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Biguanides
(only Metformin available)
- reduce glucose absorption from GIT
- reduce gluconeogenesis in liver
- reduce aerobic and increase anaerobic glycolysis
- increase glucose entry into tissue (via a non-insulin responsive
mechanism)
- No wt. gain or hypoglycaemia
Side-effects
- GIT disturbance
- anorexia
- nausea
- vomiting
- diarrhoea
- abdo pain
- metallic taste
- decreased B12 absorption
- provoke lactic acidosis
- do not give in renal impairment
- (esp. if alcoholic, dehydrated, or pregnant or co-morbid mitochondrial
myopathy, heart failure or renal impairment)
- Short-acting so may wake-up hyperglycaemic
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