Metformin

Metformin controls high blood sugar levels caused by diabetes mellitus or type 2 diabetes. In type 2 diabetes, the body's insulin has not reached the cells that carry out essential metabolic functions.

Most people manage their diabetes with diet and meal plans provided by doctors. But for those with high blood sugar levels, using Metformin with insulin might help control diabetes.

What are the uses of Metformin?

Metformin is used in treating type 2 diabetes. It works by restoring your body's response to insulin. It also reduces the amount of sugar your liver makes, which your stomach or intestines absorb.

Effectively managing diabetes can help reduce the risk of kidney damage, blindness, diabetes retinopathy, nerve problems, loss of limbs, and sexual dysfunction. In addition, heart attack or stroke-related risks might also be reduced.

How does metformin treat diabetes?

Metformin achieves blood sugar reduction through three primary mechanisms:

• Enhanced Insulin Sensitivity: It increases the body's responsiveness to insulin, a hormone that transports sugar from the blood to cells for energy. Metformin combats insulin resistance, where cells don't efficiently use insulin, resulting in elevated blood sugar levels.
• Reduced Sugar Absorption: Metformin curbs the absorption of sugar from the diet in the intestines, diminishing the influx of sugar into the bloodstream.
• Lowered Sugar Production: Metformin addresses the body's natural sugar production, primarily occurring in the liver. It limits the amount of sugar produced by the liver, contributing to overall blood sugar control.

How and when to use Metformin?

• Metformin can be taken orally. A doctor usually prescribes doses after evaluating your condition. Taking medicine 1-3 times a day with meals is typically prescribed. Also, drinking plenty of water with the medicine is usually advised.
• The dosage depends on the medical condition, other medication, and response to those medications and treatments. Always discuss with the doctor all the medicines you currently have - herbal, prescription, or non-prescription. Also, a gradual dosage increment is recommended, starting with a low dosage. Make sure you take it at the same time every day.
• If you are already taking other drugs, your doctors will determine if you should continue or stop other medications. Monitor your blood sugar level regularly, as directed by the doctor, to keep track of your body's glucose. Depending on the treatment response, the doctor will adjust the dosage. You can take it in tablets, solutions, extended-release suspension, and extended-release tablet forms.

What are the side effects of Metformin?

Side effects of Metformin are quite rare. It happens in 1 out of 100 people. Some side effects of Metformin include:

• Nausea
• Vomiting
• Diarrhoea
• Upset stomach
• Weakness
• Metallic taste
• Fever and chills
• A general feeling of discomfort
• Painful urination
• Hoarseness 
• Muscle pain and cramps
• Loss of appetite
• Cool, pale skin
• Anxiety
• Coma
• Cold sweats
• Headache
• Increased sweating
• Nervousness
• Difficulty in speech
• Shakiness

Some of the rare side effects of the medicine are:

• Lack of strength
• Unusual sleep pattern
• Drowsiness 
• Behaviour change

Taking Metformin can also cause vitamin B12 deficiency, and you might experience the following:

• Tired
• Muscle weakness
• Mouth ulcers
• Sore and red tongue
• Vision problem

Also, if you experience shallow breathing, coldness, a slower heartbeat, and eyes turning yellow, you must call your healthcare provider immediately. In rare cases, it might also cause an allergic reaction. However, there could be other side effects. You can also check the inside of the medicine leaflet to know more. Again, talk to your healthcare provider before using it for treatment.

What precautions should be taken?

• When using Metformin, read the instructions given on the package. If you need help to understand them, consult your doctor. First, you must follow the diet plan the doctor suggests. This becomes crucial for the medicine to be effective.
• You must take Metformin with meals to avoid any stomach side effects. You might experience disturbed bowel conditions during the first few weeks of the treatment. Also, swallow the tablet completely - do not chew, crush, or break it. Moreover, using the same brand of medicine as your doctor prescribes is essential. 
• Contraindications: Inform your doctor if you have impaired liver or kidney function, as this medicine may cause lactic acidosis (accumulation of lactic acid in the blood). 
• Pregnancy and breastfeeding: Inform your doctor if you are pregnant before taking this medication and use the medication precisely as prescribed. It may pass into breast milk, hence inform your doctor if you are breastfeeding. 
• Children under 10 years are not recommended to take Metformin. 

What if I miss the dose or have an overdose of Metformin?

• If you miss the dosage, take medicine as soon as possible. However, double-dosing is not recommended if it is time for your next dosage.  

• In case of an overdose, do not wait for the symptoms to appear. Instead, contact the medical emergency helpline immediately.

What are the storage conditions of Metformin?

Keep the medicine away from heat, direct sunlight, moisture, and cold temperatures. Keep them in a closed container at room temperature, outside the children's reach. 

Cautions with other medicines

Taking certain medicines, such as acetazolamide, methazolamide, topiramate, zonisamide, and dichlorphenamide, might dangerously raise the body's lactic acid, resulting in lactic acidosis. Lactic acidosis causes decreased appetite, muscle cramps, tiredness, daytime sleepiness, shallow breathing, etc. Also, it interacts with any medicine that lowers blood sugar and causes hypoglycemia.

Always tell your doctor about your ongoing medicines and treatments to avoid side effects. 

How quickly Metformin works?

Metformin starts to work within one week of treatment. However, it does not dramatically lower your blood sugar level. Depending on your dosage, showing results takes around 5-6 days. Also, Metformin is a long-term medication. Thus, some people need to take medicine forever. Moreover, the results depend on the severity of the condition. 

Metformin vs Glimepiride 

Metformin is very effective in controlling blood sugar levels in type 2 diabetes. However, it is not recommended to exceed the prescribed dosage and must be taken only as directed by the doctor. 

FAQs

1. What does metformin do to your body?

Metformin primarily helps regulate blood sugar levels in your body. It enhances insulin sensitivity, reduces sugar absorption from the intestines, and lowers sugar production in the liver.

2. Can I stop taking metformin if my sugar levels are normal?

You should not stop taking metformin without consulting your healthcare provider, even if your blood sugar levels are normal. Your doctor will determine the most appropriate treatment plan for your condition.

3. Is insulin better than metformin?

Insulin and metformin serve different purposes. Insulin is often used when blood sugar cannot be adequately controlled with oral medications alone. The choice between them depends on individual circumstances and the stage of diabetes.

4. What is the difference between metformin and Glimepiride?

Metformin and Glimepiride are both diabetes medications, but they work differently. Metformin reduces blood sugar by addressing insulin resistance and sugar absorption. Glimepiride stimulates the pancreas to release more insulin. The choice depends on your specific condition and treatment goals.

5. How does metformin differ from other diabetes medications?

Metformin is distinct from many other diabetes medications because it does not lead to hypoglycemia (low blood sugar) when used alone. It also offers weight-neutral or weight-reducing effects, making it suitable for people with Type 2 diabetes who are overweight. Other diabetes drugs may have different mechanisms of action and side effects. Your doctor selects the most appropriate one based on your needs.

References:

https://www.goodrx.com/Metformin/how-long-it-takes-Metformin-work https://www.goodrx.com/Metformin/interactions#meds-that-block-Metformin-elimination
https://www.webmd.com/drugs/2/drug-11285-7061/Metformin-oral/Metformin-oral/details
https://www.mayoclinic.org/drugs-supplements/Metformin-oral-route/precautions/drg-20067074?p=1#:~:text=Metformin%20should%20be%20taken%20with,%2C%20break%2C%20or%20chew%20it

Disclaimer: The information provided here is not meant to substitute an advice from a healthcare professional. The information is not intended to cover all the possible uses, side-effects, precautions, and drug interactions. This information is not intended to suggest that using a specific drug is suitable, safe, or efficient for you or anyone else. The absence of any information or warning regarding the drug should not be interpreted as an implicit guarantee from the organisation. We strongly advise you to consult a doctor if you have any concerns about the drug and never use the medication without a doctor’s prescription.