Final answer:
Patients at higher risk of adverse effects from Metformin include those over 35 who smoke, have histories of certain cancers or blood clots, and those with pre-existing conditions that may induce insulin resistance such as metabolic acidosis. Elderly patients and those of certain ethnic backgrounds may also be at increased risk.
Step-by-step explanation:
Patients who have a higher risk of developing adverse effects from Metformin typically include individuals with certain conditions or characteristics. Specifically, those who are older than 35 and smoke, have a history of blood clots, or have a history of breast, liver, or endometrial cancer may have increased risks when using Metformin. Additionally, type 2 diabetes patients who are of Hispanic and African-American descent might experience higher instances of ketoacidosis, a serious complication, if insulin doses are missed.
Moreover, the elderly are more susceptible to changes in glucose metabolism, leading to greater spikes in blood glucose levels and a slower return to normal. The occurrence of metabolic acidosis also poses a risk as it can induce insulin resistance, impairing the insulin signaling pathway and thereby worsening metabolic dysfunction and cardiovascular risk, particularly among patients with pre-existing conditions like chronic kidney failure.