Metformin: What It Is, Its Side Effects and Alternative Treatments
What is Metformin?
It’s an oral anti-diabetic medicine that is used to treat type 2 diabetes by controlling blood sugar levels and helps prevent it as well. It’s best to have lifestyle changes, proper diet, and exercise along with taking Metformin to have better blood sugar control.
People can use it with insulin and other medicines, but it is not for treating type 1 diabetes.
Metformin: How Does It Work?
It is a drug that is studied intricately in the country. The most common brand names are the following:
- Glucophage XR
People usually use it as a medicine for type 2 diabetes and may help in treating resistance to insulin in PCOS by addressing insulin sensitivity, resulting in less glucose production in the body.
Scientists also used Metformin in research involving kids as young as eight years old, with the researchers readily putting in a recommendation for Metformin to be used by children diagnosed with PCOS and even for those who are still not yet diagnosed with the condition.
The recommended dosage is from 500 milligrams to 2550 milligrams a day.
Here are the ways Metformin can lower blood glucose and insulin:
- It lessens the glucose produced by the liver.
- It hikes up the liver’s sensitivity, as well as the muscle, fat, and cells to the insulin produced by the body.
- It lessens the carbohydrates absorbed by the body.
Metformin and Its Side Effects
These common side effects happen in over 1 in 100 people, and it is best to speak with a doctor or pharmacist if any of the effects bother or do not go away after seven days when taking Metformin:
- Stomach ache
- Loss of appetite
- A metallic taste
These serious side effects are rare and occur in less than 1 in 10,000 people. Call a doctor immediately if these warning signs occur when taking Metformin:
- It is characterized by severe fatigue, fast or low breathing, coldness, and a slow heartbeat.
- The skin or the whites of the eyes turn yellow, which may mean liver problems
- Gets tired quickly, has less energy, pins and needles, sore and red tongue, ulcers in the mouth, muscle fatigue, and disturbed vision may be signs of vitamin B12 deficiency
- redness, skin rash, or itchiness could be signs of a skin condition
When taking Metformin, it rarely causes low blood sugar, or more commonly known as hypoglycemia or hypos, when it’s taken on its own. But it happens when Metformin is taken with other type 2 diabetes medicines like insulin or gliclazide.
Early warning signs of low blood sugar are:
- sudden hunger
- trembling or shaking
- feeling confused
- difficulty in concentrating
Low blood sugar can occur when someone falls asleep, and a person will feel sweaty, tired, and confused when they wake up.
Low blood sugar can also happen when:
- overdose on some kinds of type 2 diabetes medicines
- lack of food/energy
- are skipping meals or fasting
- do not follow a proper diet or are not getting enough nutrients
- suddenly change what they eat
- more physical activity, less eating
- more alcohol consumption while skipping meals
- take medicines or herbal medicines at the same time without consulting a physician
- have hyperthyroidism or a hormone disorder
- have a kidney or liver condition
To stop hypoglycemia from happening, make sure to get regular meals three times a day and never skip one. If by any chance exercise takes longer than usual, don’t forget to compensate by eating carbohydrates such as bread, pasta, or cereals before, during, or after the exercise.
For emergencies, best to have fast-acting carbohydrates such as sugar cubes, fruit juice, or sweets if in case blood glucose levels get very low. Never use artificial sweeteners in this scenario.
Also, keep a starchy carbohydrate such as a sandwich or a biscuit if the blood glucose levels need to be up for a longer period. If in case the hypo symptoms persist and ingesting sugar does not help, contact a physician immediately or visit the nearest hospital.
How to Manage the Side Effects of Metformin
When patients with diabetes take Metformin, and they feel sick, it is best to eat food while taking it to lessen the risk of being sick. It may also help to increase one’s dose over time, but do so with guidance from a doctor.
When someone vomits or experiences diarrhea after taking Metformin, they should take a lot of fluids to avoid dehydration.
Drink small, frequent sips if sick, and always consult with a medical professional in such a condition. If patients with diabetes pee less than the usual or let out dark, strong-smelling pee, stop taking medication and consult a doctor immediately.
Rest or relax when stomach pain occurs after taking Metformin. Drink or eat in small amounts and have frequent meals like this. Use a heating pad or hot bottled water on the stomach. If the pain gets too intense, call a doctor immediately.
If the appetite gets less and less after taking in Metformin, don’t forget to eat when hunger pangs occur, and if possible, eat smaller meals.
Metformin and Polycystic Ovary Syndrome: How Does It Work?
People who have polycystic ovary syndrome (PCOS) are highly resistant to insulin or might have high levels of insulin. This leads to too much insulin resulting in inflammation and thus develop:
- Type 2 diabetes
- High cholesterol and triglycerides (dyslipidemia)
- Non-alcoholic fatty liver disease
The Food and Drug Authority has not approved Metformin yet to treat PCOS, and there are doctors who prescribe it to resolve some of its symptoms.
They even requested Metformin’s manufacturers on May 28, 2020, to recall particular formulations that were on the market after extreme levels of N-Nitrosodimethylamine (NDMA) were found.
NDMA may cause cancer, and your doctor may ask people to still take it until they can prescribe metformin alternatives.
Things to Watch Out for When Using Metformin
Whenever you feel something different from taking medication, it’s best to contact your doctor and let them know about it. As taking in too much Metformin can cause a condition called lactic acidosis.
Lactic acidosis occurs when there is too much acid that builds up in the bloodstream. If you have lactic acidosis, you’ll experience muscle ache, a burning sensation, rapid breathing, nausea, and stomach pain.
It will more likely occur if someone meets any of the following conditions:
- an older adult
- has kidney or liver disease
- heart failure
- heavy alcohol use
- have had any scanning procedures that used iodinated contrast
Stop taking the medicine immediately when you feel the symptoms and inform your doctor right away.
There are other considerations you need to be careful of, such as taking Metformin if you are pregnant or are expecting. It’s very important to control blood sugar levels, as it might cause complications for both the mother and the baby.
Metformin may also stimulate ovulation in women at premenopausal age and increase the possibility of unintended pregnancy.
How Can I Lower My Blood Sugar Without Metformin?
Natural Ways to Lower Blood Sugar
Even though Metformin has no natural alternative, there are ways to improve a person’s sensitivity to insulin if they can’t tolerate Metformin. What’s important is to eat a healthy diet and exercise.
Natural Metformin Alternatives to Combat Insulin Resistance
70% of women who have PCOS have resistance to insulin, which is what researchers believe is the major contributor to metabolic complications such as high blood pressure, abdominal weight gain, and type 2 diabetes. There are ways to address this:
Weight loss will mean better levels of insulin, so it’s best to improve how we eat to have better control of how much insulin we have. Diet should then include:
- Low glycemic index fruits.
- Lean proteins.
- Anti-inflammatory foods to better control resistance to insulin.
Women with PCOS have high testosterone levels, which leads to them getting more muscle mass. This condition helps them to increase their metabolic rate, which means more calories are burned effectively. So exercising is a great way to be safe and healthy. It also helps to use glucose more, which means there’s less secreted insulin.
What Supplement Can Replace Metformin?
If in case lifestyle changes or proper diet don’t work, and medical professionals confirm resistance to insulin through testing, a doctor or physician can provide alternatives for an insulin-altering medication.
Some women have had success in losing weight by using medicines and changing their lifestyle, although it’s best to remember that some medications have not been FDA-approved for use in the treatment of PCOS.
One such supplement is inositol, as it uses both Myo (MYO) and d-Chiro-inositol (DCI) inositol types n a 40:1 ratio which was found to better a lot of metabolic and reproductive points of PCOS. People with PCOS will see better cholesterol, insulin, androgens, and weight levels.
N-acetyl cysteine is an antioxidant that worked as well as Metformin in several random trials to lower insulin and cholesterol levels in women with PCOS.
What Can Be Taken as Alternatives to Metformin
An antioxidant called n-acetyl cysteine was used in a trial that showed promise as one of the alternatives to Metformin for lessening resistance to insulin and lowering cholesterol for people with PCOS. Same as myo-inositol, it may restore ovulation leading to more pregnancies than Metformin. It may also improve insulin levels and other metabolic aspects of PCOS.
Here are other alternatives to Metformin:
Ethinyl estradiol / levonorgestrel
It is prescribed for birth control or emergency contraception. Doctors may also prescribe it off-label for abnormal uterine bleeding, endometriosis, ovarian cysts, PCOS, gonadotropin inhibition, or premenstrual syndrome.
Desogestrel / ethinyl estradiol
It is prescribed for birth control and may be prescribed off-label for PCOS, endometriosis, abnormal uterine bleeding, or gonadotropin inhibition and is one of the alternatives to Metformin.
What Is Insulin Resistance?
Insulin resistance, or impaired glucose resistance, happens when your body is not responding to insulin as it normally should. It may develop into prediabetes or metabolic syndrome.
Metabolic syndrome symptoms are rare, which is why diagnosis and blood tests are important, along with other clinical procedures. The patient should also undergo lifestyle changes once they experience the symptoms of metabolic syndrome, but there are times medicines are truly necessary.
Symptoms of Insulin Resistance
Insulin resistance does not usually happen immediately. It gradually develops and may not cause obvious symptoms. People afflicted with the condition may feel tired and have low energy, but as a person normally blames other things for their fatigue, their condition may go unnoticed for several years.
Several symptoms may occur if a person is afflicted with prediabetes and metabolic syndrome because of high sugar levels in the body. There are no boundaries between insulin resistance and prediabetes, and a lot of the physical effects and complications that develop over time may also overlap.
What Can You Take For Insulin Resistance Besides Metformin?
If someone has insulin resistance, it is best to take medication for hypertension, heart disease or heart failure, or high cholesterol instead of taking treatment for insulin and blood sugar levels.
Medication for treating type 2 diabetes has been used and prescribed for insulin resistance, although there is little or no proof that they effectively control the disease.
Thiazolidinediones (glitazones), including Avandia (rosiglitazone) and Actos (pioglitazone), are medications that result in a better response to insulin and are given as prescriptions for type 2 diabetes. They are often used for managing insulin resistance even without diagnosing diabetes.
Victoza and other medications that can be injected have also been part of research involving women with PCOS.
What Is the Safest Drug for Type 2 Diabetes?
As of June 2021, recent studies point to Lactus (insulin glargine) and Victoza (liraglutide)to be better treatments to control blood glucose over a longer period.
As diabetes is a progressive condition, there are medical treatments that rarely lessen or stop the progression of the disease and that only prevent or slow down the rising levels of glucose.
Through research, they put several drugs to the test to know which can keep the blood sugar level at an A1C level of less than 7%, the recommended target range.
These A1C blood tests are the common ways of controlling blood glucose levels long-term.
It was found that the drugs almost always fail at a similar rate, and they were compared as far as benefits are concerned, but Lantus and Victoza had lesser failures compared to the others.
The US National Institutes of Health funded the research, and it involved over 5,000 people with type 2 diabetes, with ages averaging 57 years old. 20% of them were black, and 18% were Hispanic. They were randomly assigned to take Lantus, Victoza, Amaryl, and Januvia and the trial lasted for four years.
After the trial, the researchers found Lantus and Victoza to be the most effective when keeping A1C levels under 7%. They found Januvia or Amaryl to have the lowest effect and have a higher risk of letting A1c levels go above 7%.
What is Glucophage?
Glucophage is a common brand name for Metformin and is used to combat type 2 diabetes by lessening the amount of sugar the body makes, and it lets the body use its natural insulin the best way possible.
It can be taken in a liquid solution or in tablet form. The usual dosage for Glucophage starts at 500 mg by mouth twice a day or 850 mg by mouth once a day. If it works well for a period, the dose may be raised by about 2,550 mg by mouth, split into several doses within the day.
Frequently asked questions about Glucophage
1. Can it be taken without a meal?
Best to take Glucophage after ingesting a meal to avoid an upset stomach. Nausea and diarrhea may likely occur if Glucophage is taken without food.
2. What happens if patients with diabetes stop taking Glucophage?
Glucophage lowers blood glucose levels, so if patients with diabetes stop taking it, blood sugar levels may skyrocket. Always ask your healthcare provider before stopping to take any medication.
3. What will happen to the kidneys when taking Glucophage?
Glucophage passes through the kidneys when it’s removed from the body, so if there’s a history of kidney disease, please let your doctor know before taking in medication. Glucophage rarely affects healthy kidneys, but regular blood work needs to be done while taking it to check that the kidneys are always healthy while undergoing treatment.
4. Can the Glucophage tablet be halved?
The short-acting tablets can be cut in half, but the long-acting ones must be kept whole.
5. How many times in a day can patients with diabetes take Glucophage?
Once or twice a day. Contact your doctor to know what dose works best.
Pros and Cons of Glucophage
- It’s good in lowering down blood glucose and A1C levels
- One of the few diabetes drugs that lessen the risk of death from diabetes-linked complications
- It doesn’t contribute to weight gain
- Rarely contributes to hypoglycemia
- Can cause stomachache, diarrhea, nausea, gas, or stomach cramps
- It is not a good option for people with kidney problems
- Alcohol abuse can increase the risk of getting a side effect of Glucophage
There are different medications in relation to controlling blood sugar levels and any related condition. A medical professional is the best person to say what’s the best treatment to follow or the best way to take in medicine. Never falter from what they prescribed to avoid any complications.
Editor’s Note on Metformin Alternatives:
This report features details on what Metformin is all about, its side effects and how to cope with them, and any alternative, natural or chemical means instead of using Metformin. You might also be interested in reading about the alternatives for Omeprazole.
If you have any queries or if you think we have published misleading information, kindly update us via the communication channels below. We’d love to hear back from you!