It could be that you are not following dietary guidelines, have stopped exercising, or have gained excessive weight. Or, it could be that you're not taking the drug as prescribed. Whatever the reason, the very first indication that metformin is not working is when your blood glucose levels are high.
Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the tablet or extended-release tablet whole with a full glass of water. Do not crush, break, or chew it.
Lifestyle changes can control or even reverse the condition. Doctors also prescribe drugs to stabilize patients' blood glucose levels. The first-line treatment is metformin, but in some patients, the drug's efficacy can decline over time, necessitating alternative treatments.
As much as possible, avoid white bread, white rice, white pasta, candy, soda, desserts, and snacks like chips or crackers. Eating foods that can spike your blood sugar will not necessarily make the metformin not work, however, it will increase the burden it has to work against.
If you eat a lot of sugar while taking Metformin, your body will have to work harder to keep your blood sugar levels within a healthy range, and the Metformin will not be as effective for weight loss. However, if it happens infrequently, you should not suffer too many negative side effects. The key is moderation.
Is it safe to have coffee while consuming Metformin? Caffeine gets broken down by the body to remove it. Metformin may reduce how rapidly the body breaks down caffeine. Metformin when consumed in combination with caffeine can enhance the effects and side effects of caffeine.
You'll have more energy as your body uses insulin more efficiently. Common diabetes-related symptoms, such as blurry vision, being thirsty all of the time, or having to pee a lot, improve or disappear.
Eat saturated fats in moderation
Red meat and dairy products—like milk, cheese, and butter—are popular sources of saturated fats. These aren't foods to avoid while taking metformin altogether but focus on lean proteins—like turkey, fish, and tofu to increase metformin's efficacy.
As a result, cinnamon seems to be as effective as metformin in increasing the Insulin sensitivity. In line with this study, Maleki et al. showed that HDL and insulin sensitivity were increased by the cinnamon supplementation while LDL, TG, and blood glucose were decreased in patients with PCOS (17).
Metformin may have an adverse effect on renal function in patients with type 2 DM and moderate CKD.
An effective substitute for Metformin is a compound known as berberine or berberine hydrochloride, which is obtained from many plant species, including goldenseal, barberry, Oregon grape, and turmeric.
“If someone isn't following healthy habits, then taking metformin will not result in weight loss,” she says. “It's important to follow a healthy diet low in refined sugars and carbohydrates if [you are] prone to high insulin levels so that maximum benefit from the medication is received.”
If your diabetes remains hard to manage even after you begin taking metformin, or you cannot tolerate metformin or do not want to take it, that's when a GLP-1RA or SGLT2i might come in. Studies have shown that both medications are safe and effective at lowering blood glucose when compared to a placebo.
The maximum daily dose is 2,000mg a day. This can be taken as four 500mg tablets a day. Liquid metformin should be taken in 5ml doses of 500mg, 850mg or 1,000mg.
Metformin reaches the highest concentration in the blood (peak concentration) 1-3 hours after taking the pill. The half-life of metformin is 2-6 hours. Half-life of a drug is the time it takes for the concentration of a drug to be reduced by 50%. However, the half-life may take up to 14 hours.
People taking metformin should supplement vitamin B12 and folic acid or ask their doctor to monitor folic acid and vitamin B12 levels. Metformin therapy has been shown to deplete vitamin B12, and sometimes, but not always, folic acid as well.
Metformin stays in your system for about four days. It has an elimination half-life of approximately 17.6 hours. It takes approximately 96.8 hours for Metformin to clear from your body.
Luckily, metformin may start to work within the first week of treatment. In one study of over 700 people, metformin ER lowered blood glucose within the first week of treatment. But it took about 2 months for it to have its full glucose-lowering effect.
Be wary of taking metformin on an empty stomach
Taking all of your medications first thing in the morning may be the easiest way to remember to take them daily, but if you take metformin on an empty stomach (or only with coffee), it may cause nausea that can last all day.
The American Diabetes Association recommends that people with diabetes consume fruit in moderation, including bananas. This doesn't mean you should ignore those carbohydrates, but you should consider how many carbs you need daily.
Be sure to take it with meals to reduce the stomach and bowel side effects that can occur – most people take metformin with breakfast and dinner. Extended-release metformin is taken once a day and should be taken at night, with dinner. This can help to treat high glucose levels overnight.
Metformin doesn't cause kidney damage. The kidneys process and clear the medication out of your system through your urine. If your kidneys don't function properly, there's concern that metformin can build up in your system and cause a condition called lactic acidosis.