How to explain metformin
Other platforms explain it with text and video. In VMS you practice it on the patient.
Metformin is the first medicine for most people with type 2 diabetes. Good teaching helps patients get past early stomach side effects.
Step by step
Explain how it works
It lowers the sugar the liver makes and helps the body use insulin. On its own it rarely causes low sugar. [1]
Explain how to take it
Take it with meals. The dose starts low and goes up slowly. [1]
Talk about stomach side effects
Nausea, loose stools or gas are common at first and often fade. The extended-release form may be easier on the stomach. [1]
Explain kidney checks
Kidney tests guide the dose. It is not started when eGFR is below 45 and is stopped below 30. [2]
Say when to pause it
Hold it during severe vomiting or dehydration, and as instructed around contrast scans or surgery. [1]
Mention vitamin B12
Long-term use can lower vitamin B12, so it is checked from time to time. [2]
Use teach-back
Ask the patient when they would stop the pill and call the clinic. [3]
Common errors
- Not warning about early stomach upset.
- Not explaining when to hold it.
- Forgetting kidney function checks.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- Open RN, Nursing Pharmacology 2e (CC BY 4.0)
- NCCPA PANCE Content Blueprint
- AHRQ Health Literacy Universal Precautions Toolkit (Teach-Back)
- AAMC Core Entrustable Professional Activities (Core EPAs)
Facts and steps follow AAMC Core Entrustable Professional Activities (Core EPAs); AHRQ Health Literacy Universal Precautions Toolkit (Teach-Back). VMS is not affiliated with these organizations. Updated: 2026-10-11.