[Guideline: type 2 diabetes mellitus therapy: metformin, a critical perspective]

Acta Med Port. 2011 Mar-Apr;24(2):331-8. Epub 2011 May 20.
[Article in Portuguese]


Clinical guidelines have the potential to increase health gains, but also to cause harm. In this opinion article we state some misgivings about the application of the Portuguese National Health Directorate's guideline type 2 diabetes therapy: metformin in primary care. We seek to highlight guideline wording that may allow for multiple interpretations (alternatives to monotherapy with metformin, hierarchy of drugs to be associated with metformin, and metformin contraindications). Furthermore, we argue that it seems that choosing a glycemic target of 6.5% in a normative document to be applied in the general population may have unforeseen consequences.

MeSH terms

  • Blood Glucose / analysis
  • Contraindications
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Metformin / therapeutic use*
  • Practice Guidelines as Topic / standards*


  • Blood Glucose
  • Hypoglycemic Agents
  • Metformin