Metformin
Perioperative metformin recommendations differ between guidelines.
ADA 2026
The recommendation is to hold metformin and other oral glucose-lowering agents on the day of surgery/procedure.
AHA/ACC 2024
The cardiovascular guidance states that continuation of metformin during the perioperative period is reasonable in patients with diabetes or impaired glucose tolerance.
Applying the guidance
Local policy, renal function, contrast exposure, procedure characteristics and glycaemic plan therefore matter.