Contraindications for Metformin doubted

[Guest guest]

Thought this could be significant to some of us, as it has been

determined through animal studies that Metformin increases life span.

Note Al Pater's earlier post Oct 15:

/message/21127

Link and full text of my new post is below.

Regards,

Dave

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & dopt=Abstra\

ct & list_uids=16418951

1: Dtsch Med Wochenschr. 2006 Jan 20;131(3):105-10. Related Articles,

Links

Click here to read

[Currently listed contraindications to the use of metformin - more

harmful than beneficial?]

[Article in German]

Holstein A, Egberts EH.

Medizinische Klinik I, Klinikum Lippe-Detmold, Detmold.

Summary. For fear of lactic acidosis the currently listed

contraindications to the use of metformin exclude a large number of

people with type 2 diabetes from efficacious antihyperglycaemic and

cardioprotective treatment. Yet recent data call the traditional

contraindications to metformin into question. As the incidence of

lactic acidosis in patients with type 2 diabetes is the same with or

without metformin therapy (about 9 per 100000 patient years) there is

no evidence that metformin therapy is associated with an increased

risk of lactic acidosis. Similarly, despite disregard internationally

of major metformin contraindications, there has been no corresponding

increase in the incidence of lactic acidosis. Metformin treatment of

elderly diabetics with multiple comorbidities and explicit

contraindications has led to significantly better clinical parameters

in them than in the control group without metformin; and there were no

cases of lactic acidosis. The two groups did not differ with regard to

progression of renal failure, patient-oriented endpoints or overall

mortality. Compared with its predecessors phenformin and buformin,

metformin is considerably less lipophilic and has a shorter plasma

half-life; it is eliminated renally in unchanged form. In type 2

diabetics treated with metformin - even those over 70 years of age and

those in mild renal failure - no relevant increases in lactate levels

were found. In patients with lactic acidosis there was no correlation

between the levels of metformin and lactate. The prognosis of lactic

acidosis is determined less by the serum concentrations of metformin

and lactate than by the hypoxia caused by the underlying disease and

comorbidities. These findings raise doubts about the significance of

metformin in the pathogenesis of lactic acidosis. On the basis of the

current data, advanced age per se, mild renal impairment and stable

heart failure can no longer be upheld as contraindications to the use

of metformin. It should be safe to withdraw metformin the evening

before radiological examinations with intravenous contrast media or

surgical procedures under general anaesthesia in diabetics with normal

renal function.

PMID: 16418951 [PubMed - in process]