The safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes Association and the Korean Society of Nephrology have agreed on consensus statements concerning metformin use for patients with T2DM and renal dysfunction, particularly when these patients undergo imaging studies using iodinated contrast media (ICM). Metformin can be used safely when the estimated glomerular filtration rate (eGFR) is ≥45 mL/min/1.73 m². If the eGFR is between 30 and 44 mL/min/1.73 m², metformin treatment should not be started. If metformin is already in use, a daily dose of ≤1,000 mg is recommended. Metformin is contraindicated when the eGFR is <30 mL/min/1.73 m². Renal function should be evaluated prior to any ICM-related procedures. During procedures involving intravenous administration of ICM, metformin should be discontinued starting the day of the procedures and up to 48 hours post-procedures if the eGFR is <60 mL/min/1.73 m².

Citations

Citations to this article as recorded by  

• Distribution and elimination kinetics of midazolam and metabolites after post-resuscitation care: a prospective observational study
  Wonjoon Jeong, Jung Sunwoo, Yeonho You, Jung Soo Park, Jin Hong Min, Yong Nam In, Hong Joon Ahn, So Young Jeon, Jang Hee Hong, Ji Hye Song, Hyein Kang, My Tuyen Thi Nguyen, Jaehan Kim, Changshin Kang
  Scientific Reports.2024;[Epub]     CrossRef
• Prediction of glycosylated hemoglobin level in patients with cardiovascular diseases and type 2 diabetes mellitus with respect to anti-diabetic medication
  Alisher Ikramov, Shakhnoza Mukhtarova, Raisa Trigulova, Dilnoza Alimova, Saodat Abdullaeva
  Frontiers in Endocrinology.2024;[Epub]     CrossRef
• Determinants of vitamin B12 deficiency in patients with type-2 diabetes mellitus — A primary-care retrospective cohort study
  Andrew Kien Han Wee, Rehena Sultana
  BMC Primary Care.2023;[Epub]     CrossRef
• Risk factors for post-contrast acute kidney injury in patients sequentially administered iodine- and gadolinium-based contrast media on the same visit to the emergency department: a retrospective study
  Changshin Kang, Soo Hyun Han, Jung Soo Park, Dae Eun Choi
  Kidney Research and Clinical Practice.2023; 42(3): 358.     CrossRef
• Guideline for the diagnosis and treatment of diabetes mellitus in patients with transfusion-dependent thalassemia
  Mohammad E. Khamseh, Mojtaba Malek, Nahid Hashemi-madani, Fariba Ghassemi, Neda Rahimian, Amir Ziaee, Mohammad Reza Foroughi-Gilvaee, Pooya Faranoush, Negin Sadighnia, Ali Elahinia, Mohammad Reza Rezvany, Mohammad Faranoush
  Iranian Journal of Blood and Cancer.2023; 15(4): 293.     CrossRef
• Continuous use of metformin in patients receiving contrast medium: what is the evidence? A systematic review and meta-analysis
  Ting-Wan Kao, Kuo-Hua Lee, Wing P. Chan, Kang-Chih Fan, Che-Wei Liu, Yu-Chen Huang
  European Radiology.2022; 32(5): 3045.     CrossRef
• Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes Mellitus and Cardiovascular Disease: The Past, Present, and Future
  Filipe Ferrari, Rafael S. Scheffel, Vítor M. Martins, Raul D. Santos, Ricardo Stein
  American Journal of Cardiovascular Drugs.2022; 22(4): 363.     CrossRef
• Comparative Efficacy of Lobeglitazone Versus Pioglitazone on Albuminuria in Patients with Type 2 Diabetes Mellitus
  Kyung-Soo Kim, Sangmo Hong, Hong-Yup Ahn, Cheol-Young Park
  Diabetes Therapy.2021; 12(1): 171.     CrossRef
• Treatment Patterns of Type 2 Diabetes Assessed Using a Common Data Model Based on Electronic Health Records of 2000–2019
  Kyung Ae Lee, Heung Yong Jin, Yu Ji Kim, Yong-Jin Im, Eun-Young Kim, Tae Sun Park
  Journal of Korean Medical Science.2021;[Epub]     CrossRef
• Albuminuria Is Associated with Steatosis Burden in Patients with Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease (Diabetes Metab J 2021;45:698-707)
  Eugene Han, Hye Soon Kim
  Diabetes & Metabolism Journal.2021; 45(6): 972.     CrossRef
• KRCP's past and future path
  Tae-Hyun Yoo
  Kidney Research and Clinical Practice.2020; 39(3): 233.     CrossRef
• Metformin Use and Risk of All-Cause Mortality and Cardiovascular Events in Patients With Chronic Kidney Disease—A Systematic Review and Meta-Analysis
  Yao Hu, Min Lei, Guibao Ke, Xin Huang, Xuan Peng, Lihui Zhong, Ping Fu
  Frontiers in Endocrinology.2020;[Epub]     CrossRef
• Pharmacotherapy for patients with diabetes mellitus
  Joon Ho Moon, Soo Lim
  Journal of the Korean Medical Association.2020; 63(12): 766.     CrossRef