[Chinese expert consensus on metformin in clinical practice: 2023 update].

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Abstract

Metformin has robust glucose-lowering effects and multiple benefits beyond hypoglycemic effects. It can also be used in combination with various hypoglycemic drugs and is cost effective. In the absence of the strong indications of glucagon like peptide-1 receptor agonist (GLP-1RA) or sodium glucose cotransporter 2 inhibitor (SGLT2i) for cardiorenal protection, metformin should be used as the first-line pharmacological treatment for newly diagnosed type 2 diabetes and the basic drug for the combined treatment of hypoglycemic drugs. Metformin does not increase the risk of liver and kidney function damage, but patients with renal dysfunction should adjust the dosage of metformin based on estimated glomerular filtration rate (eGFR) levels. Moreover, the correct use of metformin does not increase the risk of lactic acidosis. Because long-term use of metformin is associated with a decrease in vitamin B12 levels, patients with insufficient intake or absorption of vitamin B12 should be regularly monitored and appropriately supplemented with vitamin B12. In view of the new progress made in the basic and clinical research related to metformin, the consensus updating expert group updated the consensus on the basis of the Expert Consensus on the Clinical Application of Metformin (2018 Edition).

【二甲双胍临床应用中国专家共识:2023年更新】。
二甲双胍具有强大的降糖作用,除降糖作用外还有多种益处。它也可以与各种降糖药联合使用,具有成本效益。在胰高血糖素样肽-1受体激动剂(GLP-1RA)或葡萄糖共转运蛋白2抑制剂钠(SGLT2i)对心肾保护的适应症不强的情况下,二甲双胍应作为新诊断的2型糖尿病的一线药物治疗和降糖药物联合治疗的基础药物。二甲双胍不会增加肝肾功能损害的风险,但肾功能不全的患者应根据估计的肾小球滤过率(eGFR)水平调整二甲双胍的剂量。而且,正确使用二甲双胍并不会增加乳酸性酸中毒的风险。由于长期使用二甲双胍与维生素B12水平下降有关,应定期监测维生素B12摄入或吸收不足的患者,并适当补充维生素B12。鉴于二甲双胍相关基础和临床研究取得新进展,共识更新专家组在《二甲双胍临床应用专家共识(2018年版)》的基础上更新了共识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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