Why Metformin is Prescribed to be Held Prior to Surgery- Understanding the Pre-Operative Protocol

Why is Metformin Held Before Surgery?

Metformin, a commonly prescribed medication for type 2 diabetes, has been a topic of interest in the medical community due to its potential effects on patients undergoing surgery. The question of why metformin is held before surgery has been raised by both healthcare professionals and patients. This article aims to explore the reasons behind this practice and its implications for patient care.

Firstly, metformin is known for its role in improving insulin sensitivity and reducing glucose production in the liver. By doing so, it helps to lower blood sugar levels in individuals with type 2 diabetes. However, during surgery, the body’s metabolism changes, and blood sugar levels can become unstable. To prevent complications such as hypoglycemia or hyperglycemia, it is crucial to hold metformin before surgery.

One of the primary reasons for holding metformin before surgery is the risk of lactic acidosis, a rare but serious complication. Metformin works by inhibiting the production of lactate in the liver, which can lead to an accumulation of lactic acid in the body. In situations where the body’s ability to metabolize lactate is compromised, such as during prolonged fasting or in individuals with kidney dysfunction, the risk of lactic acidosis increases. By holding metformin before surgery, healthcare providers can minimize this risk and ensure patient safety.

Moreover, holding metformin before surgery is essential to prevent postoperative hypoglycemia. Since metformin decreases insulin resistance, it can cause blood sugar levels to drop rapidly, especially when combined with other medications or stress-induced changes in metabolism. By discontinuing metformin before surgery, healthcare providers can reduce the risk of hypoglycemia and ensure that patients remain stable during the perioperative period.

Additionally, holding metformin before surgery allows healthcare providers to better manage blood sugar levels during the perioperative period. By adjusting insulin therapy or other glucose-lowering medications, healthcare professionals can maintain optimal blood sugar control and minimize the risk of complications such as infection or delayed wound healing.

In conclusion, the practice of holding metformin before surgery is based on several important considerations. It helps to minimize the risk of lactic acidosis, prevent postoperative hypoglycemia, and allows healthcare providers to manage blood sugar levels effectively during the perioperative period. By understanding the reasons behind this practice, both healthcare professionals and patients can work together to ensure the best possible outcome for individuals with type 2 diabetes undergoing surgery.