What Is Metformin?

Metformin is a prescription medicine most commonly used to treat type 2 diabetes by improving the body’s response to insulin and reducing the amount of glucose released by the liver. It is also prescribed for some people with polycystic ovary syndrome (PCOS) and other conditions where improving insulin resistance may be beneficial.  

What Is Metformin?
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Dr. Chrysoula I. Liakou MD, PhD Google Scholar LinkedIn

Internal Medicine Specialist
Cancer Immunology Researcher

WHAT IS METFORMIN? SIDE EFFECTS, DOSAGE, AND RISKS


Metformin is a prescription medication commonly used by individuals with type 2 diabetes to help regulate their blood sugar levels. However, recent studies suggest that metformin may offer additional benefits beyond glucose control, such as weight loss.


This article will explore the uses, potential side effects, interactions, and more information about metformin.



What Is Metformin?


Metformin, or Glucophage, is a prescription medication for type 2 diabetes. Healthcare providers prescribe it with a doctor-approved diet to help control blood sugar levels in individuals with this condition.


Metformin is available in the form of tablets or an oral solution. The generic version provides an immediate-release formulation, while the brand name Glucophage offers an extended-release version. Your doctor will determine the most suitable form of metformin for your specific needs.


Uses


Metformin is approved for the treatment of type 2 diabetes. When diagnosed with type 2 diabetes, their healthcare provider typically emphasises the importance of lifestyle changes, such as adopting a healthier diet and engaging in regular exercise, to manage the condition. However, suppose these lifestyle modifications do not effectively improve blood sugar levels. In that case, the healthcare provider may prescribe metformin as an initial medication option to help regulate blood sugar and maintain it within a healthy range.


Metformin can also be used for:

  • Gestational diabetes

  • Prediabetes

  • Polycystic ovary syndrome (PCOS)

  • Antipsychotic-induced weight gain


How It Works


Metformin works by effectively lowering blood sugar levels through the following mechanisms:

  1. Reducing liver glucose production: It helps decrease the amount of glucose the liver produces.

  2. Increasing insulin sensitivity: Metformin improves the body's response to insulin, making the cells more sensitive to its effects. This helps the cells better absorb glucose from the bloodstream.

  3. Decreasing intestinal sugar absorption: It reduces sugar absorption into the blood from the intestines.


Metformin typically does not cause low blood sugar (hypoglycemia) when prescribed. It usually takes about three hours for the medication to start working. Always follow your healthcare provider's instructions when taking metformin, as taking it incorrectly can interfere with its effectiveness and lead to additional side effects.


Effectiveness


Numerous studies conducted over the years have consistently highlighted the effectiveness of metformin in managing type 2 diabetes. Research published in Diabetes Spectrum has revealed that combining intensive lifestyle changes with metformin can significantly reduce 31% to 58% in the progression of diabetes. These findings strongly indicate that metformin is an effective medication for controlling type 2 diabetes.



Metformin For Weight Loss


While metformin has been widely used for treating type 2 diabetes for a long time, recent studies suggest that it may also benefit weight loss. In a study conducted in 2020, participants who took metformin lost more weight over 29 weeks than those who received a placebo. When combined with a healthy diet and regular exercise, metformin can help reduce excessive weight gain.


It's important to understand that the FDA has not officially approved metformin as a weight-loss medication. Healthcare professionals do not prescribe Metformin exclusively for weight loss. However, if you have type 2 diabetes and require metformin to control your blood sugar levels, you may also experience the positive effects of weight management associated with its use.


Dosage


Metformin is not intended as a weight loss medication, so a specific dosage is not prescribed. Usually, individuals with type 2 diabetes begin by taking 500 mg twice a day. If this dose does not effectively manage blood sugar levels, a healthcare provider may consider increasing the dosage to 2550 mg daily.


Side Effects


Metformin is commonly associated with the following side effects:

  • Low blood sugar

  • Upset stomach or vomiting

  • Diarrhea


Less common may include:

  • Stomach pain or vomiting

  • Irregular or slow heart rate

  • Trouble breathing

  • Feeling cold

  • Muscle pain or weakness

  • Feeling dizzy or light-headed


Metformin Alternatives


Various medications treat type 2 diabetes, including metformin. Some individuals may be prescribed insulin injections, a hormone the pancreas produces that helps regulate blood sugar levels.


Another option is GLP-1 agonists, which assist in managing blood sugar levels and may also aid in weight loss for individuals with type 2 diabetes. Several oral medications are also available that can effectively control the condition. Talking with your healthcare provider to find the best medication options is best.



How To Take Metformin


To ensure proper usage of metformin, it is essential to follow the instructions provided by your medical provider and pharmacist. Usually, metformin is taken with a meal unless instructed otherwise by your provider. It is crucial to avoid crushing or chewing extended-release pills. If you use the oral solution, shake it well and measure the dosage carefully.


Interactions


It is important to be aware of potential drug interactions with metformin. Lantus and Synthroid are two common medications that strongly interact with metformin. Combining both can amplify metformin's effect on blood sugar or increase the risk of lactic acidosis. Therefore, discussing all your medications, supplements, and vitamins with your medical provider before starting metformin is crucial.


It is advisable to avoid consuming alcohol while taking metformin. While a small amount of alcohol occasionally is generally considered safe, consuming large quantities of alcohol can raise the risk of lactic acidosis and low blood sugar.



Contraindications And Precautions


Metformin should not be taken by people who have metabolic acidosis, severe kidney disease, or diabetic ketoacidosis. If you require medical imaging involving a dye injection into your veins, such as an x-ray or CT scan, it may be necessary to temporarily stop taking metformin. Discussing this with the healthcare provider who ordered and will administer the imaging test is crucial.


When taking metformin, it is recommended to consult your healthcare provider if you have plans to become pregnant or are breastfeeding.


Metformin can occasionally cause a drop in blood sugar levels, leading to hypoglycemia. Symptoms of hypoglycemia may include:

  • Hunger

  • Headache

  • Feeling shaky or weak

  • Irritability

  • Dizziness

  • Drowsiness

  • Weakness

  • Fast heartbeat

  • Clammy skin

  • Confusion


It's essential to know the signs of low blood sugar and how to treat it effectively. Your doctor might prescribe a medication called glucagon to counteract hypoglycemia. Additionally, it's beneficial to educate your friends and loved ones about hypoglycemia so they can assist when necessary. To prevent hypoglycemia, always remember to eat when taking your metformin. It's often better to have frequent small meals rather than three larger ones.



How Mobi Doctor Can Help


Discover how Mobi Doctor can help you manage your diabetes conveniently from the comfort of your home. Here's how you can obtain metformin online through three simple steps:

  • Respond to a few straightforward questions.

  • Consult with your primary care provider.

  • Receive the necessary prescription and care you require.


Metformin FAQs

Metformin is primarily prescribed to treat type 2 diabetes by helping lower blood sugar levels. It may also be used for conditions such as prediabetes, gestational diabetes in selected cases, and polycystic ovary syndrome (PCOS), where improving insulin sensitivity can provide clinical benefits.

Metformin lowers blood glucose by reducing the amount of sugar produced by the liver and making the body’s cells more responsive to insulin. It also reduces the amount of glucose absorbed from food, helping improve overall blood sugar control without directly increasing insulin production.

No. Although it is best known as a treatment for type 2 diabetes, metformin is also prescribed for some people with PCOS, insulin resistance, and certain other conditions where improving insulin sensitivity may be helpful. The reason for prescribing metformin depends on your individual medical history and treatment goals.

The most common side effects affect the digestive system and include nausea, diarrhoea, bloating, stomach discomfort, and a metallic taste. These symptoms are usually most noticeable when treatment begins and often improve as the body adjusts to the medication.

Metformin is not a weight-loss medicine, but some people experience modest weight loss while taking it. This is thought to be related to improved insulin sensitivity and, in some people, a reduced appetite. The amount of weight lost varies considerably between individuals.

Arrange a medical review if side effects remain troublesome, your blood sugar levels are not improving, or you develop persistent vomiting, severe diarrhoea, dehydration, or symptoms of vitamin B12 deficiency such as unusual tiredness, numbness, or tingling. Long-term users may require periodic vitamin B12 monitoring.

If you’ve been prescribed metformin or would like to understand whether it may be appropriate for your condition, Mobi Doctor can review your medical history, discuss your symptoms, and advise whether further assessment or treatment is appropriate based on your individual circumstances.

You should not stop taking metformin without medical advice. Blood sugar levels often improve because the medicine is working, and stopping treatment suddenly may allow them to rise again. If your health has changed or you’re considering stopping metformin, your doctor can advise whether this is appropriate.

Yes. Metformin can interact with some prescription medicines, supplements, and imaging contrast agents. Always tell your healthcare provider about all medicines and supplements you are taking before starting metformin or any new treatment.


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