in vitamin B12 absorption, preventing the effective uptake of vitamin B12 into the bloodstream.

4. Taste Disturbances

Taste receptors are located in epithelial cells on the tongue and other areas. The drug may interfere with the signal transduction pathways within taste receptor cells or alter the chemical environment surrounding the cells, resulting in impaired taste perception. Patients may experience taste abnormalities such as a metallic taste, which can affect appetite and eating experiences.

5. Skin Allergy

An individual's immune system may recognize certain components of metformin sustained-release tablets as foreign antigens. Upon initial exposure to these antigens, the immune system produces specific antibodies and sensitizes lymphocytes. Upon re-exposure to the drug, antigen-antibody binding activates the sensitized lymphocytes, triggering a series of immune responses and the release of inflammatory mediators such as histamine. Histamine causes vasodilation and increased vascular permeability in the skin, leading to allergic reactions such as itching, erythema, and rashes.

During treatment with metformin sustained-release tablets, it is important to regularly monitor blood glucose levels, liver and kidney function, and complete blood counts to promptly detect any adverse effects caused by the medication. Additionally, to reduce gastrointestinal side effects, it is recommended to take the medication with meals or immediately after meals.