Biguanide

The biguanides are oral treatments used for the treatment of type 2 diabetes. These antidiabetic agents belong to the insulin sensitising family of medicines.

How do the biguanides work?

Unlike other antidiabetic agents, the biguanides do not act on insulin secretion. Rather, they reduce blood glucose by reducing the production of glucose by the liver. They then facilitate the use of glucose by muscles and its storage in adipose tissue (fat).

Do they have contraindications or precautions?

The biguanides may cause gastro-intestinal side effects such as diarrhoea or dyspepsia which usually reduce with time. They can also – and rarely – cause poor absorption of vitamin B12. These treatments are contraindicated in patients at risk of acidosis and those who have or are at risk of heart failure or respiratory diseases. And also in alcoholism. It should be noted that this treatment must also be stopped before any surgical procedure which requires general anaesthesia.

Sources:

• Merck Manual – 4^th edition -
• (Association de langue française pour l'étude du diabète et des maladies métaboliques) French Association for the study of diabetes and metabolic diseases, website accessed on 19 April 2011