Metformin 101: Blood Sugar Levels, Weight, Side Effects
As a type 2 diabetic, you've probably heard of Metformin, or you might even be taking it yourself. Metformin (brand name “Glucophage” aka “glucose-eater”) is the most commonly prescribed medication for type 2 diabetes worldwide…and for good reason. It is one of the safest, most effective, least costly medication available with minimal, if any, side effects. There are always lots of questions around Metformin – how does metformin lower blood sugar, does metformin promote weight loss or weight gain, will it give me side effects – and lots more. Today we'll hopefully answer some of those questions. How Metformin Works Metformin belongs to a class of medications known as “Biguanides,” which lower blood glucose by decreasing the amount of sugar put out by the liver. The liver normally produces glucose throughout the day in conjunction with the pancreas’ production of insulin to maintain stable blood sugar. In many people with diabetes, both mechanisms are altered in that the pancreas puts out less insulin while the liver is unable to shut down production of excess glucose. This means your body is putting out as much as 3 times as much sugar than that of nondiabetic individuals, resulting in high levels of glucose in the bloodstream. Metformin effectively shuts down this excess production resulting in less insulin required. As a result, less sugar is available for absorption by the muscles and conversion to fat. Additionally, a lower need for insulin slows the progression of insulin resistance and keeps cells sensitive to endogenous insulin (that made by the body). Since metformin doesn’t cause the body to generate more insulin, it does not cause hypoglycemia unless combined with a sulfonylurea or insulin injection. Metformin is one of the few oral diabe Continue reading >>
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6 Reasons Why Metformin Might Not Be Safe For Pcos
Have you been prescribed metformin for PCOS and are wondering what the side affects are? Metformin is often described as a ‘safe’ drug, but read on to find out why this might not be the case. When I was diagnosed with PCOS, the first thing I asked my GP was what I could take to ‘fix’ it. She gently explained that there was no pill or surgery that could cure my condition. However, there was a drug that could help with the elevated insulin levels caused by it. Metformin, she claimed, was a safe drug with no major side effects that would help with insulin resistance and weight loss. Sign me up. At first, I thought metformin was the wonder drug. I lost about 5kg in 4 months, more than I had ever been able to lose previously. I was ecstatic. I had a quick look online to see whether there were any side effects and initially found that diarrhea, loose stools, fatigue, and muscle soreness were commonly experienced. But I thought that it was small price to pay for finally being able to lose some weight. However, when I investigated further I found that that there are some much more sinister side effects of metformin that aren’t so widely publicised. These include: – Depleting our bodies of essential nutrients. – Increasing the risk of having a baby with a neural tube defect by up to 9 times. – Reducing energy levels by almost 50%. – Killing beneficial gut bacteria. This article is not intended to be a case against metformin for PCOS. There is no doubt that metformin helps to reduce weight, lowers blood glucose levels, and promotes ovulation. My concern is the lack of studies about the safety of long-term use of metformin for PCOS, especially in utero. Drugs can help with the associated symptoms of a disease, but they cannot fix the root cause of it. Metformin i Continue reading >>
How One Man Stopped Metformin After Losing Weight
Exercise and weight loss lower blood sugar because they both reduce the body's insulin resistance, the key problem in people with type 2 diabetes. Therefore, increasing exercise or losing weight can sometimes lower or eliminate your need for diabetes medication. It's easier to keep your blood sugar in check without medication if your body is more sensitive to the insulin your body does make (most people with type 2 diabetes make at least some of the hormone). I was able to stop taking metformin, the drug I had been taking to lower my glucose—Louis Sarkes, Type 2 Diabetes Patient Louis Sarkes, 50, was diagnosed with type 2 diabetes in 2006 after a routine blood test during his annual physical exam. "I was surprised, but motivated to do something right away," said Sarkes, who is a money manager based in Baltimore, Md. He went to an all-day session on weight loss at Johns Hopkins University (where his doctor is based). He listened to doctors, nutritionists, and other patients talk about weight loss and exercise strategies, setbacks and successes. More about diabetes and exercise "I chose a diet low in sugars and high in fruits, vegetables and whole grains, and kept carbohydrates at 30 to 35 grams per meal, or no more than 100 grams in a day," says Sarkes. He didnt count every calorie, but kept a general sense and tried to keep the daily limit of calories to 1,800. "To get as much information as I could, especially on tips for sticking with the diet, I met with the nutritionist on my own, and also read everything on the Internet I could find," he said. He followed the advice of his nutritionist and didn't feel guilty if he went over his carbohydrate or calorie limithe just started again as soon a possible. He found healthy snacks he liked and avoided high-fat, high calori Continue reading >>
Can You Stop Diabetes Meds?
When it comes to diabetes there are many success stories, especially among those who know that diet and exercise play a big part in blood sugar control. Medication is also key to getting your numbers into a healthy range. But if you’re like many people who take something daily for diabetes, you probably wonder if you can ever stop. Maybe -- if your blood sugar numbers are good and you’re committed to a healthy lifestyle. The first step is to talk to your doctor. Here’s what you can expect from that chat. Why Do You Want to Stop? First, know that it's OK to ask your doctor if you can stop taking meds once you’ve met the blood sugar goals you've both set, says Robert Gabbay, MD, PhD, chief medical officer of the Joslin Diabetes Center in Boston. And it can be done, he adds. The first step: Tell your doctor why you want to stop. Then he’ll ask you some questions. The doctor’s looking for specific answers, says endocrinologist Gregg Faiman, MD, of University Hospitals Case Medical Center in Cleveland. He wants to know: Is it too hard for you to keep up with taking your medicine? Do the side effects lower you quality of life? Is the medication too expensive? After that, you and your doctor have to agree about how you’re going to keep your blood sugar under control. You wouldn’t be on the drug if you didn’t need it, Faiman says. “Stopping a medication requires an in-depth discussion. You have to commit to keeping your diabetes under control.” Medication Matters If you take the drug metformin, a common treatment for type 2 diabetes, your doctor could lower it in stages as you lose weight and get fitter, Faiman says. You may even be able to stop it -- at least for a while -- if you’re making good lifestyle choices and you keep your blood sugar under cont Continue reading >>
Common Questions About Diabetes Medicines
How do I know if my diabetes pill is working? The best way to find out how well your diabetes pill is working is to test your blood sugar. Ask a member of your health care team what time of day is best for testing. You'll want to test when your diabetes medicine is expected to be most active in your body. Keep a record of your blood sugar levels (PDF) during that time to see if they're at or near your goal. If your levels are at or near your goal and you're not having any problems with the medicine, then it's probably working well. If you're still not sure, talk to your doctor or other member of your care team. Can I stop taking my diabetes medicine after my blood sugar is under control? It's reasonable to think that after a person gets good blood sugar control, it means the end of managing diabetes. But that's not the case. People with type 1 diabetes aren't able to make their own insulin, so they will always need to take insulin shots every day. For people with type 2 diabetes who are on medicine, the answer isn't as clear. Sometimes when people are first diagnosed, they start on pills or insulin right away. If the person also works hard to control diabetes with diet and exercise, he or she can lower the need for medicine and might be able to stop taking it altogether. As long as the person is able to keep blood sugar levels normal with diet and exercise, there isn't a need for medicine. However, type 2 diabetes changes over time. The change can be fast or slow, but it does change. This means that even if a person was able to stop taking medicine for a while, he or she might need to start taking it again in the future. If a person is taking medicine to keep blood sugar normal, then it's important to keep taking it to lower the chances for heart disease and other healt Continue reading >>
Metformin And Insulin Resistance
About a year ago, my endocrinologist determined that I was exhibiting signs of insulin resistance. In short, my body requires more than the average amount of insulin to cover carbohydrate. She suggested that I start taking metformin, noting that it would do two things for me: It would decrease the amount of insulin I need to take and it would help curb my appetite, thus resulting in weight loss. When I first got on it, I thought it was great. My blood sugar levels improved, my appetite was in fact curbed, and all seemed wonderful — until I stopped taking my metformin. As a high school senior, I had atrocious sleeping habits! That, coupled with the fact that taking metformin was really killing my appetite, was causing me to become exhausted and get some pretty severe headaches. Looking back on it now, it’s very clear that the metformin wasn’t the problem, it was me. However, as a stubborn senior in high school, I was determined to maintain my sleeping habits, as I deemed them completely normal and in accordance with the typical behavior exhibited by my peers (boy, how I’ve changed…). So, I stopped the metformin. The last three weeks or so, I’ve been back on metformin regularly. I decided to start it up again after my last appointment with my CDE. Thus far, it’s really been working wonders and my blood sugars have decreased substantially! Where my 30-day average was hovering around 190 just a few weeks ago, it has now dropped to 137! I was seriously shocked when I saw how much my average fell. For the most part, my blood sugar levels are in range, but I have had my fair share of lows as well. Managing metformin really is a science that can change on a daily basis depending on my activity level. For example, the first two weeks that I was back on metformin, I Continue reading >>
How To Wean Off Of Diabetes Medication
One of my greatest pleasures in life is to help patients achieve remission of their type 2 diabetes. This means their blood sugar levels have become normal in the absence of any diabetes medication. Many clinicians and patients are interested in learning my views about how to go about decreasing and discontinuing diabetes medications. The main role for medications is to help reduce or delay the risk of nasty complications of diabetes, particularly the damage to the retina, kidney, nerves, and circulation. The higher the average blood sugar level, as indicated by the hemoglobin A1c level, the greater the complication risk (which increases exponentially with increasing A1c). We know from clinical trials that using medication to keep the A1c at or below 7% can help reduce the risk of these complications. There is broad agreement that clinicians should recommend starting or increasing diabetes medications to patients who cannot get their A1c level to 7% or less via lifestyle change. Many patients come to me because the A1c is already over 7% and their primary care provider proposes increasing their diabetes medication, unless the patient can get to 7% or less with improved eating and/or exercise habits. Some of these patients are already on many pills, and insulin shots are the frequently the next appropriate treatment. Many patients would rather make the lifestyle changes than take more medication, so when the doctor frames the issue in this way, then a patient might become inspired to renew or increase the lifestyle efforts. The clinician might say “lets recheck the A1c in 3 months, and start the new medication if it is still above 7.0%”. My goal with patients is to use the lifestyle strategies I’ve discussed previously in this blog to drive the A1c as low as possib Continue reading >>
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Getting Off Metformin
I want to share some of the problems I have in hope that somebody else might have similar experiences and help me understand this problem. I have been taking Metformin for 20 days and it seems to help. First my sugar wasnt that high. It was 7.3 when I was eating everything (I ate lots of sugar: drinks, candies, high glycemic starches etc). So I got diagnosed with Fatty Liver and Diabetes Mellitus T2 and told to go on a diabetic diet (low sodium because of BP). I have been strict on this diet and fasting glucose was down to 6. But one night (20 days in the diet) I started shaking - like I was cold, had nausea, later I got so tired. Blood glucose was 6 so I was confused. Doktor prescribed Metformin 1 tabled 500mg to take with largest meal. I was taking Metformin for 10 days and things improved. Still few nights (after a brisk walk) I had nausea and my blood pressure was oscillating but there was no shaking and tiredness. Blood glucose was 5.5 Once I stopped taking Metformin for two days to see what will happen. My sugar was always 4.7-5.7 but in 2 days I got the shakes again and tiredness. So I got back to Metformin. But then new doctor told me to reduce this to 250 mg (half a tablet) with larges meal (probably cause she was worried that my AST and ALT, liver numbers from blood test have not decreased ). Now after largest meal I feel ok but later in the evenings (after meals without Metformin) I get small shakes feeling. Not to big. And I am easily tired after walking. So I am seeing a specialist tomorrow who I will ask to increase this dose back to 500 a day. I suspect I have insulin resistance and even though my blood sugars are well kept in controll with too much insulin not enough of sugar gets to the body - but I cant explain the nausea feeling when taking Metformin Continue reading >>
Can Metformin Take Your Blood Sugar Levels Too Low If You Take Too Much??
Can Metformin take your blood sugar levels too low if you take too much?? D.D. Family Getting much harder to control Although the drug in and of itself does not CAUSE a low...if you have a low because of extreme exercise, or other issues, it can keep you from "saving" yourself and rebounding back to normal levels; thus exasperating the situation. If you are having lows on a regular basis while on the medication, then it is time to rethink the medication, and talk to your doctor about decreasing the dosage. When I was on it, I had lows, and it was the signal that my diet and exercise regime was working...and, the doctor cut me back until I no longer needed the medication for diabetic control. Would you further explain saving yourself, that was has me for a loss. I am on the maximum dose and I am fairly petite. I rarely go low unless I am drinking which it says you shouldn't do. So it hasn't interfered with my normal glycogen release from my liver. In fact my liver still dumps way too much glucose. I know some type 1's feel if they are going low from too much insulin their liver won't kick in glycogen if they are on metformin. But I have never seen that in the literature. The one rare side effect Lactic Acidosis may cause lows but that is different. 115 pounds, Breast Cancer dx'd 6/16, 6 months of chemo and 6 weeks of radiation 2000 metformin ER, 100 mg Januvia,Glimperide, Prolia, Gabapentin, Meloxicam, Probiotic with a Prebiotic, , Lisinopril, B-12, B-6, Tumeric, Magnesium, Calcium, Vit D, and Occuvite mostly vegan diet, low fat and around 125 carbs a day, walk 5-6 miles every other day and 1 hour of yoga and light weights. D.D. Family Type 2 Diet and Exercise since 1997 Would you further explain saving yourself, that was has me for a loss. When your body drops low, you Continue reading >>
Can Type 2 Diabetes Be Reversed?
Weve heard that diabetes is a chronic progressive illness. You cant get better, you have to get worse. The best you can do is slow it down. But at least five approaches now claim to reverse Type 2. What does that mean? The official expert line on Type 2 has long been that people start by controlling the condition with diet and exercise. But they move fairly quickly to pills (like metformin), then to insulin or insulin plus pills. In recent years, insulin has been started more quickly, and new drugs like the incretin mimetics are changing the progression of treatment. But it is still thought that the disease progresses and cant be stopped. Being told you are chronic progressive is like having a curse put on you. It can sap your confidence and destroy your hope. But is it true? Dozens of Diabetes Self-Management readers say no. On a blog post by Diane Fennell about a study of low-carb diets in Sweden, people commented eloquently on how they have gotten better by reducing carbohydrate intake. Bob wrote: By limiting carbs, my A1c dropped from an 8.6 to a most recent reading of 4.9. I also know people who eat whole-grain pasta, bread and have oatmeal every morning, because a doctor told them so, bemoaning their numbers. Following a different (acid/alkaline) diet, Dan wrote that his A1C dropped, and his cholesterol and blood pressure are normal. Hes off nearly all his statins, blood pressure medicines, and insulin. Terri wrote: I am a diabetic who eats a low carb vegan diet. I am far healthier now at 53 than ever before and maintain perfect glucose control. And on and on. Its worth reading the whole thread, and there are scores of similar discussions all over the Internet. The reality is that people with Type 2 get better all the time. They reduce their medicines or get off Continue reading >>
Stopping Metformin: When Is It Ok?
The most common medication worldwide for treating diabetes is metformin (Glumetza, Riomet, Glucophage, Fortamet). It can help control high blood sugar in people with type 2 diabetes. It’s available in tablet form or a clear liquid you take by mouth before meals. Metformin doesn’t treat the underlying cause of diabetes. It treats the symptoms of diabetes by lowering blood sugar. It also increases the use of glucose in peripheral muscles and the liver. Metformin also helps with other things in addition to improving blood sugar. These include: lowering lipids, resulting in a decrease in blood triglyceride levels decreasing “bad” cholesterol, or low-density lipoprotein (LDL) increasing “good” cholesterol, or high-density lipoprotein (HDL) If you’re taking metformin for the treatment of type 2 diabetes, it may be possible to stop. Instead, you may be able to manage your condition by making certain lifestyle changes, like losing weight and getting more exercise. Read on to learn more about metformin and whether or not it’s possible to stop taking it. However, before you stop taking metformin consult your doctor to ensure this is the right step to take in managing your diabetes. Before you start taking metformin, your doctor will want to discuss your medical history. You won’t be able to take this medication if you have a history of any of the following: alcohol abuse liver disease kidney issues certain heart problems If you are currently taking metformin, you may have encountered some side effects. If you’ve just started treatment with this drug, it’s important to know some of the side effects you may encounter. Most common side effects The most common side effects are digestive issues and may include: diarrhea vomiting nausea heartburn abdominal cramps Continue reading >>
Can I Stop My Diabetes Medications?
I was recently diagnosed with type 2 diabetes. I am taking 10 mg of glipizide and 500 mg of metformin twice a day. My A1C was 12.5, but I have been feeling better, and I even stopped taking the glipizide every morning. My blood glucose average is now 170. Is that good, or should I continue to take my glipizide every morning? Continue reading >>
Metformin Forever
Metformin controls the insulin resistance of people who have type 2 diabetes so well that, if possible, all of us should be taking it. That’s what Roderic Crist, M.D., told me at the annual convention of the American Society of Bariatric Physicians in Denver this weekend. Dr. Crist specializes in family medicine in Cape Girardeau, Missouri. “Not everybody can take every drug,” he added, when I followed up our conversation by calling him at his office after he returned home. “But most of the time people can take metformin if they take it carefully.” Doctors increasingly prescribe it not only for type 2 diabetes but also for insulin resistance, polycystic ovary syndrome, and non-alcoholic fatty liver disease. Roughly one-third of Dr. Crist’s patients have diabetes. Well over half, if not two-thirds of the people he sees are insulin resistant. “I treat insulin resistance with that drug even if they aren’t fully diabetic.” he says. “If they have high triglyceride levels and low HDL levels, particularly if they are centrally obese, they should probably be on metformin. It helps slow the progression of the disease from one thing to the next.” But he goes further. He prescribes metformin to almost all of his patients who have type 2 diabetes — no matter how low their A1C level is. And he tells his patients that their levels should be 5.0 or less — not the American Diabetes Association’s less stringent recommendation of 7.0 or less. “If their A1C is at 5, their diabetes is in complete remission. So I have that as a goal.” And he still prescribes metformin to them after they reach that goal. “The two important issues are that it will prevent progression and it should be used in the earliest phases of insulin resistance. We vastly underutilize me Continue reading >>
Stop The Metformin Madness
I have never been a fan of Metformin. It seemed too good to be true. Many years ago I had a conversation with a researcher about all of its possible therapeutic indications. His lab was actively pursuing the anti-cancer angle. That should have been a clue that Metformin might be causing more damage than we recognized, but it wasn’t. At that point, I was still enamored with the wonders of pharmacology and hadn’t yet begun my path toward understanding medication adverse reactions. Indeed, it wasn’t until very recently, when a family member began suffering from one of these reactions, that I began my investigation in full. This is what I learned. Type 2 Diabetes is Big Business The global profits from Type 2 diabetes medications rested at a paltry $23 billion dollars in 2011 but are expected to grow to over $45 billion annually by 2020. The market growth is bolstered in large part by the ever-expanding demand for therapeutics like Metformin or Glucophage. Metformin is the first line of treatment and standard of care for insulin resistance across all populations of Type 2 diabetics with over 49 million Americans on Metformin in 2011-2012. It is particularly popular in women’s health with an increasing reliance on Metformin for the metabolic dysfunction observed in women with PCOS, PCOS-related infertility and even gestational diabetes. Metformin is prescribed so frequently and considered so innocuous that it is sometimes euphemistically referred to as vitamin M. If we quickly scan the safety research for metformin, there is little immediate evidence suggesting any side effects whatsoever. In fact, in addition to controlling blood sugar by blocking the hepatic glucose dump, this drug is suggested to promote weight loss, increase ovulation in women, (thereby helping a Continue reading >>
Metformin
Metformin may rarely cause a serious, life-threatening condition called lactic acidosis. Tell your doctor if you have kidney disease. Your doctor will probably tell you not to take metformin. Also, tell your doctor if you are over 65 years old and if you have ever had a heart attack; stroke; diabetic ketoacidosis (blood sugar that is high enough to cause severe symptoms and requires emergency medical treatment); a coma; or heart or liver disease. Taking certain other medications with metformin may increase the risk of lactic acidosis. Tell your doctor if you are taking acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), or zonisamide (Zonegran). Tell your doctor if you have recently had any of the following conditions, or if you develop them during treatment: serious infection; severe diarrhea, vomiting, or fever; or if you drink much less fluid than usual for any reason. You may have to stop taking metformin until you recover. If you are having surgery, including dental surgery, or any major medical procedure, tell the doctor that you are taking metformin. Also, tell your doctor if you plan to have any x-ray procedure in which dye is injected, especially if you drink or have ever drunk large amounts of alcohol or have or have had liver disease or heart failure. You may need to stop taking metformin before the procedure and wait 48 hours to restart treatment. Your doctor will tell you exactly when you should stop taking metformin and when you should start taking it again. If you experience any of the following symptoms, stop taking metformin and call your doctor immediately: extreme tiredness, weakness, or discomfort; nausea; vomiting; stomach pain; decreased appetite; deep and rapid breathing or shortness of breath; dizzi Continue reading >>
