Metformin for diabetes: What you need to know (Metformin)

If you have Type 2 Diabetes, your doctor will most likely prescribe you a medication called Metformin. This is a very important medication that is widely used by diabetics in our country and around the world. So, why is this medication so important? How does it work in our body? What are the possible side effects? What are the things to be afraid of? Let's talk about all of this simply, as if we were talking to a friend today.

How does metformin work inside the body?

Simply put, metformin helps control your blood sugar levels in three main ways. Think of it like a smart manager.

1. Reduces sugar production by the liver: Normally, our liver produces the glucose (sugar) our body needs. In a person with diabetes, this process is a little too much. Metformin gives the liver a "signal" that says, "Okay, now reduce production a little, there's already too much sugar in the blood."

2. Increases the body's sensitivity to insulin: The main problem in diabetes is insulin resistance. This means that even though there is insulin in the body, the cells of the body, especially the muscle cells, do not respond properly to that insulin. Metformin helps these cells become more sensitive to insulin. Then, the sugar floating in the blood can easily enter the muscles and be used as energy.

3. Reduces the absorption of sugar from food: The body absorbs sugar from the food we eat from the intestines. Metformin reduces the speed and amount of sugar absorbed from these intestines.

These three methods alone can help lower your A1c test , which is a measure of your average blood sugar levels over the past few months. This medication can also help delay the progression of prediabetes to diabetes.

Metformin types and brands

Metformin comes under many different brand names. Your doctor may have prescribed it to you under names like Glucophage, Fortamet, Riomet. These are available in tablet and liquid form.

Sometimes metformin is given in combination with another diabetes medicine. For example, Janumet is a combination pill that combines sitagliptin and metformin. Your doctor will decide which type and dose you should take.

What are the most common side effects?

Like any medication, Metformin can have side effects. But don't worry , most of these are minor and will go away over time as your body gets used to the medication. The most common side effects are stomach upset.

The most important thing is not to stop taking the medication suddenly because of these side effects. Talk to your doctor about this. He or she will tell you how to manage them.

The best way to minimize these discomforts is to take the medication with or after a meal . It is easier on the stomach than taking it on an empty stomach.

Another thing is that some extended-release (ETU) tablets (these are the types that release the medicine into the body over time) may sometimes come out with the stool. Don't worry if you see this. The medicine has been absorbed into the body.

Rare but serious side effects

These are very rare to see, but it is very important to be aware of them.

1. Lactic Acidosis

This is the most serious but rare side effect of metformin. It occurs when a chemical called lactic acid builds up in our bodies. It occurs in a very small number of people. The following people are particularly at risk:

• People with kidney or liver disease
• People who drink alcohol excessively
• People with serious heart conditions
• People who are dehydrated due to fever, diarrhea, or vomiting

Watch out for these symptoms:

In addition to stomach pain, dizziness, and feeling light-headed, if you experience numbness or unusual coldness in your limbs or a change in your heartbeat , call your doctor immediately or go to the nearest hospital's Emergency Department (ETU).

2. Vitamin B12 Deficiency

Some people may experience low vitamin B12 levels when taking metformin for a long time. This can increase symptoms of peripheral neuropathy, which is already a risk factor for diabetes. It can also cause anemia, or blood loss.

Therefore, it is wise to talk to your doctor and have your vitamin B12 levels checked periodically.

3. Hypoglycemia - low blood sugar

It is very rare for someone taking Metformin alone to have their blood sugar drop too low. However, if you take other diabetes medications (e.g. Gliclazide, Insulin) with Metformin, exercise excessively, or do not eat properly, your blood sugar may drop too low. If you experience symptoms such as sweating, shaking, extreme hunger, or dizziness, eat something sweet (a spoonful of sugar, a piece of candy) immediately.

How to manage side effects?

There are several things you can do to avoid or reduce many side effects.

• Start with a low dose: Your doctor will usually start with the lowest dose first, then gradually increase the dose as your body adjusts.
• Take the medicine with food: This is the best way to reduce stomach discomfort.
• Ask about the Extended-Release (ETU) type: This type of pill is taken once a day. Since the medication is released into the body over time, side effects like bloating and nausea are much less likely. If you are having more trouble with the regular pill, ask your doctor if you can switch to this type.

Metformin and other medications

Metformin can interact with other medications you are taking, so it is important to tell your doctor about all medications you are taking (including vitamins).

In particular, if you are undergoing a test that involves the injection of contrast dye, such as a CT scan or MRI, you may need to stop taking Metformin a few days before. Inform the relevant medical staff in advance.