Diabetes type 2 and metformin

What is metformin used for?

Metformin is commonly used to help people with type 2 diabetes manage their blood sugar levels. For most, metformin works to bring down blood sugar gradually when combined with a healthy diet and exercise (I found Adam Brown’s book, Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me to be helpful, particularly in deciding what to eat and not to eat). It’s not so much a quick fix with overnight results as it is an important component of a larger health regimen that keeps the condition manageable.

Is metformin safe?

Metformin is considered a safe, cheap, and effective medication worldwide, and is widely accessible in most countries. 

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 it’s 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 there’s 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.

What is the best time to take metformin?

Standard metformin is taken two or three times per day. 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. 

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 (e.g. dehydration) 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 (low blood sugar), particularly for those who take insulin and drugs which increase insulin secretion (such as sulfonylureas), but also when combined with excessive alcohol intake. Even though I’m not on insulin, I started on continuous glucose monitoring (CGM) 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.

 

The “Faux Low”

There is another common side effect often experienced by people taking metformin for the first time. It’s something called a “faux low.”

A faux low happens when you drop your blood sugars to a “normal” range after running consistently high (i.e. above 180 mg/dl), whether by starting on a therapy like metformin or going on a low-carb diet, or both! Your body responds to this change as if it’s in real hypoglycemia (below 70 mg/dl).

Although every person with diabetes has a different blood-sugar threshold and different symptoms, people often feel irritable, tired, shaky, and dizzy when their blood sugar is 70 mg/dl or lower. 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.e. your meter says you’re at 96 mg/dl), keep taking your metformin as directed. Don’t start carb-loading (eating carb-rich foods like orange juice to bring sugars back up).

If I’m indeed having a faux low and not a real one, I found that drinking water and taking a high-sodium, non-carbohydrate snack (nuts are great for this, especially macadamia nuts which are high in fat) nips the symptoms in the bud, allowing me to move on with my life.

Note that especially for type 2 folks out there on metformin and insulin or sulfonylureas, hypoglycemia is a real risk. If you’re feeling low, check your blood sugar – there will be times when you do need to treat hypoglycemia with glucose tablets or orange juice or the like.

Metformin interactions: what should I avoid while taking metformin?

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.

Does metformin cause cancer?

In 2019 the FDA investigated whether some forms of metformin contain high levels of a carcinogenic (cancer-causing) chemical called N-nitrosodimethylamine (NDMA). In 2020, 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. 

Other Possible Metformin Benefits

Most people with type 2 diabetes tolerate metformin well and are glad it’s available in generic form, which keeps the price low. The medication is so effective as a first-line therapy the American Diabetes Association includes it in its diabetes Standards of Care.

But metformin could have additional uses and benefits outside of treating type 2 diabetes.

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 American Diabetes Association has said more doctors should be prescribing metformin to treat prediabetes (a state of higher-than-normal blood glucose levels that doesn’t meet the diagnostic criteria for diabetes), especially for people under the age of 60, although the FDA has yet to bless metformin’s use for the condition.

Can metformin cause weight loss?

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.

Scientists are also examining metformin’s potential to protect against heart disease in people with type 2 diabetes – some older data supports this. While robust heart outcome trials with metformin are yet to be conducted, more attention is being paid to this research area.

Metformin and type 1 diabetes

It will be an exciting development if metformin is helpful in the treatment of cancer or neurodegenerative conditions like Huntington’s. 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. Particularly because insulin often causes weight gain, healthcare providers prescribe metformin “off-label” (not for intended use approved by regulatory agencies) to their type 1 patients. While the study didn’t find that metformin definitively protects against heart disease, based on observed trends in the data, the authors concluded that it may have a role in heart disease risk management.

The Bottom Line?

If you are a person with type 2 diabetes, there are plenty of benefits to taking metformin for its original, intended purpose.

Its side effects are minimal for most people. It’s affordable and covered by Medicare and most insurance plans. Speaking for myself: metformin doesn’t have to cure aging or cancer to be immensely valuable. It helps me process insulin and go on with my life. For me, that’s enough.

Type 2 diabetes Symptoms

Check if you have type 2 diabetes

Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes include:

  • peeing more than usual, particularly at night
  • feeling thirsty all the time
  • feeling very tired
  • losing weight without trying to
  • itching around your penis or vagina, or repeatedly getting thrush
  • cuts or wounds taking longer to heal
  • blurred vision

You’re more at risk of developing type 2 diabetes if you:

  • are over 40 (or 25 for south Asian people)
  • have a close relative with diabetes (such as a parent, brother or sister)
  • are overweight or obese
  • are of Asian, African-Caribbean or black African origin (even if you were born in the UK)

Type 2 diabetes is often diagnosed following blood or urine tests for something else.

However, you should see a GP straight away if you have any symptoms of diabetes.

To find out if you have type 2 diabetes, you usually have to go through the following steps:

  1. See a GP about your symptoms.
  2. The GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back.
  3. If you have diabetes, the GP will explain the test results and what will happen next.

If you’re diagnosed with diabetes

What the GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend.

Generally, they’ll talk to you about:

  • what diabetes is
  • what high blood sugar means for your health
  • whether you need to take medicine
  • your diet and exercise
  • your lifestyle – for example, alcohol and smoking

If you have questions about your diagnosis

It’s usually difficult to take in everything the GP tells you during the appointment.

Talk to family and friends about what the GP told you, and write down any questions you have.

Then make another GP appointment and take your list of questions with you.

There’s also a lot of information on diabetes available.

What happens after the diagnosis

Usually, the following things happen after your diagnosis:

  1. The GP may prescribe medicine. It might take time for you to get used to the medicine and to find the right doses for you.
  2. You will usually need to make changes to your diet and be more active.
  3. You’ll have to go for regular type 2 diabetes check-ups.
  4. You’ll have to look out for certain signs to avoid other health problems.

A free education course for type 2 diabetes can help you manage your condition.

Most people need medicine to control their type 2 diabetes.

This helps keep your blood sugar level as normal as possible to prevent health problems.

You may have to take it for the rest of your life, although your medicine or dose may need to change over time.

Adjusting your diet and being active is usually also necessary to keep your blood sugar level down.

Medicines for type 2 diabetes

There are many types of medicine for type 2 diabetes. It can take time to find a medicine and dose that’s right for you.

You’ll usually be offered a medicine called metformin first.

You may need to take extra medicines, or a different medicine such as insulin, if:

  • treatment is not keeping your blood sugar levels within a healthy range
  • you have heart problems or need to lose weight

Your GP or diabetes nurse will recommend the medicines most suitable for you.

Your medicine might not make you feel any different, but this does not mean it’s not working. It’s important to keep taking it to help prevent future health problems.

Metformin

Metformin is the most common medicine for type 2 diabetes. It can help keep your blood sugar at a healthy level.

It comes as tablets you take with or after meals.

Common side effects of metformin include feeling or being sick and diarrhoea. If this happens to you, your doctor may suggest trying a different type called slow-release metformin.

Type two Diabetes

What is type 2 diabetes?-Type 2 diabetes

    • Type 2 diabetes is a common condition that causes the level of sugar (glucose) in the blood to become too high.
    • It can cause symptoms like excessive thirst, needing to pee a lot and tiredness. It can also increase your risk of getting serious problems with your eyes, heart and nerves.
    • It’s a lifelong condition that can affect your everyday life. You may need to change your diet, take medicines and have regular check-ups.
    • It’s caused by problems with a chemical in the body (hormone) called insulin. It’s often linked to being overweight or inactive, or having a family history of type 2 diabetes.

        Check if you have type 2 diabetes

        Many people have type 2 diabetes without realising. This is because symptoms do not necessarily make you feel unwell.

        Symptoms of type 2 diabetes include:

        • peeing more than usual, particularly at night
        • feeling thirsty all the time
        • feeling very tired
        • losing weight without trying to
        • itching around your penis or vagina, or repeatedly getting thrush
        • cuts or wounds taking longer to heal
        • blurred vision

        You’re more at risk of developing type 2 diabetes if you:

        • are over 40 (or 25 for south Asian people)
        • have a close relative with diabetes (such as a parent, brother or sister)
        • are overweight or obese
        • are of Asian, African-Caribbean or black African origin (even if you were born in the UK)

        Type 2 diabetes is often diagnosed following blood or urine tests for something else.

        However, you should see a GP straight away if you have any symptoms of diabetes.

        To find out if you have type 2 diabetes, you usually have to go through the following steps:

        1. See a GP about your symptoms.
        2. The GP will check your urine and arrange a blood test to check your blood sugar levels. It usually takes about 1 to 2 days for the results to come back.
        3. If you have diabetes, the GP will explain the test results and what will happen next.

        If you’re diagnosed with diabetes

        What the GP will discuss with you during your appointment depends on the diagnosis and the treatment they recommend.

        Generally, they’ll talk to you about:

        • what diabetes is
        • what high blood sugar means for your health
        • whether you need to take medicine
        • your diet and exercise
        • your lifestyle – for example, alcohol and smoking

        Important:Important

        The GP will do their best to discuss the diagnosis with you, but this first appointment might only be 10 to 15 minutes.

        If you have questions about your diagnosis

        It’s usually difficult to take in everything the GP tells you during the appointment.

        Talk to family and friends about what the GP told you, and write down any questions you have.

        Then make another GP appointment and take your list of questions with you.

        There’s also a lot of information on diabetes available.

        What happens after the diagnosis

        Usually, the following things happen after your diagnosis:

        1. The GP may prescribe medicine. It might take time for you to get used to the medicine and to find the right doses for you.
        2. You will usually need to make changes to your diet and be more active.
        3. You’ll have to go for regular type 2 diabetes check-ups.
        4. You’ll have to look out for certain signs to avoid other health problems.

        A free education course for type 2 diabetes can help you manage your condition.

        Sign yourself up online to Healthy living for people with type 2 diabetes. The GP may refer you to Diabetes education and self management for ongoing and newly diagnosed (DESMOND).

        Child Diabetes from a parent’s point of view.

        Nobody saw you. At 3am, headlamp on, sneaking into her room Every. Single. Night. Praying she doesn’t wake as you bleed her finger for the 10th time today4mmol. Shit.Too low for 3am.Get the juice carton

        “She needs this to survive,” you repeat to yourself“ Will she be able to handle this life?” “Will I?”

        Nobody saw you cry Because you always had to be so strong You can’t let them see your broken heart You must keep going She has to be so brave, you must set the example Soldier on

        Nobody saw you desperately shoving sugar in your shaking and confused child“One more sip, baby”“One more gummy bear for mummy, please

        ”Nobody saw you Trying to count how many carbs she ate Tiny teeth marks on an apple – is that 5 carbs worth or 8?Did she eat three french fries, or was it six? Not enough insulin, she goes high and there’s long-term damage to her organs Too much insulin and we’re looking at an immediate and dangerous issue.

        Nobody saw you on the phone With your insurance company With your diabetes supply company Your endocrinologist Your nurse10 phone calls this week when you were supposed to be working Or napping Or eating

        Nobody saw you, nobody listened when you tried to educate them To tell them about a condition so complex that they can never truly understand unless they live with it It’s an autoimmune disease No, it can’t be prevented No, there is no cur eyes, she can eat.

        that Nobody saw you So scared to sleep through an alarm Terrified they might not wake up in the morning Waking up to feel like you can’t do this crazy dance another day But you rise to take on another 24 hours – for them Check the blood sugar, treat the high, count the carbs, treat the low Nobody saw any of that They simply saw you at the park, the museum, grocery shopping

        see you, brave ones see your grit and your daily grind I see your fears for the future I see your fierce love and determination for your child I see you raising a warrior, and in the process becoming one yourself!

        Diabetes Symptoms in Women over 50

        Diabetes Symptoms in Women over 50 are very helpful in early diabetes diagnosis. Early diagnosis of diabetes can prevent diabetes complications. Late diagnosis may cause damage to vital organs. 

        What are Diabetes Symptoms in Women over 50?

        Diabetes symptoms in women over 50 include

        • excessive thirst
        • passing urine too often
        • vaginal thrush
        • yeast infections in vagina or mouth
        • urinary infections
        • female sexual dysfunction
        • polycystic ovary syndrome
        • sudden loss or gain of body weight
        • feeling tired and weak always etc.

        These are the diabetes symptoms women must look out for when they are over 40 or over 50. Women over 50 must take diabetes symptoms seriously. This can help prevent further damage to health. ‘Diabetes symptoms in women over 50’ as well as pre diabetic symptoms are very helpful in diagnosis of diabetes. Early signs of diabetes are so valuable that you cannot afford to ignore these warning signs. All diabetes symptoms, diabetes 2 symptoms as well as diabetes type 1 symptoms are serious. Upon noticing any diabetes symptoms in women over 50, one must encourage to ask ‘Am I diabetic?’ or ‘Is diabetes curable?’.

        But women over 50 rarely do that questioning. They do not normally check what causes diabetes. Due to this attitude, they are always at risk of more serious diabetes complications that can be prevented by taking diabetes symptoms seriously.

        You can use a diabetes symptom checker to understand early signs of diabetes. Using a diabetes testing kit at home to check for high blood sugar levels is a good start to deal with diabetes.

        What causes Diabetes in Women over 50?

        A woman’s body undergoes significant metabolic changes throughout life time. These changes have more impact on health as the age increases.

        By and large, Diabetes is a life style and metabolic disease. Unhealthy life style and metabolic changes in a woman’s body cause diabetes symptoms in women over 50.

        Sometimes doctors call them pre-diabetic symptoms.

        A diabetic patient’s body shows high blood sugar as it cannot process insulin or cannot produce insulin.

        Diabetes can appear in people of any age, sex or ethnic origin.

        Eating too much and not doing as much exercise is the most obvious cause of diabetes. When you know you are at risk of diabetes, it may help to understand what a diabetic can eat.

        Diabetes can happen to both men and women. However, there are some interesting observations with diabetes symptoms in women.

        To begin with, You must always discuss the signs of being diabetic in women over 40 or over 50 with a doctor.

        Generally speaking, doctors can find it easy to help you if you report early signs of Diabetes in women over 50.

        Do women over 50 pay attention to signs of being diabetic?

        Women over 50 often ignore signs of being diabetic. In general, they are less aggressive in seeking treatment for diabetes. Moreover, Women over 50 have similar attitude towards hypertension or any other cardio vascular diseases.

        In general, women do not respond to any symptoms of life style diseases as men do.

        However, Women over 50 should actually be taking both diabetes type 1 and type 2 symptoms seriously.

        In fact, they ignore diabetes symptoms. Women must take all diabetic symptoms seriously irrespective of their age. Women must see doctors whether they are over 40, over 50 or much younger.

        There are other life style diseases like hypertension, high cholesterol etc. They also deserve urgent action whether they show up in men or women.

        Are Diabetes Symptoms in Women over 50 different to those in men?

        Diabetic complications are different in women compared to those in men. This may be due to hormones and the way their bodies are built etc.

        Even the kind of heart diseases in women are different compared to men.

        Inflammations are also different in women compared to men.

        Likewise, some Diabetes symptoms too are different in women and men.

        Both women and men can use a diabetes symptom checker. It helps to gain understanding of diabetes.

        Women experience some diabetic symptoms in a unique way than men. These are in addition to the diabetic symptoms seen in men.

        Hence, if you have symptoms of diabetes, you must see a doctor. Then, doctor can help with diabetes tests and diagnosis. A doctor can also help you understand with what causes diabetes.

        Do any diabetes symptoms in women over 50 appear in men too?

        As can be seen, some diabetes symptoms in women over 50 are specific to women.

        There are other symptoms that are common to both men and women. Both men and women may show such symptoms. The diabetic signs in women over 50 common also in men include:

        • increased thirst and hunger
        • frequent urination
        • weight loss or gain that has no obvious cause
        • fatigue
        • blurred vision
        • wounds that heal slowly
        • nausea
        • skin infections
        • patches of darker skin in areas of the body that have creases
        • irritability
        • breath that has a sweet, fruity, or acetone odour
        • reduced feeling in your hands or feet

        In summary, You must take diabetes early symptoms seriously. You also need to look into what caused diabetes in your case.