Metformin For Type 2 Diabetes - Benefits and Side Effects

Metformin is prescribed to people with type 2 diabetes and prediabetes if they cannot control their blood sugar levels well enough through diet and exercise alone. The medication helps lower blood sugar levels by reducing the amount of glucose produced by the liver and making cells more sensitive to insulin. Metformin does not cause weight loss, but it can help obese people lose weight as part of a healthy lifestyle program that includes diet and exercise. Some people are not eligible to take Metformin because they have liver or kidney problems or a condition called acidosis. Other medications may interfere with the drug's ability to work and add to the risk of side effects.

Why Take Metformin?

Metformin helps regulate blood sugar levels in the body, which can help people living with type 2 diabetes. Metformin is recommended as the first line of treatment for type 2 diabetes because it reduces the risk of developing heart disease and stroke in people with diabetes. Additionally, it reduces the risk of developing kidney disease, blindness, and nerve damage.

How does Metformin work?

Metformin works to decrease the amount of glucose released into the blood from the liver and reduces the glucose amount absorbed into fat and muscle cells. Metformin also improves insulin sensitivity, which can help further control blood glucose levels.

What does Metformin Contain?

Metformin contains 500 mg of metformin hydrochloride, the active ingredient. It also contains carboxymethyl cellulose, citric acid monohydrate, and magnesium stearate.

Key Facts about Metformin

• Metformin works best when combined with lifestyle changes such as diet, exercise, and weight loss when needed.
• Metformin may also decrease blood cholesterol levels in some people.
• It is also prescribed to treat metabolic syndrome, polycystic ovary syndrome, and certain cancers. Metformin can be used alone or combined with other drugs and is not addictive.
• Metformin also helps prevent or delay the onset of type 2 diabetes in people at risk for developing it (e.g., those who are overweight and have high blood sugar).

Type 2 Diabetes and Metformin

Type 2 diabetes is a chronic condition that affects how your body processes glucose, or sugar. This disease is characterized by insulin resistance and impaired insulin secretion. Insulin is needed to convert sugar into energy in our cells. When there's too much sugar in our blood, it can lead to complications such as high blood pressure, heart disease, kidney failure, and blindness.

How does Metformin Help to Control and Prevent Type 2 Diabetes?

Metformin lowers blood sugar levels by reducing the amount of glucose produced in the liver, and increasing insulin sensitivity in muscle, fat, and liver cells. Metformin helps the body produce more insulin that can help the body use glucose for energy. It also reduces the amount of glucose released from the stomach into the intestines. As a result, it slows down how quickly food empties from your stomach into your intestines so that your blood sugar levels lower after you eat.

When to Start Taking Metformin?

Metformin is a medication used to treat type 2 diabetes. It may be prescribed to those diagnosed with prediabetes, or those at high risk of developing diabetes and are not responding to lifestyle changes alone.

There are no initial standard guidelines on how much Metformin to prescribe, as it depends on a person’s weight, blood sugar levels, and how well they respond to the medication.

Benefits of Metformin

Metformin has several benefits, including -

• Lowers blood sugar levels.
• Reduces the risk of heart diseases such as heart attacks and strokes.
• Increases insulin sensitivity.
• Improve cholesterol level.
• Prevents kidney damage.
• Helps with weight loss.

Side Effects of Metformin

Metformin side effects are often overlooked by patients and doctors alike. Metformin has been found to cause the following side effects -

• Nausea.
• Vomiting.
• Diarrhoea.
• Headaches.
• Dizziness.
• Insomnia.

 How to reduce the side effects of metformin?

The best way to reduce the side effects of metformin is to take it together with food rather than on an empty stomach. The common side effects of taking metformin are gastrointestinal symptoms like nausea and diarrhea which can be avoided when it is balanced with food.

Along with a balanced diet, regular exercise habits and adopting a healthy lifestyle can help in reducing the side effects of metformin thereby increasing the complications and preventing the spike in blood sugar levels. However, make sure to check your sugar levels regularly so that you don’t end up having low sugar levels.

Also read about the side effects of medicines for diabetes other than Metformin

Alternatives to Metformin for Type 2 Diabetes

There are many alternatives to Metformin for type 2 diabetes. These alternatives can be used in conjunction with Metformin or as a replacement. 

The first alternative to Metformin is insulin, typically prescribed via injections or an insulin pump. Often when someone cannot take Metformin because of its side effects or if they have kidney problems. The downside of using direct insulin is that it needs to be monitored carefully, and it also has side effects like weight gain, hypoglycemia, and even heart failure.

Another alternative to Metformin is the drug Dapagliflozin. This drug is an SGLT2 inhibitor that reduces blood sugar levels and helps control them. It can also help reduce weight, an essential factor in type 2 diabetes health management. Apart from Dapagliflozin, other drugs can manage type 2 diabetes, such as TZDs, GLP-1 agonists, insulin secretagogues, and alpha-glucosidase inhibitors (AGIs).

Other Alternatives include-

1. Sulfonylureas

These drugs stimulate the pancreas to produce insulin and lower blood sugar levels. In use since the 1950s, but they have some side effects like weight gain, low blood sugar, and hypoglycemia.

2. Alpha-glucosidase Inhibitors

These drugs slow down the digestion process and slowly release carbohydrates into the bloodstream, lowering postprandial glucose levels.

3. Exenatide

It's an injectable medicine that works by slowing down the release of sugar into the blood after a meal.

Taking Metformin without having Diabetes

There are several reasons why you should not take Metformin when you don't have diabetes:

1. There are side effects associated with taking this medication if you do not need it. For example, the medicine can cause stomach upset and diarrhoea.
2. The drug may drop your blood sugar levels too low and lead to hypoglycemia, which can be dangerous for those without diabetes.

Foods to include while taking Metformin

Metformin is a sugar tablet of 500 mg that is used to treat high blood glucose levels in people with type 2 diabetes. It is helpful to control high blood sugar levels when taken along with a proper diet and regular exercise program. While a person with type 2 diabetes takes metformin, some foods can help and support regulating blood glucose levels. The following are some types of food that one can include in their diet while taking metformin –

Complex Carbohydrates – Complex carbohydrates are found in foods such as peas, beans, vegetables, whole grains oats, and unrefined grains like brown rice and quinoa. These carbs are rich in fiber which slows down the process of converting the carbs into glucose due to which the glucose levels remain stable. These carbs also help in promoting healthy insulin and glucose levels and support weight loss and gut health. However, always keep a check on the overall consumption of carbs as carbohydrates can affect blood sugar levels directly.

Healthy fats – A low-fat diet is always recommended, however, an intake of healthy fats is always suggested as the type of fat you consume affects the body accordingly. Healthy fats are found in fish, nuts, olive oil, and avocado as they contain unsaturated fats that fight against inflammation and protect the heart. Understand more about the difference between good and bad fats.

Fiber – Fiber helps manage blood glucose levels, keeps the digestive tract healthy and aids in weight loss. Fiber is found in whole grains, vegetables and fruits. Taking 25-30 gm of fiber each day can be beneficial to the body.

Lean proteins – Lean sources of protein are  chicken, tofu and fish. These lean proteins help in the control of blood sugar levels and minimize saturated fat intake.

Vegetables – Non-starchy vegetables help in slowing down carb metabolism. Therefore, filling half the plate with vegetables like broccoli, leafy greens, cabbage, cauliflower, asparagus etc. is recommended.

Low-carb fruits – Low-carb fruits such as berries help in balancing the glucose levels in the body along with providing fibre and essential nutrients.

Foods or Drinks to Avoid While Taking Metformin?

Metformin does not interact with certain foods and so they make the treatment of diabetes less effective. To get an effective result, it is better to avoid certain foods and drinks which are mentioned below –

Alcohol – Consuming alcohol while taking metformin can lead to a condition called lactic acidosis when the blood turns acidic and there is a build-up of a chemical called lactate in the body. While consuming alcohol in moderation should not be a problem, it is better to avoid it.

Simple and refined carbs – Carbs such as white bread, white rice, white pasta, and snacks which include chips and crackers should be avoided as they are refined and contain a high amount of carbs in them. As metformin helps in reducing blood sugar, consuming carbs-rich food while taking metformin will not be as effective as it should be. Also sugary foods and drinks like soda, candy and desserts shoot up glucose levels making metformin less effective.

Saturated fats – Saturated fats are found in red meats and dairy products such as milk, cheese, butter etc. which contributes to imbalanced lipids. They also increase the risk of cardiovascular diseases due to inflammatory disorders. These foods can keep glucose levels elevated for a long time. So, taking food with saturated fats should be avoided while taking metformin.

Trans Fat – Foods rich in trans-fat such as baked goods and fast foods increase the inflammation in the body leading to heart ailments.

Sodium – Consumption of too much sodium in the diet or sodium-rich foods such as bacon, sauces, instant soup, salted nuts, canned foods, pickles etc can aggravate the risk of hypertension and affect heart health.

Other things to avoid while taking metformin

Metformin is used to treat people with type 2 diabetes. Though there is negligible risk involved in taking metformin, one needs to be careful when on other medications. Certain types of medications do not easily interact with metformin and can increase the risk of lactic acidosis. 

The following are some of the things to avoid while taking metformin –

• Anticonvulsants which includes topiramate and zonisamide
• Various oral contraceptives
• Corticosteroids like prednisone
• Diuretics such as acetazolamide
• Blood pressure medications which include amlodipine
• Antipsychotic drugs like chlorpromazine

Duration of Taking Metformin

The duration to take Metformin depends on your diagnosis and how well your body responds to the drug.

Metformin For Type 2 Diabetes - Benefits and Side Effects

Metformin is a drug used for the treatment of type 2 diabetes. Diabetes is a chronic metabolic disorder that affects how your body uses sugar. There are two types of diabetes. Type 1 diabetes occurs when the pancreas does not produce any insulin, and type 2 diabetes occurs when the pancreas does not produce enough insulin or the body's cells do not react to it. Type 2 diabetes is more common and accounts for about 90% of all cases of diabetes in adults. The goal of treatment for type 2 diabetes is to control blood glucose levels as close to normal as possible without causing low blood sugar (hypoglycemia).

Metformin is the most common and well-known medication for diabetes. It is an oral medication that helps regulate blood sugar levels by reducing glucose production in the liver and improving insulin sensitivity. These aids allow cells to take up glucose from the blood more efficiently. Metformin also increases glucagon-like peptide 1 (GLP-1) levels, a hormone released from cells in the small intestine after a meal, which decreases appetite and slows stomach emptying.

When to see a doctor?

Metformin may or may not suit some categories of people depending on their body types. You may need to see a doctor if you experience the following -extreme tiredness, discomfort, weakness, vomiting, nausea, decreased appetite, stomach ache, rapid breathing or experiencing shortness of breath, dizziness, muscle pain, slow or fast heartbeat, feeling cold, flushing of the skin. Also make sure that you discuss with the doctor any issues you have had before, some complications, surgeries, allergies etc. Learn more about the common and best medicines for diabetes.

FAQs

When should a type 2 diabetic start the intake of metformin?

Metformin is prescribed to people with type 2 diabetes who are unable to control their blood sugar levels by exercise and diet. A type 2 diabetic should start taking metformin when the lifestyle changes produce a negligible positive result. In such a situation, depending upon your weight and blood sugar level, the doctor will prescribe you the required dose of metformin. However, metformin comes with both benefits and side effects, therefore, consuming it rationally is vital.  

What are the dangers of taking metformin? 

Though the intake of metformin may have numerous benefits, the dangers you might experience due to its intake cannot be neglected. Consuming metformin for a long time can cause vitamin B12 deficiency which leads to breathlessness, dizziness, tiredness, etc. Some of the other side effects of taking metformin include nausea, vomiting, headache, insomnia, diarrhea, etc.  

How does metformin help type 2 diabetes?

Metformin reduces the glucose produced in the liver and increases insulin sensitivity in muscle, fat, and liver cells. It also triggers the production of insulin in the body which enables the body to use the glucose properly for generating energy. Eventually, it helps to keep your sugar levels controlled after you eat. Some other benefits of consuming metformin include reduced risk of heart diseases due to improved cholesterol levels, triggers weight loss, and prevents kidney damage.