A 56-year-old man has been referred to the surgical outpatient department with a right-sided inguinal hernia. He has requested a day surgical procedure. The patient has type 2 diabetes and hypertension. He has no history of a myocardial infarction or angina. He lives in a house with ten stairs, which he can climb easily without shortness of breath. He takes metformin 500 mg TDS for his diabetes and atenolol 50 mg daily for his hypertension. He is a non-smoker and drinks fewer than 12 units of alcohol per week.
Examination His blood pressure is 130/80 mmHg and the pulse rate is 88/min. His BMI is 28 kg/m 2 and random blood sugar level is 6 mmol/L. The chest is clear and heart sounds are normal. Abdominal examination reveals an easily reducible non-tender right inguinal hernia. What would you advise about the metformin prior to surgery? (Answer is posted in the comment section below!)…
