I take Metformin as a "given" for IR and assume that everyone who can will take it. I would love science to come up with other options for IR, but none seem to be in the pipeline.
Remember that for a long time the USA banned Metformin partly due to a claimed increase risk of DKA! FDA warnings are often based on a single case and should be considered by UK consultants, but may be too much information to expect UK GP to consider, however FKA warning are made use of by NICE.
Whenever a doctor tells me that everyone should take Satins, I remind them about Thalidomide and the dangers of mass medications of the population. These days Thalidomide is used on a very limited bases including for some cancers and I expect that GPs are not allowed to prescribe it, but it is life saving for a few people.
https://medlineplus.gov/druginfo/meds/a696005.html
Reading between the lines, it would seem there may be a connection between dehydration and DKA, but it seems to be the elephant in the room. We see it with SGLT-2 Inhibitors, and here with Metformin, but no one is giving a definitive answer on what is triggering the serious condition, We are still in the dark as to a cause.
I was on Actos until my second stroke, and was only taken off it when it becsme contraindicted for patients who
Already had a CVE, but not newbies, even though the med is associated with causing said CVE in the first place. It is banned in USA and I believe on the Continent and India since 2011 , but not in UK. I firmly believe statins will turn out to be a similar bad choice, and they (Big Pharma) are pushing them for an increasing number of conditions so that eventually the whole world will be on them. Does the name Damien mean anything to you> The Omen? or Stoma in Brave New World?
Having discovered the very dubious trial data that the drug companies used to justify statins in the first place, then I will never use them again. Their statistics has been demonstrated to be open to misinterpretation and the false determination of cause . effect, and is open to misuse. Did they misuse this? From the two reports I studied, there was no way I could get the raw data to substantiate their conclusions, and it seem I am not alone in making this observation. The textbook describing the statistics methods has been withdrawn from publication, on the grounds I outline above, The few library copies that remain are overstamped Archive info only, Not to be used for new investigations. The online version has a Front sheet making this same declaration. New studies aince2016 must use different methodology, ans should be more believable, but reportds from before this date must be considered suspect, expecially since it is usually the companies themselves doing the research, and funding it and writing the conclusions too, Vested interest. Moi?