A patient with type 2 diabetes mellitus has recently had his metformin dose increased due to poor control. He is now suffering from diarrhoea. What is the likely cause of this?
- Bacterial overgrowth
2) Bile acid malabsorption - Autonomic neuropathy
- Infective diarrhoea
- Chronic Pancreatitis
explanation
Metformin leads to bile acid malabsorption and thus can lead to diarrhoea at higher doses due to reduced water and electrolyte reabsorption in the large intestine. Autonomic neuropathy can lead to diarrhoea but given the recent increased metformin this is much more likely.