Risk factors of gastrointestinal adverse reactions in patients with T2DM treated with metformin
Objective To analyze the risk factors of gastrointestinal adverse reactions in patients with type 2 diabetes mellitus(T2DM)treated with metformin.Methods A total of 318 patients with T2DM admitted to Department of Internal Medicine,Jinan Second People's Hospital from December 2018 to August 2022 were selected for the retrospective study.After receiving metformin for the first time,according to whether the patients had gastrointestinal adverse reactions within 1 treatment course(3 months),they were divided into a gastrointestinal adverse reaction group(61 cases)and a non-gastrointestinal adverse reaction group(257 cases).The risk factors of gastrointestinal adverse reactions in the patients were analyzed by univariate analysis and multivariate logistic regression analysis.t and x2 tests were applied.Results Sixty-one cases(19.18％)of the 318 patients complicated with gastrointestinal adverse reactions.The body mass index(BMI)of the gastrointestinal adverse reaction group was lower than that of the non-gastrointestinal adverse reaction group[(21.47±1.15)kg/m2 vs.(22.89±1.01)kg/m2];the metformin dosage and the proportions the patients who drank,took insulin treatment,and took the combination with alpha glycosidase inhibitor in the gastrointestinal adverse reaction group were higher than those in the non-gastrointestinal adverse reaction group[(1 379.12±122.03)mg/d vs.(1184.12±112.16)mg/d,29.51％(18/61)vs.16.73％(43/257),34.43％(21/61)vs.21.01％(54/257),and 47.54％(29/61)vs.26.46％(68/257)];there were statistical differences(t=9.605 and 12.000;x2=5.191,4.922,and 10.336;all P＜0.05).The results of multivariate logistic analysis showed that increased BMI was a protective factor for gastrointestinal adverse reactions in the patients(OR=0.520,P＜0.05);increased dose of metformin,alcohol consumption,and combination with alpha-glucosidase inhibitors were risk factors for gastrointestinal adverse events in the patients(OR=2.008,2.179,and 1.933;all P＜0.05).Conclusions Patients with T2DM mellitus treated with metformin are at risk of gastrointestinal adverse reactions.The risk factors include decreased BMI,increased dose of metformin,alcohol consumption,and combination with alpha-glucosidase inhibitors.For high-risk patients with gastrointestinal adverse reactions,intervention strategies should be timely adjusted according to the above factors.
Type 2 diabetes mellitusGastrointestinal adverse reactionsMetforminClinical characteristicsRisk factors
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