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Focus on Diabetes: All You Need to Know About Metformin

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METFORMIN is considered the first line of defense for people with Type Two diabetes as it is safe, effective, and affordable. It’s not linked to weight gain and it puts very little stress on the internal organs.

But it has side effects for some people according to the diaTribe Foundation.

If you expected it to work like insulin in pill form and reduce blood sugar levels right away, you will be disappointed. Metformin doesn’t work like that. Not at all.

It doesn’t immediately lower your blood sugar but can take four or five days to produce any result depending on your dosage.

It might not solve all your problems in the blink of an eye. But it is an effective medicine, and its interaction with the body is complex and interesting.

Metformin, which is also sold under the trade names Glucophage, Fortamet, Glumetza, and Riomet, is of the class of drugs called biguanides, which inhibit the production of glucose in the liver.

The medicine does not increase insulin levels in the body, but instead lessens the amount of sugar the body produces and absorbs. As it lowers glucose production in the liver, metformin also lowers blood sugar by increasing the body’s sensitivity to insulin. It also decreases the amount of glucose that our bodies absorb from the foods we eat.

For most people with Type 2 diabetes, metformin works to bring down blood sugar gradually when combined with a healthy diet and exercise.  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.

Metformin does cause side-affects 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.

Asking your doctor for the extended release version of metformin can keep these symptoms at bay, and so can tracking your diet.

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.

People with diabetes will find it useful to engage in 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.

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. Faux lows cam make one dizzy, lightheaded, nauseous, and extremely hungry.

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