What Are Less Common Side Effects Of Metformin
The medication can cause more serious side effects, though these are rare. The most serious of these is lactic acidosis, a condition caused by buildup of lactic acid in the blood. This can occur if too much metformin accumulates in the blood due to chronic or acute kidney problems. Severe acute heart failure, or severe liver problems can also result in a lactate imbalance.
Metformin can also increase the risk of hypoglycemia , particularly for those who take insulin and drugs which increase insulin secretion , but also when combined with excessive alcohol intake. Even though Im not on insulin, I started on continuous glucose monitoring to be able to keep a closer eye on my blood sugar levels. 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.
For most people who take metformin, side effects are mild and relatively short in duration.
Is Metformin Considered Safe Or Dangerous In Any Way
Overall, metformin is considered safe for preventing and treating type 2 diabetes. There is a small risk that taking metformin causes low blood sugar, a condition called hypoglycemia. However, this is more likely to happen when you take other medicines that lower blood sugar levels, such as insulin, at the same time .
The U.S. Food and Drug Administration has issued a black box warning that metformin can rarely cause lactic acidosis, the most serious adverse effect with metformin . Lactic acidosis means lactic acid builds up to dangerously high levels in your blood. Its rare, affecting just 1 in 30,000 people a year, and is more likely in people who have other serious kidney or liver problems .
Signs of lactic acidosis include rapid and shallow breathing, vomiting, nausea, abdominal pain, weakness, lethargy or unusual sleepiness, and headaches. Lactic acidosis is a medical emergency requiring prompt medical attention . Again, this is a rare occurrence.
Some Side Effects Can Be Serious If You Experience Any Of These Symptoms Or Those Listed In The Important Warning Section Call Your Doctor Immediately Or Get Emergency Treatment:
- chest pain
Metformin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s MedWatch Adverse Event Reporting program online or by phone .
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Getting The Most From Your Treatment
Continue to take Metformin regularly unless your doctor tells you otherwise. It is important that you keep your regular clinic appointments.
If you have been advised by your doctor or nurse about changes to your diet, stopping smoking or taking regular exercise, it is important that you to follow this advice.
Generally, if you are on Metformin alone you do not need to check your blood glucose levels, unless otherwise recommended by your doctor or nurse.
Different Types Of Metformin
Metformin comes as 2 different types of tablet: standard-release tablets and slow-release tablets.
Standard-release tablets release metformin into your body quickly. You may need to take them several times a day depending on your dose.
Slow-release tablets dissolve slowly so you do not have to take them as often. One dose is usually enough, and you’ll take it with your evening meal.
Your doctor or pharmacist will explain what type of metformin tablets you’re on and how to take them.
Metformin is also available as a liquid for children and people who find it difficult to swallow tablets.
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How Does Metformin Treat Diabetes
Many healthcare providers prescribe because it helps lower your blood sugar levels after meals and your bodys baseline blood sugar levels . Both of these measurements are important when it comes to managing prediabetes and type 2 diabetes and keeping blood sugar under control.
Metformin lowers blood sugar in 3 major ways:
Cautions With Other Medicines
There are some medicines that interfere with the way metformin works.
If you’re taking any of the following medicines, your blood sugar levels may need to be checked more often and your dose adjusted:
- steroid tablets, such as prednisolone
- tablets that make you pee more , such as furosemide
- medicines to treat heart problems and high blood pressure
- male and female hormones, such as testosterone, oestrogen and progesterone
- other diabetes medicines
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.
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What Are The Contraindications To Taking Metformin
There are a few scenarios in which taking metformin is contraindicated .
- Kidney disease or poor kidney function
- Current or history of lactic acidosis
- Allergy or hypersensitivity to metformin
If you need radiological studies with intravenous contrast, like a CT scan, you should temporarily stop your metformin to prevent kidney problems. Also, people with liver disease, in general, should avoid using metformin because it increases your risk of developing lactic acidosis .
Metformin Use In Childhood And Adolescence
Type 2 diabetes mellitus has dramatically increased in children and adolescents worldwide to the extent that has been labeled an epidemic . Before 1990, it was a rare condition in the pediatric population by 1999, the incidence varied from 8% to 45%, depending on geographic location, and was disproportionally represented among minority groups . There are few studies of metformin use in the pediatric population. Most of them are of short duration and heterogeneous designs.
The beneficial role of metformin in young patients with type 2 diabetes has been demonstrated in a randomized, controlled trial which showed a significant decrease in fasting blood glucose, HbA1c, weight, and total cholesterol. The most frequently reported adverse events were abdominal pain, diarrhea, nausea/vomiting, and headaches. There were no cases of clinical hypoglycemia, lactic acidosis, or clinically significant changes in physical examinations . When compared to glimepiride , metformin lowered HbA1c to < 7%, similar to glimepiride, but was associated with significantly less weight gain. A total of 42.4% and 48.1% of subjects in the glimepiride and metformin groups, respectively, in the intent-to-treat population achieved A1C levels of < 7.0% at week 24 .
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Are There Any Other Precautions Or Warnings For This Medication
Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.
Alcohol intake: Anyone taking metformin should avoid excessive alcohol intake.
Blood sugar control: If you have fever, trauma, infection, or surgery, you may have a temporary loss of blood sugar control. At such times, your doctor may think it is necessary to stop metformin and temporarily inject insulin. Metformin may be started again after the problem is resolved.
Blood sugar monitoring: Monitor your blood sugar regularly at intervals as discussed with your doctor or diabetes educator.
Diabetes complications: The use of metformin will not prevent the development of complications particular to diabetes mellitus .
Diet: Metformin is a treatment to be taken in combination with a proper diet. Metformin is not a substitute for proper diet.
Dye or contrast agents: If you are going to have an X-ray procedure that uses dye or a contrast agent, you may need to stop taking this medication for a short time. Contact your doctor for instructions.
Vitamin B12 levels: This medication may decrease vitamin B12 levels. Your doctor will monitor your B12 levels with blood tests while you are taking this medication.
How Long Does Metformin Take To Be Effective
Metformin does not give instant results, such as it does not immediately decrease your blood sugar levels.
Metformin usually starts to be effective in about 48 hours or 2 days of taking it and it shows considerable effects after taking it for 4 to 5 days. Point to remember is that the time taken for metformin to work or be effective depends on the dose the patient is taking.
If your metformin is not working for you or is not as effective as before, even with exercise and dietary changes then your doctor can increase the metformin dose to see if it has any effect on your sugar levels or can prescribe medications to be taken along with metformin.
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The Benefits Of Metformin
Metformin is an inexpensive drug and is now considered to be first line therapy for those diagnosed with type 2 diabetes. Metformin has also been heralded as the answer to anti-ageing with major benefits to our health including our heart, stroke prevention, and even warding off cancer. Read on to learn why metformin is sometimes considered a wonder drug.
How Effective Is Metformin
Metformin is very effective for most people with type 2 diabetes. In fact, a widely cited 2012 scientific review in Diabetes Care found that metformin reduced A1C levels by an average of 1.12% for patients with type 2 diabetes.
A more recent 2019 study published in the Pakistan Journal of Medical Sciences found that type 2 patients with the highest A1C levels saw the most dramatic increase after starting metformin.
The best way to measure the efficacy of metformin is to take an A1C test, which shows average blood-glucose levels over the past 12 weeks. As a result, you’ll need to wait about three months after starting metformin to measure your A1C levels and get an accurate result, Rehman says.
Most people are prescribed metformin long term and should not stop the medication without talking to their doctor. “Diabetes type 2 is a chronic life-long disease, which means metformin is mostly prescribed for the long term,” Rehman says.
It should be used along with lifestyle changes, like exercising more and counting carbohydrates, both of which can help control blood-sugar levels. In rare cases, in which patients effectively make major lifestyle changes, their doctor might wean them off metformin.
“In a small set of patients, with new diabetes type 2 diagnosis, lifestyle changes such as 10% body weight loss and carb-controlled diets can lead to diabetes type 2 remission,” Rehman says.
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Risks Or Side Effects Of Taking Metformin
If you are taking the drug for the effective management of diabetes, you should be aware of the risks and side effects which the drug might cause. Following are the associated risks:
Given the risks associated with taking Metformin, an expert advice is a must before going for the medicine.
We hope that the above post has been helpful in educating you about Metformin and how the drug is used for combatting diabetes. However, a word of precaution needs to be mentioned here: the drug may not be meant for all types of patients and as such, you need to be extremely cautious while taking it and any type of side-effect felt should immediately be communicated to the doctor who might have prescribed Metformin. In the case of regular side-effects, you need to stop the dosage at the earliest possible time!!
What You Should Do When Your Metformin Is Not Working And Your Blood Sugar Remains High
If you feel that your metformin is not working for you, then what you should do is inform your doctor immediately.
Just taking metformin is not enough. For treating diabetes, it is very important to follow a healthy diet along with regular exercise. When a patient is suffering from type 2 diabetes, it becomes even more imperative in order to get the desired efficacy from metformin to change your diet and add exercise to your daily routine.
Some diabetics can control their sugar levels just by regular exercise and dietary changes without the use of any medicine. However, if these do not work for you, then you need medication to keep your diabetes in check.
The following rules should be followed to keep the blood sugar levels in control and for metformin to work:
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What Are The Side Effects Of Metformin
Metformin does not cause side effects for most people that take it. However, for a small number of people, the most common side effects are:
- Feeling and being sick
- Stomach pain
- Loss of appetite
If you experience these side effects, your doctor or nurse may advise you to reduce the dose or in certain cases may advise you to stop the medicine.
Taking Metformin with meals can help reduce these side effects and usually they settle in most people after a few weeks.
A slow-release version of Metformin, which is taken once a day, is sometimes prescribed to people that are experiencing side effects.
Some of the other less common side effects of Metformin include:
- A change in your taste buds
- Reduced vitamin B12 levels
- Skin rash
- Severe itching
Please speak to your doctor or nurse if you have side effects that are not improving.
Metformin has been associated with a rare condition called lactic acidosis. Lactic acidosis is associated with the build-up of acids in your blood and is most commonly seen in people admitted with severe illness and/or infection.
The risk of lactic acidosis is increased if your kidneys do not work well. Your doctor or nurse will monitor your kidney function periodically by doing a simple blood test. Your doctor or nurse may ask you to reduce or stop taking your Metformin if your kidneys are not functioning well. Metformin does not itself cause kidney damage.
Metformin For Diabetes: How It Works Side Effects And What You Need To Know
During a recent diabetes class Maria, newly diagnosed with type 2 diabetes, said What the heck is metformin? Everyone I know is taking it. Ive started calling it Vitamin M because its more common than Vitamin C supplements! This made us all laugh out loud as we recognized the truth in that observation.
Metformin is an important antidiabetic agent that is widely used for patients with diabetes and has also been effectively used with patients who are at risk of diabetes. Based on the American Diabetes Association 2019 Standards of Medical Care in Diabetes, Metformin, if not contraindicated and if tolerated, is the preferred initial pharmacologic agent for the treatment of type 2 diabetes. Metformin has been on the market in the United States since 1995. With this long history of use, we know a lot about how metformin works and how people respond to this valuable medication.
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What Are The Most Common Side Effects Of Metformin
Metformin does cause side effects in some people, but many of these are mild, and are associated with taking the medicine for the first time. Nausea and gastric distress such as stomach pain, gas, bloating, and diarrhea are somewhat common among people starting up on metformin.
For some people, taking large doses of metformin right away causes gastric distress, so its common for doctors to start small and build the dosage up over time. Many people start with a small metformin dose 500 milligrams once a day and build up over a few weeks until the dosage reaches least 1,500 milligrams daily. This means theres less chance of getting an upset stomach from the medicine, but also means it may take a bit longer to experience the full benefit when getting started on metformin.
I experienced some mild side effects when I started taking metformin, and I found that the symptoms correlated with how many carbs I had in my diet. Once I dropped my carbs to 30-50 grams per day something that took me weeks to do any symptoms of gastric upset went away.
Asking your doctor for the extended-release version of metformin can keep these symptoms at bay, and so can tracking your diet.
Effects On The Inflammatory Pathway
The benefits of metformin on macrovascular complications of diabetes, separate from its conventional hypoglycemic effects, may be partially explained by actions beyond glycemic control, particularly by actions associated with inflammatory and atherothrombotic processes . Metformin can act as an inhibitor of pro-inflammatory responses through direct inhibition of NF-kB by blocking the PI3KAkt pathway. This effect may partially explain the apparent clinical reduction of cardiovascular events not fully attributable to metformins anti-hyperglycemic action .
Some studies also point to a modest effect on inflammatory markers in subjects with IGT in T2DM while others have found no effect at all .
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Can You Stop Taking Metformin
Dont stop taking your metformin unless your doctor recommends you do.
Starting a long-term prescription can be challenging and you might feel like you want to stop taking your tablets, but this isnt a good idea. If you do feel overwhelmed by your medication then try talking to someone. Our helpline can support you with information and advice. And our forum is also a great place to meet people who are going through or have been through similar things that youre dealing with.
Coming off medication in diabetes remission
Some people are able to stop taking diabetes medication like metformin, by putting their diabetes into remission. This means that blood sugar levels are in the non-diabetes range without needing any medication. There are many ways people with diabetes have done this, but they mostly involve making changes to your diet and losing weight.
Its important to remember that this isnt an option for everyone and isnt an easy thing to do. If youre thinking of making changes to your diet, its a good idea to speak to your healthcare team first.
Weve got lots of information about diabetes remission so you can get all the facts.
Jon was diagnosed with type 2 in 2013 and was given metformin. But after learning more about his condition, Jon started to address his weight. After a couple of months, he was able to gradually stop taking medication.