open access

Vol 73, No 6 (2022)
Review paper
Submitted: 2022-08-22
Accepted: 2022-08-27
Published online: 2022-10-19
Get Citation
The content of this article is also available in the following languages:
Polski

Use of metformin in patients who require intravascular administration of a contrast agent

Dominika Rokicka1, Marta Wróbel1, Dorota Stołtny1, Krzysztof Strojek1
·
Pubmed: 36519659
·
Endokrynol Pol 2022;73(6):913-916.
Affiliations
  1. Department of Internal Medicine, Diabetology and Cardiometabolic Disorders, Faculty of Medical Sciences Zabrze; Medical University of Silesia, Katowice, Poland

open access

Vol 73, No 6 (2022)
Expert Opinion
Submitted: 2022-08-22
Accepted: 2022-08-27
Published online: 2022-10-19

Abstract

Metformin is a drug that has been widely used around the world for many years. Due to its properties, metformin is used in the treatment of carbohydrate disorders (in type 2 diabetes, prediabetes) and in insulin resistance syndromes (including polycystic ovary syndrome).

Many patients using metformin, due to complications of carbohydrate metabolism disorders, including cardiovascular complications or other accompanying diseases, require cardiological or radiological diagnostics related to the administration of a contrast agent.

The aim of this study is to summarize the recommendations regarding the use of metformin before procedures involving the use of contrast agents and to share our own experience in this area, based on observations of a large group of patients with cardiological diseases hospitalized at the Silesian Centre for Heart Diseases in Zabrze.

Abstract

Metformin is a drug that has been widely used around the world for many years. Due to its properties, metformin is used in the treatment of carbohydrate disorders (in type 2 diabetes, prediabetes) and in insulin resistance syndromes (including polycystic ovary syndrome).

Many patients using metformin, due to complications of carbohydrate metabolism disorders, including cardiovascular complications or other accompanying diseases, require cardiological or radiological diagnostics related to the administration of a contrast agent.

The aim of this study is to summarize the recommendations regarding the use of metformin before procedures involving the use of contrast agents and to share our own experience in this area, based on observations of a large group of patients with cardiological diseases hospitalized at the Silesian Centre for Heart Diseases in Zabrze.

Get Citation

Keywords

metformin; contrast agents

About this article
Title

Use of metformin in patients who require intravascular administration of a contrast agent

Journal

Endokrynologia Polska

Issue

Vol 73, No 6 (2022)

Article type

Review paper

Pages

913-916

Published online

2022-10-19

Page views

4695

Article views/downloads

4305

DOI

10.5603/EP.a2022.0079

Pubmed

36519659

Bibliographic record

Endokrynol Pol 2022;73(6):913-916.

Keywords

metformin
contrast agents

Authors

Dominika Rokicka
Marta Wróbel
Dorota Stołtny
Krzysztof Strojek

References (17)
  1. GLUCOPHAGE. Charakterystyka Produktu Leczniczego. https://leki.urpl.gov.pl/files/43_Glucophage_500_mg_tabl_powl_500mg.pdf.
  2. Christensen MMH, Brasch-Andersen C, Green H, et al. The pharmacogenetics of metformin and its impact on plasma metformin steady-state levels and glycosylated hemoglobin A1c. Pharmacogenet Genomics. 2011; 21(12): 837–850.
  3. Gong Li, Goswami S, Giacomini KM, et al. Metformin pathways: pharmacokinetics and pharmacodynamics. Pharmacogenet Genomics. 2012; 22(11): 820–827.
  4. Wróbel MP, Marek B, Kajdaniuk D, et al. Metformin — a new old drug. Endokrynol Pol. 2017; 68(4): 482–496.
  5. van der Molen A, Reimer P, Dekkers IA, et al. Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients : Recommendations for updated ESUR (European Society of Urogenital Radiology) Contrast Medium Safety Committee guidelines. Eur Radiol. 2018; 28(7): 2856–2869.
  6. Zalecenia kliniczne dotyczące postępowania u chorych na cukrzycę 2022. Stanowisko Polskiego Towarzystwa Diabetologicznego. Diabetol Klin. 2022; 2(Supl. A): 1–133.
  7. Navaneethan SD, Zoungas S, Caramori ML, et al. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney Int. 2020; 98(4S): S1–S115.
  8. Shams E, Mayrovitz HN. Contrast-Induced Nephropathy: A Review of Mechanisms and Risks. Cureus. 2021; 13(5): e14842.
  9. Goergen SK, Rumbold G, Compton G, et al. Systematic review of current guidelines, and their evidence base, on risk of lactic acidosis after administration of contrast medium for patients receiving metformin. Radiology. 2010; 254(1): 261–269.
  10. Thomsen HS, Morcos SK. Contrast media and metformin: guidelines to diminish the risk of lactic acidosis in non-insulin-dependent diabetics after administration of contrast media. ESUR Contrast Media Safety Committe. Eur Radiol. 1999; 9: 738–740.
  11. Inzucchi SE, Lipska KJ, Mayo H, et al. Metformin in patients with type 2 diabetes and kidney disease: a systematic review. JAMA. 2014; 312(24): 2668–2675.
  12. Richy FF, Sabidó-Espin M, Guedes S, et al. Incidence of lactic acidosis in patients with type 2 diabetes with and without renal impairment treated with metformin: a retrospective cohort study. Diabetes Care. 2014; 37(8): 2291–2295.
  13. Salpeter SR, Greyber E, Pasternak GA, et al. Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus: systematic review and meta-analysis. Arch Intern Med. 2003; 163(21): 2594–2602.
  14. van der Molen AJ, Reimer P, Dekkers IA, et al. Post-contrast acute kidney injury — Part 1: Definition, clinical features, incidence, role of contrast medium and risk factors : Recommendations for updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol. 2018; 28(7): 2845–2855.
  15. ACR Manual on Contrast Media 2021 ACR Committee on Drugs and Contrast Media. https://www.acr.org/-/media/ACR/files/clinical-resources/contrast_media.pdf.
  16. Food and Drug Administration (FDA). FDA revises warnings regarding use of the diabetes medicine metformin in certain patients with reduced kidney function. 2016. http://www.fda.gov/Drugs/DrugSafety/ucm493244.htm (15 December 2017).
  17. Van der Molen AJ, Geenen RWF, Dekkers HM et al for the Radiological Society of the Netherlands (RSTN). Guideline safe use of contrast media, part 1. Vught, RSTN: 2017.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Via MedicaWydawcą jest  VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl