Case of Metformin induced urticaria in Type 2 diabetes reported
Dr Lata Kanyal Butola and colleagues at the Jawaharlal Nehru Medical College, Sawangi Wardha, Maharashtra, India reported an interesting case of drug-induced urticaria with itching nearly 1 month after initiation of metformin. The case has been published in the Journal of Evolution of Medical and Dental Sciences.
Metformin is the first line of treatment for type 2 diabetes mellitus for controlling high blood sugar by decreasing glucose production by the liver and by increasing insulin sensitivity of body tissues. India at present is at the top of the world with the highest number of people with diabetes mellitus (31.7 million). However, WHO has also predicted that by 2030 T2DM may affect up to 79.4 million individuals in India.
Some of the functions of Metformin is that it is an oral agent considered as an insulin sensitizer because it helps in lowering insulin levels, reduces hepatic glucose production improves peripheral glucose utilization and helps in uptake and utilization of gut glucose.
In the present case study, a 26-year-old woman recently diagnosed with type 2 diabetes mellitus during a routine check-up visited the physician complaining of itching for the past 2 weeks. The reported blood sugar at that time was 276 mg/dl and an HbA1c of 7.6 %. The patient was earlier diagnosed with PCOD, Hypothyroidism and obesity. Metformin 500 mg (BD) was prescribed. However, after 2- days, the patient initially developed itchy red color spots on her hand which was developed later in the whole body. Metformin was immediately stopped. A detailed biochemistry investigation revealed slightly decreased serum creatinine (0.5 mg/dl) and Vitamin C (0.26 mg/dl) levels with an increase in SGOT (47 U/L) and SGPT (51 U/L), explained Butola.
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