summer slump sale Save up to 40% today
Medicine (MD/DO)
Antihyperglycemic Agents

Master Metformin with Picmonic for Medicine

With Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing.


Recommended Picmonics

picmonic thumbnail
picmonic thumbnail
Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)
picmonic thumbnail
Glyburide and Glipizide (2nd Generation Sulfonylureas)
picmonic thumbnail
Pioglitazone (Thiazolidinediones)
picmonic thumbnail
Acarbose (Precose) and Miglitol (Glyset) (Alpha Glucosidase Inhibitors)


Metformin is part of the Biguanide class of diabetic drugs. It is the first line medical treatment for diabetes mellitus type 2 and can also be used for PCOS. Its exact mechanism of action is not fully understood, but this medication leads to decreased gluconeogenesis and increased insulin sensitivity to lower blood sugar levels. Side effects of this drug include lactic acidosis, GI distress, weight loss, and vitamin B12 deficiency. Metformin should be avoided in patients with renal failure.
Diabetes Mellitus Type 2
Dyed-bead Pancreas in a (2) Tutu

Metformin is the first line medical therapy for patients with type 2 diabetes mellitus (T2DM) because unlike other antidiabetic agents, it does not cause hypoglycemia.

Polycystic Ovary Syndrome (PCOS)
Peacock with PCOS

Metformin can be used in PCOS particularly in women with co-morbid insulin resistance, as evidenced by the presence of type 2 diabetes or lab measures of insulin resistance. It can also assist with weight loss.

Decreased Gluconeogenesis
Down-arrow Glue-genie

Metformin has multiple mechanisms of action. Metformin decreases hepatic gluconeogenesis via inhibition of mitochondrial glycerophosphate dehydrogenase (mGPD), an enzyme which normally facilitates the conversion of glycerol to glucose.

Increased Insulin Sensitivity
Up-arrow Insect-syringe at Sensitive-tears

Metformin also increases insulin sensitivity, which is the primary affliction in patients with T2DM. Metformin helps increase peripheral glucose uptake, helping to lower the blood sugar.

Lactic Acidosis
Lake Acidic-lemon

Metformin can cause elevations in lactate levels due to its inhibition of gluconeogenesis and prevention of lactate being converted to glucose. Therefore a side effect can be lactic acidosis, seen especially in cases of overdose or concurrent renal failure.

GI Distress
GI with Flare-gun

Metformin use can cause GI distress. It is associated with diarrhea, nausea and vomiting.

Weight Loss

This drug promotes weight loss, which is actually a favorable side effect for most patients.

B12 Deficiency
(12) Dozen Viking (B) Bees Broken

Another side effect of metformin is inhibition of vitamin B12 and/or folate absorption from the gastrointestinal tract.

GFR < 30 ml/min
Gopher < (30) Dirty

Due to the increased risk of lactic acidosis, metformin is contraindicated in patients with a GFR < 30 ml/min. Patients whose GFR is greater than 45ml/min are generally considered to be candidates for a full dose of metformin. Patients whose GFR is 30-45 should be closely monitored and prescribed metformin judiciously. For patients receiving intravenous contrast for radiologic studies, metformin may be stopped for a period of time since contrast increases the risk of acute kidney injury.


Take the Metformin Quiz

Picmonic's rapid review multiple-choice quiz allows you to assess your knowledge.

It's worth every penny

Our Story Mnemonics Increase Mastery and Retention

Memorize facts with phonetic mnemonics

Unforgettable characters with concise but impactful videos (2-4 min each)

Memorize facts with phonetic mnemonics

Ace Your Medicine (MD/DO) Classes & Exams with Picmonic:

Over 1,900,000 students use Picmonic’s picture mnemonics to improve knowledge, retention, and exam performance.

Choose the #1 Medicine (MD/DO) student study app.

Picmonic for Medicine (MD/DO) covers information that is relevant to your entire Medicine (MD/DO) education. Whether you’re studying for your classes or getting ready to conquer the USMLE Step 1, USMLE Step 2 CK, COMLEX Level 1, or COMLEX Level 2, we’re here to help.

Works better than traditional Medicine (MD/DO) flashcards.

Research shows that students who use Picmonic see a 331% improvement in memory retention and a 50% improvement in test scores.