Of course, regular checking with a blood glucose meter is also helpful in preventing low blood sugar episodes. Because long-term use of metformin can block absorption of vitamin B12, causing anemia, sometimes people need to supplement vitamin B12 through their diet as well.
There is another common side effect often experienced by people taking metformin for the first time. When I experienced faux lows, I felt similarly dizzy, lightheaded, nauseous, and extremely hungry. If you experience symptoms like these and have confirmed with a glucose meter the low you are feeling is indeed false i. Note that especially for type 2 folks out there on metformin and insulin or sulfonylureas, hypoglycemia is a real risk.
When taken at the same time, some drugs may interfere with metformin. Make sure your healthcare team is aware of any medications that you take before you start on metformin, especially certain types of diuretics and antibiotics. Remember, insulin and insulin releasing medications can increase your risk of hypoglycemia, so it is particularly important to carefully monitor your glucose levels. You should also avoid drinking excessive amounts of alcohol while taking metformin — aim for no more than one glass per day for women, and two per day for men.
Alcohol can contribute to lactic acidosis. In the FDA investigated whether some forms of metformin contain high levels of a carcinogenic cancer-causing chemical called N-nitrosodimethylamine NDMA. In , the FDA recommended the recall of several versions of extended-release metformin, and more than a dozen companies have since voluntarily recalled certain lots of the medication. While low levels of NDMA are commonly found in foods and drinking water, high levels of the substance are toxic and can cause cancer.
You can check to see if your metformin has been recalled here. For people taking extended-release metformin, the FDA recommends that you continue to take your medication until you talk to your healthcare professional. The medication is so effective as a first-line therapy the American Diabetes Association includes it in its diabetes Standards of Care. Researchers are currently studying whether the medicine can help in the fight against cancer, neurodegenerative conditions, vision problems like macular degeneration, and even aging.
It will be a while, however, before uses other than blood-glucose lowering are proven to be effective. At the same time, metformin is also used in the treatment of gestational diabetes and polycystic ovary syndrome. The FDA has also not officially approved metformin as an aid in losing weight. Many people with type 2 diabetes have lost weight after taking the drug, as researchers are still torn over exactly how metformin affects the weight.
Some believe it decreases appetite, while others say it affects the way the body stores and uses fat. While robust heart outcome trials with metformin are yet to be conducted, more attention is being paid to this research area. But what if it is found to help people managing type 1 diabetes? Metformin is not currently approved by US or European regulatory agencies for use in type 1s, but people have been known to take the medication anyway, and many doctors prescribe it if someone with type 1 diabetes is overweight.
There are actually several reasons metformin is an attractive option for many type 1s. One, metformin has been found to help reduce glucose production in the liver, which is a problem in type 1 diabetes. Two, people often form resistance to the insulin they take, and metformin can help improve insulin sensitivity. And, metformin may support weight loss and protection against heart disease. A study published in the Lancet following type 1 participants for three years found that compared to placebo, participants taking metformin lost weight.
If you are a person with type 2 diabetes, there are plenty of benefits to taking metformin for its original, intended purpose.
When you first start taking metformin standard-release tablets, you'll be advised to increase the dose slowly. This reduces the chances of getting side effects. If you find you cannot tolerate the side effects of standard-release metformin, your doctor may suggest switching to slow-release tablets.
If you miss a dose of metformin, take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. An overdose of a large number of metformin tablets can cause serious health problems. The symptoms are severe and quick to appear.
Talk to your doctor or pharmacist if these side effects bother you or do not go away after 1 week:. Metformin does not usually cause low blood sugar known as hypoglycaemia, or "hypos" when taken on its own. But hypos can happen when you take metformin with other diabetes medicines, such as insulin or gliclazide. To prevent hypoglycaemia, it's important to have regular meals, including breakfast. Never miss or delay a meal.
If you're planning to exercise more than usual, make sure you eat carbohydrates like bread, pasta or cereals before, during or after exercise. Always carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice or some sweets, in case your blood sugar level gets low.
Artificial sweeteners will not help. You may also need to eat a starchy carbohydrate, like a sandwich or a biscuit, to maintain your blood sugar for longer. If taking in sugar does not help or the hypo symptoms come back, contact your doctor or the nearest hospital. Make sure your friends and family know about your diabetes and the symptoms of low blood sugar levels so they can recognise a hypo if it happens.
It's possible to have a serious allergic reaction anaphylaxis to metformin. These are not all the side effects of metformin. For a full list, see the leaflet inside your medicines packet. If you're taking any of the following medicines, your blood sugar levels may need to be checked more often and your dose adjusted:. Some women might need a small adjustment in their metformin dose after starting contraceptive pills. That's because contraceptive pills change how your body handles sugar. There's very little information about taking herbal remedies and supplements with metformin.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Metformin stimulates ovulation in women with PCOS and can encourage regular periods, even if you do not have diabetes. Metformin is not licensed to treat PCOS specifically, but it can sometimes be prescribed to improve fertility. You may have to see a specialist doctor for this. You may not have any symptoms of diabetes, so you will not necessarily feel any different when you take metformin.
Metformin will help keep your blood sugar level stable and reduce your chances of diabetes-related problems in the future. Metformin is safe to take for a long time. It will not make you put on weight, and may even help you lose some weight. You may need more checks if you're an older person or your kidneys are not working normally.
Metformin can cause vitamin B12 deficiency if you take it for a long time. Treatment for diabetes is usually for life. But if your kidneys are not working properly, your doctor will tell you to stop taking metformin. If you have diabetes , you're entitled to free prescriptions for all of your medicines, not just your diabetes ones. The application form for the medical exemption certificate is called FP92A.
You can get this from your doctor's surgery. Metformin will not affect the combined pill or emergency contraception. But some women might need a small adjustment in their metformin dose after starting contraceptive pills. There's no clear evidence to suggest that taking metformin will reduce fertility in either men or women. But speak to a pharmacist or a doctor if you're trying to get pregnant. They may want to review your treatment. Your doctor may tell you to stop taking metformin a few days before having an operation or medical tests.
A general anaesthetic that puts you to sleep can also hide low blood sugar. Yes, you can drink alcohol while taking metformin, but it's best for men and women to drink no more than 2 units per day. A standard glass of wine ml is 2 units.
A pint of lager or beer is usually 2 to 3 units of alcohol. Be careful eating food and drink containing karela. This is because it can lower your blood sugar levels and mean your diabetes is not controlled as well as it should be. Karela also called bitter gourd is used to flavour foods, such as curries like bitter gourd masala. If your blood sugar levels are stable, taking metformin should not affect your ability to drive, cycle or use machinery and tools.
Metformin itself will not make your blood sugar levels too low, but your doctor might prescribe it alongside other medicines for diabetes that can affect your blood sugar. Metformin is usually prescribed when diet and exercise alone has not been enough to control your blood sugar levels.
Page last reviewed: 8 February Next review due: 8 February Anyone who takes metformin needs to follow an approved exercise plan for the medication to have an effect. Carbohydrates contribute to raising blood sugar. However, not all carbohydrates are bad for people with diabetes.
Foods that rank high on the glycemic index cause blood sugar levels to rise quickly, while foods that rank low have less drastic and immediate effects.
Diabetes Canada provide the following examples of carbohydrate-rich foods that rank low, medium, and high on the glycemic index. Doctors and nutritionists recommend that people with diabetes or who have a higher risk of the condition eat plenty of foods rich in dietary fiber, such as beans and other legumes. This type of fiber is not digested in the small intestine and does not contribute to drastic increases in blood sugar like foods with lower fiber contents.
Discover 38 healthy high fiber foods here. If metformin is not working, blood sugar levels can rise. This requires immediate medical attention. This issue does not always cause symptoms, but severely high blood sugar can cause :.
Learn more about high blood sugar here. As the American Diabetes Association caution, if blood sugar levels continue to rise, it can lead to diabetic ketoacidosis, also known as a diabetic coma. Learn more about diabetic ketoacidosis here. Metformin can cause minor side effects and some severe ones that require immediate medical attention. A rare but very serious side effect is lactic acidosis, or a buildup of acid in the blood. This can be fatal. If a person notices the following symptoms, they should receive emergency medical attention:.
Metformin can cause some minor side effects. Common ones include:. Taking metformin with a meal may help ease these side effects. If they are mild but persist for a few weeks or longer, contact the doctor. Metformin is a diabetes medication in a category of drugs called biguanides, but there are no alternatives for it in this class. Other diabetes medications work in different ways.
Beyond insulin and metformin, other drug treatments include:. Learn more about diabetes medications here. Doctors choose the most appropriate diabetes medication for each person depending on their needs. Some of these drugs are injected, and some people may prefer not to use them for this reason.
The doctor will take these considerations into account. The first-line treatment for type 2 diabetes is a combination of changes to diet and exercise routines and the medication metformin. It may take several weeks or months before this treatment reduces blood sugar levels. Sulfonylureas and insulin can have faster results, but they can carry additional risks.
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