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. 2017 Jul;35(3):154-161.
doi: 10.2337/cd15-0045.

Metformin Use in Practice: Compliance With Guidelines for Patients With Diabetes and Preserved Renal Function

Gregory J Salber  1 , Yu-Bo Wang  2 , John T Lynch  3 , Karen M Pasquale  3 , Thiruchandurai V Rajan  4 , Richard G Stevens  5 , James J Grady  2 , Anne M Kenny  1
Affiliations

Metformin Use in Practice: Compliance With Guidelines for Patients With Diabetes and Preserved Renal Function

Gregory J Salber et al. Clin Diabetes. 2017 Jul.

Abstract

IN BRIEF Several contraindications limit the use of metformin, most notably the risk of lactic acidosis. This article reports on an examination of a population of patients with diabetes with preserved renal function to evaluate provider compliance with guidelines on metformin use and to identify factors that contributed when practice diverged from recommendations. It found that metformin was withheld from approximately one-third of these patients because of 1) an existent contraindication to metformin, 2) patient behavior or preference, or 3) provider preference or bias based on patient or personal factors. Although providers generally follow current recommendations for the use of metformin, deviations from guidelines in practice are common.

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Figures

FIGURE 1.
FIGURE 1.
The percentage of individuals receiving metformin based on A1C level.
FIGURE 2.
FIGURE 2.
The percentage of individuals receiving metformin based on age.
FIGURE 3.
FIGURE 3.
ORs of receiving metformin for outcome measures, including age, number of comorbidities, provider age, A1C level, history of CHF, and use of medications, including ACE or ARB, statin, nonstatin cholesterol medication, other diabetes medications, and insulin.
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