Which adverse effect of metformin will a nurse teach a client with type 2 diabetes to monitor for when used as monotherapy?

Which adverse effect of metformin will a nurse teach a client with type 2 diabetes to monitor for when used as monotherapy?

• A. Weight gain
• B. Constipation
• C. Lactic acidosis
• D. Hypoglycemia

Answer: (C)

Metformin used as monotherapy can cause lactic acidosis, a rare but serious buildup of lactic acid that requires prompt attention. This risk is higher in people with reduced kidney function, liver disease, dehydration, heavy alcohol use, or conditions that limit tissue oxygenation. Teach clients to report symptoms such as unusually rapid breathing or shortness of breath, extreme fatigue or weakness, muscle pain, stomach discomfort or nausea, dizziness, or a sense of being suddenly ill or confused. If these occur, stop the medication and seek urgent medical evaluation. It’s also important to know that metformin does not typically cause hypoglycemia when used alone, and GI upset is more common but usually less dangerous than lactic acidosis. In situations like planned imaging with iodinated contrast, metformin may be held to reduce risk, with evaluation of kidney function before restarting.

Metformin used as monotherapy can cause lactic acidosis, a rare but serious buildup of lactic acid that requires prompt attention. This risk is higher in people with reduced kidney function, liver disease, dehydration, heavy alcohol use, or conditions that limit tissue oxygenation. Teach clients to report symptoms such as unusually rapid breathing or shortness of breath, extreme fatigue or weakness, muscle pain, stomach discomfort or nausea, dizziness, or a sense of being suddenly ill or confused. If these occur, stop the medication and seek urgent medical evaluation. It’s also important to know that metformin does not typically cause hypoglycemia when used alone, and GI upset is more common but usually less dangerous than lactic acidosis. In situations like planned imaging with iodinated contrast, metformin may be held to reduce risk, with evaluation of kidney function before restarting.