Table 3.
The side effects of Metformin.
| Author(s) and date | Gastrointestinal | Diabetic Ketoacidosis | Lactic Acidosis | Hypoglycemia |
|---|---|---|---|---|
| Ahmed et al. [19] | 5 events | Not reported | Not reported | No major hypoglycemia events; no significant effect of Metformin on minor hypoglycaemic events (% ≤3.9 mmol/l and area under curve 3.9 mmol/l on CGMS: 8.6% vs 13.3%; p = 0.2 and 0.08 vs 0.1; p = 0.5 respectively) |
| Anderson et al. [20] | Metformin group (22), placebo group (14) | Metformin group (2), placebo group (2) | None | Moderate hypoglycemia in Metformin group (40, placebo group (2). No severe hypoglycemia |
| Bjornstad et al. [16] | Nausea, diarrhea, reduced appetite, stomach pain in ten participants in the Metformin group (40%) compared with 2 participants in the placebo group (8%; P < 0.01) | None | None | None |
| Burchardt et al. [17] | None | None | None | None |
| Cree-Green et al. [14] | (5) in the Metformin group | (1) in the Metformin group | None | No severe hypoglycemia |
| Libman et al. [15] | 50 events in the Metformin group (70% [95% CI, 60% to 81%]) and 24 events in the placebo group (35% [95% CI, 23% to 46%]; P < .001) (mean difference, 36% [95% CI, 19% to 51%]; P < .001) | 3 (4% [95% CI, 1% to 9%]) participants in the Metformin group vs 2 (3% [95% CI, 1% to 7%]) participants in the placebo group (mean difference, 1% [95% CI, −16% to 18%]; P ≥ .99) | None | Severe hypoglycemia 5 (7% [95% CI, 1% to 13%]) participants in the metformin group and 0 in the placebo group (mean difference, 7% [95% CI, −9% to 23%]; P = .06) |
| Nadeau et al. [22] | No difference between groups in gastrointestinal symptoms (metformin: nausea 8%, diarrhea 7%, abdominal pain 1% vs. placebo: nausea 8%, diarrhea 6%) or ketones |
None | No severe adverse events | No severe hypoglycemia |
| Setoodeh et al. [12] | Not reported | Not reported | Not reported | None |
| Zawada et al. [11] Ziaee et al. [13] |
(12) temporary gastrointestinal symptoms in the form of bloating, heaviness in the abdomen, and diarrhea (resolved spontaneously after a few days of use and did not constitute a reason to terminate Metformin therapy) The adverse effects (bloating, stomachache, diarrhea and hypoglycemia) were recorded, but they were not reported by the study |
No DKA. Acetonuria in seven patients (17.95%) on the first day of the run-in period before adding Metformin. On the day of control examination, five patients (10.26%) presented acetonuria (p = 0.08) Not reported |
None Not reported |
No hypoglycemia Not reported |