Metformin's pros include effectively lowering blood sugar, being inexpensive, not causing weight gain (sometimes promoting slight loss), and potentially offering cardiovascular/anti-aging benefits, making it a first-line Type 2 diabetes treatment. Cons often involve initial gastrointestinal issues (diarrhea, nausea, gas), long-term risk of Vitamin B12 deficiency, and the very rare but serious risk of lactic acidosis, requiring careful kidney monitoring.
"Metformin, however, can cause lactic acidosis in conditions where lactic acid production is high and the disposal of lactic acid is reduced. In conditions such as circulatory failure, sepsis, and anoxia or hypoxia, metformin use may result in lactic acidosis and should be avoided.
Common alternatives to metformin include glucagon-like peptide-1 (GLP-1) agonists, sodium-glucose transport 2 (SGLT2) inhibitors, and dipeptidyl peptidase-4 (DPP-4) inhibitors. Less often, thiazolidinediones or sulfonylureas are used as an alternative to metformin.
Metformin and diabetes prevention
Studies show that people with obesity and metabolic syndrome who took metformin decreased their risk of developing diabetes by 30%. And the benefits lasted long term — the risk of developing diabetes decreased 18% over 15 years.
The most common side effects of metformin are gastrointestinal (GI) issues, such as nausea, diarrhea, vomiting, heartburn, loss of appetite, stomach pain, stomach upset, and a metallic taste in the mouth (Bonnet, 2016).
Common side effects
A number of natural products, from probiotics to spices and herbs such as fennel, ginger or peppermint, may help ease gas from metformin. Sometimes even helpful medications have side effects that are difficult to tolerate.
“Because the metformin helps your cells absorb sugar like they should, I've noticed an increase in energy and the ability to actually feel satisfied and not want to snack so much because my body's utilizing sugar like it should,” Steve says. Another unintended benefit: He's more apt to do yard work and walk the dogs.
How long to take it for. Treatment for diabetes is usually for life. But if your kidneys are not working properly, your doctor will tell you to stop taking metformin and switch you to a different medicine. Do not stop taking metformin without talking to your doctor.
Rare Side Effects of Metformin
Some people (in one study, it was less than 5%) reported heartburn, headaches, upper respiratory infection, or a bad taste in the mouth when they took extended-release metformin.
SECOND-LINE ORAL DRUGS AFTER METFORMIN: OPTIONS LEFT OPEN. Currently, multiple options are available as a second-line drug after metformin. Agents which can be used orally include sufonylureas (SUs), pioglitazone, dipeptidyl peptidase-4 inhibitors (DPP-4I) and sodium glucose transporter 2 inhibitors (SGLT2I).
A1C target levels can vary by each person's age and other factors, and your target may be different from someone else's. The goal for most adults with diabetes is an A1C that is less than 7%. If your A1C level is between 5.7 and less than 6.5%, your levels have been in the prediabetes range.
Dietary modifications help the patients to control blood glucose. Traditional herbs and spices are commonly used for control of glucose among which cinnamon (Ròu Guì; Cinnamomum cassia) has the greatest effect. Research has shown that adding cinnamon to diet can help to lower the glucose level.
While it's possible to stop taking Metformin, there are essential things to keep in mind before making any changes. If you want to learn how to get off Metformin (or any medications), the very first step is to have a conversation with your doctor or healthcare provider before stopping.
The current drug labeling strongly recommends against metformin use in some patients whose kidneys do not work normally because use of metformin in these patients can increase the risk of developing a serious and potentially deadly condition called lactic acidosis, in which too much lactic acid builds up in the blood.
While uncommon, metformin can also cause blood glucose to drop too low and lactic acidosis. In severe cases, these side effects are medical emergencies. Long-term metformin use isn't known to cause dementia or kidney damage, or to worsen polycystic ovary syndrome (PCOS).
It's important to keep taking it. Metformin will help keep your blood sugar level stable and reduce your chances of diabetes-related problems in the future. Are there any long-term side effects? Metformin is safe to take for a long time.
Over the Counter and Herbal Alternatives to Metformin That Show Promise
Life expectancy is known as the number of years a person is expected to live. At age 50, life expectancy is 6 years shorter for people with type 2 diabetes than for people without diabetes. By meeting type 2 diabetes treatment goals, life expectancy can increase by 3 years, or for some, as much as 10 years.
As already discussed, metformin can result in sleep disturbance, and this might affect normal dream patterns.
Two signs that metformin is working are that you've seen a reduction in your blood glucose and hemoglobin A1C (your average glucose over the past 2 to 3 months). Nausea and diarrhea are common side effects of metformin, but they usually improve within a few weeks of starting the medication.
have ever had an allergic reaction to metformin or other medicine. have uncontrolled diabetes. have liver or kidney problems. have a severe infection.
Conclusions: People with diabetes taking metformin were less likely to report back, knee, neck/shoulder and multisite musculoskeletal pain than those not taking metformin. Therefore, when treating these patients, clinicians should be aware that metformin may contribute to fewer reports of musculoskeletal pain.
If you take metformin without food you may end up with an upset stomach, especially if you are just starting treatment. Nausea and vomiting are some of the most common side effects with metformin and can occur in over 30% of patients.
Up to 25% of diabetes patients taking metformin find they have bloating, gas, diarrhea, belly pain, and constipation. Often these side effects disappear on their own. By starting with a low dose and taking metformin with food, you can ease the side effects.