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    Type II Diabetes medication alternatives for Metformin
    keshrose posted:

    My 83 yo grandmother was recently hospitalized for lactic acidosis caused by her Metformin intake. She does not consume alcohol at all but has had mild congestive heart failure for some time (a risk factor for Metformin users in addition to her 80+ age). I'm wondering if anyone has any knowledge or experience with this situation and what medication(s) were prescribed to replace the Metformin in order to manage the underlying Diabetes.

    Thanks all!
    Michael Dansinger, MD responded:
    It is a difficult situation. Although I do what I can with my patients to avoid the need for drugs, I must say that when a drug is needed I favor metformin when possible. Too bad for the side effects. Doctors have been getting better and better at avoiding lactic acidosis by avoiding metformin in certain at-risk patients and through judicious monitoring.

    Sometimes doctors and patients choose to tolerate higher glucose and A1c levels, especially in older patients. Sometimes other drugs like sulfonylureas or insulin are needed. All the drugs have their own challenges and risks that must be weighed against the challenges and risks of less intensive treatment.

    Lifestyle change is always the best way to proceed when trying to minimize or avoid diabetes drugs.

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