Risk Factors For Metformin-Induced Side Effects Among Patients With Diabetes Mellitus At Prof. Dr. W. Z. Johannes Regional General Hospital, Kupang

Abstract

Type 2 Diabetes Mellitus (T2DM) is a chronic disease with an increasing global prevalence. Metformin is the first-line pharmacological therapy for T2DM; however, its use is frequently associated with gastrointestinal side effects, such as nausea, vomiting, and diarrhea, which may negatively affect patients' adherence to treatment. This study aimed to analyze the risk factors associated with metformin-induced side effects among patients with Type 2 Diabetes Mellitus.  This observational analytic study employed a cross-sectional design involving 52 patients with Type 2 Diabetes Mellitus at Prof. Dr. W. Z. Johannes Regional General Hospital, Kupang, from January to June 2024. Data were collected from medical records and structured interviews using a standardized checklist. Bivariate analysis was performed using the Chi-square test and Fisher's Exact test, followed by multivariate logistic regression analysis to identify the dominant risk factors associated with metformin-induced side effects. Age (p = 0.042), Body Mass Index (BMI) (p = 0.043), and metformin dosage (p = 0.001) were significantly associated with the occurrence of metformin-induced side effects. Nausea was the most frequently reported adverse effect, accounting for 85% of all reported side effects, followed by abdominal cramps (11%) and vomiting (4%). All respondents reported taking metformin after meals, as recommended to reduce gastrointestinal adverse effects.  Age, Body Mass Index (BMI), and metformin dosage were identified as the primary risk factors associated with metformin-induced side effects among patients with Type 2 Diabetes Mellitus. Nausea was the most commonly reported adverse effect. Appropriate patient education regarding metformin use is essential to minimize adverse effects, improve medication adherence, and optimize treatment outcomes.