Metformin(庫魯化錠)是用來治療第二型糖尿病的雙胍類(biguanide)口服降血醣藥物。Metformin 比磺醯尿素類(sulfonylureas)口服降血糖藥具有不造成低血糖、不增加體重及血中胰島素過高等臨床優勢。因為這些優勢,metformin 在門診常被廣泛使用。然而,metformin 在許多慢性缺氧疾病狀態(如:心血管、肝、腎、肺疾病及年老等)的使用時,可能會增加病患乳酸中毒的機率而被視為使用禁忌。國外文獻中許多的案例報告也陸續指出,嚴謹的使用規範必須確實執行以避免這種嚴重的藥物不良反應發生。本文根據台灣南部某區域教學醫院門診目前metformin 於門診病患的使用經驗,探討其使用安全性結果。
Metformin is a biguanide oral hypoglycemic agent used to lower blood glucose levels in patients with type 2 diabetes. Metformin has certain clinical advantages over sulfonylureas because it does not cause hypoglycemia, nor does it promote weight gain or hyperinsulinemia. Therefore, metformin is widely used for type 2 diabetic patients, particularly in outpatient clinics. Metformin, however, is thought to increase the risk of lactic acidosis, and is considered to be contraindicated in many chronic hypoxemic conditions that may be associated with lactic acidosis? such as cardiovascular, renal, hepatic and pulmonary disease, and advancing age. Here we report and discuss the use of metformin, based on the experience from the outpatient clinic of a regional teaching hospital in southern Taiwan.