Is Metformin Advisable For An Elderly Patient?

Posted on Tue, 24 Jul 2018

Question: should a man over 80 take metformin. His glucose level 108 and his A1C is 6.1 and his average glucose is 128?

Answered by Dr. Saddiq Ulabidin (50 minutes later)

Brief Answer:
Age is not an absolute contraindication for metformin

Detailed Answer:
Hi! Welcome to Healthcaremagic. Thanks for sharing your concerns with us. We will try to help you in best way possible.

Based on the history you have shared, yes low dose metformin can be taken in this case as age is no absolute contraindication for the use of metformin but caution has to the taken with renal functions as with age GFR or normal kidney functions are lesser than normal and this is result of normal age related wear and tear in kindey functional units or nephrons.

Also it can cause lactic acidosis so patient should be assessed for any metabolic derangements beforehand. However the HbA1c that you have shared, is quite under control as below 6.5 and with these sugar levels that you shared, life style modifications and diet control are preferred choice of therapy.

Though metformin has advantage that it causes less incidences of hypoglycemia but with these readings chances still exist. Also if patient is underweight metformin can cause weight loss which on the other hand is beneficial in heavy weighted individuals.

Hope this has answered your query. If you have any questions please feel free to ask. Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Saddiq Ulabidin (46 hours later)

I think my doctor is concerned about the glucose, fasting of 108 was way to high and that I should start metformin. I disagree. I am a runner and average 32 miles a week. And do not take any other medications except vitamins. I think if I can keep the glucose at 108 or below and the A1C at 6.1 that it would not to take metformin. Could respond?

Answered by Dr. Saddiq Ulabidin (1 hour later)

Brief Answer:
Yes food control and excercises can help you achieve control

Detailed Answer:
Hi! Yes fasting sugars and HbA1c are not bad but you don't need to get relax to let it be rather more food compliance and excercises should be continued to achieve better control and hopefully you will do good with such supportive measures without treatment at this range. Regards

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Above answer was peer-reviewed by : Dr. Yogesh D