Metformin for granuloma annulare lacks proof, while a practical delirium-prevention plan guides care
The column explains that using metformin to treat granuloma annulare has no proven benefit yet, despite a 2026 study proposing possible mechanisms; while metformin is low-risk, it isn’t recommended without solid evidence, with standard dermatologic options including steroids, UV therapy, and, in severe cases, medicines like methotrexate or hydroxychloroquine, and emerging JAK inhibitors. The piece also outlines a comprehensive delirium-prevention plan for older patients after planned procedures, emphasizing family involvement, maintaining orientation with glasses/hearing aids and a clock, familiar objects, keeping the room well-lit during the day and dark at night, encouraging mobility, avoiding restraints, safe pain management, adequate nutrition and hydration, and careful medical monitoring to minimize delirium risk.
