Gastrointentinal intolerance metformin and acute diverticulitis

Authors

  • Carlos Walter Contreras-Camarena Servicio de Medicina Interna. Hospital Nacional Dos de Mayo. Universidad Nacional Mayor de San Marcos. Lima. Perú https://orcid.org/0000-0002-7394-995X
  • Humberto Lira-Veliz Departamento de Emergencias y Cuidados Críticos. Hospital Nacional Dos de Mayo. Universidad Nacional Mayor de San Marcos. Lima. Perú https://orcid.org/0000-0003-0634-9927

DOI:

https://doi.org/10.32818/reccmi.a5n3a9

Keywords:

metformin, adverse effects, diarrhea, colonic diverticulitis.

Abstract

Metformin intolerance occurs in 20 to 30% of diabetics; it is definitively suspended in 5% due to severe gastrointestinal effects. We present the case of a 65 year-old male, diabetic type 2, with diverticular disease, who repeatedly presented diarrhea and abdominal pain due to metformin. He was admitted to the intensive care unit for acute diverticulitis and discharged with insulin and definitive withdrawal of metformin. We suggest considering the probability of increased risk for metformin intolerance in the presence of intestinal morphological changes.

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References

Bouchoucha M, Uzzan B, Cohen R. Metformin and digestive disorders. Diabetes Metab. 2011; 37(2): 90-6. doi: https://doi.org/10.1016/j.diabet.2010.11.002.

Bonnet F, Scheen A. Understanding and overcoming metformin gastrointestinal intolerance. Diabetes Obes Metab. 2017; 19(4): 473-81. doi: https://doi.org/10.1111/dom.12854.

Dujic T, Zhou K, Donnelly LA, Tavendale R, Palmer CNA, Pearson ER. Association of Organic Cation Transporter 1 With Intolerance to Metformin in Type 2 Diabetes: A GoDARTS Study. Diabetes. 2015; 64(5): 1786-93. doi: https://doi.org/10.2337/db14-1388.

Elbere I, Kalnina I, Silamikelis I, Konrade I, Zaharenko L, Sekace K et al. Association of metformin administration with gut microbiome dysbiosis in healthy volunteers. PLoS One. 2018; 13(9): e0204317. doi: https://doi.org/10.1371/journal.pone.0204317.

McCreight LJ, Stage TB, Connelly P, Lonergan M, Nielsen F, Prehn C, et al. Pharmacokinetics of metformin in patients with gastrointestinal intolerance. Diabetes Obes Metab. 2018; 20(7): 1593-601. doi: https://doi.org/10.1111/dom.13264.

McCreight LJ, Bailey CJ, Pearson ER. Metformin and the gastrointestinal tract. Diabetología. 2016; 59: 426-35. doi: https://doi.org/10.1007/s00125-015-3844-9.

Zhou K, Donnelly LA, Kimber CH, Donnan P, Doney A, Leese G, et al. Re- duced-function SLC22A1 polymorphisms encoding organic cation trans- porter 1 and glycemic response to metformin: a GoDARTS study. Diabetes. 2009; 58: 1434–1439. doi: https://doi.org/10.2337/db08-0896.

Wu H, Esteve E, Tremaroli V, Khan MT, Caesar R, Mannerås-Holm L, et al. Met- formin alters the gut microbiome of individuals with treatment-naive type 2 diabetes, contributing to the therapeutic effects of the drug. Nat Med. 2017; 23(7): 850-8. doi: https://doi.org/10.1038/nm.4345.

Fluxá D, Quera R. Enfermedad diverticular: mitos y realidades [Diverticu- lar disease: myths and realities]. Rev Med Chil. 2017; 145(2): 201-208. doi: https://doi.org/10.4067/S0034-98872017000200009.

Freckelton J, Evans JA, Croagh D, Moore GT. Metformin use in diabetics with diverticular disease is associated with reduced incidence of diverticulitis. Scand J Gastroenterol. 2017; 52(9): 969-72. doi: https://doi.org/10.1080/00365521.2017.1325930.

Published

2020-12-31

How to Cite

1.
Contreras-Camarena CW, Lira-Veliz H. Gastrointentinal intolerance metformin and acute diverticulitis. Rev Esp Casos Clin Med Intern [Internet]. 2020 Dec. 31 [cited 2024 Dec. 22];5(3):123-5. Available from: https://www.reccmi.com/RECCMI/article/view/577

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