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Improving the Surgical Outcomes by Metformin

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Metformin is a drug used in treating type 2 diabetes which is also said to improve the outcome after surgery. Read the article below to know more.

Medically reviewed by

Dr. Shivpal Saini

Published At September 1, 2023
Reviewed AtSeptember 4, 2023

Introduction

The world population is suffering from certain lifestyle disorders, of which the most common one is diabetes. Diabetes usually causes complications in various systems which leads to decreased life expectancy, and the cost of managing the condition has become a major concern for the public. Metformin is a drug that can be used in the treatment of stroke, cancer, and also infectious diseases. Improvements after surgery on using the drug Metformin are also reported. As it is already known that people with diabetes show major complications after the surgery, the use of this drug has shown better results of improvement after surgery.

What Is Diabetes?

Diabetes is a common public health disorder that can develop in any age group. A problem with the normal body cells not responding to a hormone, insulin, leads to a stage of prediabetes which further leads to a diabetic condition. For the body cells to respond, the pancreas produces more amount of insulin which leads to an increase in blood sugar levels. This increase in blood sugar levels is termed diabetes.

What Is Metformin?

Metformin shows anti-proliferative effects in many organs. It helps in restoring the insulin response in the body. It acts by controlling the blood glucose level and decreases the blood sugar levels produced by the liver which is absorbed by the intestines and stomach. Metformin and other hypoglycemic activity have been taken with diet and exercise changes to prevent diabetes in people who are at high risk of becoming diabetic. It is used in women with polycystic ovarian syndrome. On the whole, it is first synthesized and found to decrease the blood glucose level and is only used for a short time.

What Are the Estimated Side Effects of Using Metformin?

Various side effects can occur without the use of metformin

  • Metformin has no significant adverse effects. However, it may cause a serious condition called lactic acidosis with the following symptoms dizziness, severe drowsiness, muscle pain, tiredness, chills, blue cold skin, fast difficulty breathing, stomach pain, nausea, or vomiting. Lactic acidosis usually occurs due to drug overdose or in some contraindicated conditions. It is more likely to occur in patients with medical conditions, including a serious liver infection or a kidney disease metformin usually do not cause hypoglycemia; however, low blood sugar mainly occurs if this drug is used with another Anti-diabetic drugs hypoglycemia is more likely to occur with heavy exercise drinking large amounts of alcohol or not consuming enough calories from food.

  • Serious allergic reactions to this drug are not noticed.

  • Gastrointestinal tolerance is one of the most frequently occurring serious adverse effects.

What Are the Improved Surgical Outcomes of Using Metformin?

Surgical outcomes can range from mild to severe such as the following:

  • Reduction in the hospital mortality rate and post-surgical complications.

  • Reduction in the usage of intensive care and low medical expenditure.

  • Improvement in surgical outcomes depended mostly on the dosage of Metformin.

  • Diabetes Mellitus: Metformin is used to treat type 2 diabetes mellitus. Reduction in the serum glucose level by several different mechanisms without increasing insulin secretion can be made by metformin hence stabilizing the diabetic patient after surgery.

  • Pre-diabetic Case: Lifestyle modifications must be implemented to restore the patients from pre-diabetic cases, which can improve the surgical outcome.

  • Polycystic Ovary Syndrome: Promising results have not been shown due to the use of metformin in women suffering from PCOS. The efficacy of the drug differs for differing populations. The outcome of metformin after surgery is still being researched.

  • Cancer Protection: Antiproliferative effects have been shown on intestines, pancreas, ovaries, prostate, and lung cancer. Preventing the multiplication of cancer cells helps in the prevention of cancer.

  • HIV-Associated Diabetes: The use of antiretroviral drugs in HIV infection has been associated with glucose tolerance, insulin resistance, hyperinsulinemia, and type 2 diabetes. Metabolic alterations are associated with the loss of subcutaneous fat and increased visceral fat. Maintenance of a diabetic condition, even in HIV patients, can improve the outcome of the surgery.

  • Nephrotoxicity Prevention: Prevention of toxicity of kidney can also occur after surgery which is prevented by the use of metformin. It protects tubular injury by regulating oxidative stress and restoring the biochemical alterations on the renal tubules. Metformin also protects the kidney cells in diabetic nephropathy.

They have a reduced risk of post-operative stroke due to the use of the metformin mechanism, and their lining in reducing stroke frivolity in patients remains multifactorial. It is a glucose-lowering agent with actions decreasing the production of reactive oxygen species intracellularly in endothelial cells. Increase the risk of infection after surgeries have also been investigated with the use of metformin, and is found that the infectious risk of skin diabetes patients is reduced with the use of metformin is known to alter the folded metabolism in bacteria by inhibiting the division of bacteria and removing them.

Is the Mortality After Surgery Decreased With the Use of Metformin?

Mortality was similar between metformin-treated and non-treated individuals. Several studies were conducted that prove the safety of the drug to continue very operatively but also that metformin may lower the mortality in surgical patients with diabetes. Some data show a long-term protective effect on mortality for patients with diabetes taking metformin. The catastrophic and inflammatory properties of metformin, even in patients without diabetes mellitus, may also confer acute organ protection in the operative period. Even in HIV patients, maintaining a diabetic state can enhance the procedure's results. As there is rarely a chance of lactic acidosis, the potential benefits of continuing metformin therapy during the operative period appear to warrant the studies which were conducted.

Conclusion

Metformin can cause a reduced risk of hospital mortality and post-operative complications like pneumonia, septicemia, acute renal failure, and stroke however the advantages and effects of metformin on postoperative outcomes should be validated by further research. It depends on the surgeon and the physician to decide the use of metformin to improve the outcome of the surgery or not, as it is only applicable to some of the patients, as discussed in the article.

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Dr. Shivpal Saini
Dr. Shivpal Saini

General Surgery

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