If you can\u2019t manage your diabetes with lifestyle alone, your doctor will likely advise you to start taking medication to control your blood glucose levels. <\/p>\n\n\n\n
Metformin is one of the most commonly prescribed medications for type 2 diabetes, while insulin is often the only medication used for type 1 diabetes<\/a>. <\/p>\n\n\n\n There are several metformin alternatives, and it can be difficult to decide which medication to take. <\/p>\n\n\n\n How do you know if metformin is best for you or if it\u2019s time to try another diabetes medication?<\/p>\n\n\n\n One of the most commonly prescribed medications for type 2 diabetes is metformin. Metformin<\/a> is the generic name most widely prescribed, and the brand name for metformin is Glucophage.<\/p>\n\n\n\n Metformin doesn\u2019t cause low blood sugar (hypoglycemia), which is one of its major benefits and a reason it’s often prescribed as the first diabetes medication for patients with type 2 diabetes. Because it doesn\u2019t cause low blood sugar, people with type 2 diabetes<\/a> can take metformin with other medications like sulfonylureas and injectable insulin<\/a>.<\/p>\n\n\n\n Metformin is in a drug class called biguanides. Biguanides help reduce the amount of sugar your liver makes while improving insulin sensitivity<\/a>, which helps reduce high blood sugar<\/a>. There are two types of metformin – regular and extended-release (XR).<\/p>\n\n\n\n The common dosage for metformin ranges from 500 milligrams to a maximum of 2,550 milligrams per day. It\u2019s usually recommended to split the dose among meals, typically three times per day. <\/p>\n\n\n\n While metformin is most commonly used for type 2 diabetes, it\u2019s also used to help treat polycystic ovarian syndrome (PCOS)<\/a>. Polycystic ovarian syndrome is a hormonal disorder in women often stemming from insulin resistance<\/a>. <\/p>\n\n\n\n RELATED:<\/strong> Metformin Diet: 5 Foods To Eat and 6 You Should Avoid<\/a>.<\/p>\n\n\n\n Metformin acts by reducing the amount of glucose (sugar) produced by your liver and helps your cells be more sensitive to insulin. <\/p>\n\n\n\n Unlike other types of diabetes medication, metformin doesn\u2019t cause low blood sugar. Because it won\u2019t cause hypoglycemia<\/a>, you can use it in addition to other medications, including injectable insulin.<\/p>\n\n\n\n Many people with diabetes are hesitant to take medication that requires an injection. Metformin is only in pill form, so it doesn\u2019t require injections.<\/p>\n\n\n\n Metformin is much more affordable than some of the newer types of diabetes medications<\/a> available today. Choosing the generic brand will be even more cost-effective.<\/p>\n\n\n\n The most common metformin side effects<\/a> are gastrointestinal-related. <\/p>\n\n\n\n If you start taking metformin, you may experience some of these side effects:<\/p>\n\n\n\n Metformin might also reduce your body\u2019s ability to absorb vitamin B12 in your stomach. Approximately 6-30%<\/a> of people taking metformin experience vitamin B12 deficiency. According to studies, the higher the metformin dose, the greater the risk of vitamin B12 deficiency. <\/p>\n\n\n\n Vitamin B12 is important for creating DNA and red blood cells. Vitamin B12 deficiency can lead to anemia, which is when you have lower levels of red blood cells than is healthy. Anemia<\/a> from vitamin B12 deficiency is pernicious anemia. <\/p>\n\n\n\n It comes with symptoms such as:<\/p>\n\n\n\n You often treat a vitamin B12 deficiency with vitamin B12 injections. Oral supplements aren\u2019t usually used to treat pernicious anemia because the issue lies in the stomach\u2019s ability to absorb vitamin B12.<\/p>\n\n\n\n Most people taking metformin experience minor side effects. However, there is a low risk of more severe side effects from taking metformin. Lactic acidosis<\/a> is a serious condition where your body creates more lactic acid than your body can clear. <\/p>\n\n\n\n The symptoms of lactic acidosis<\/a> usually set in quickly and include:<\/p>\n\n\n\n Metformin overdose<\/a> is the main risk factor for developing lactic acidosis<\/a>. <\/p>\n\n\n\n You might stop taking metformin if the side effects are interfering with your life or causing you distress. Metformin impacts everyone differently, so it\u2019s impossible to predict who will have little to no side effects and who will have severe side effects.<\/p>\n\n\n\n If your blood sugar levels are no longer well-controlled on metformin and metformin isn’t working<\/a> for you anymore, your provider may recommend some metformin alternatives to add to your metformin or to use without metformin.<\/p>\n\n\n\n You might also consider stopping metformin<\/a> if you\u2019re reaching your blood glucose targets. Some people can manage their blood sugar levels with lifestyle alone and may no longer need metformin. Patients who undergo weight loss surgery<\/a> and lose a significant amount of weight can often stop some medications such as metformin.<\/p>\n\n\n\n The glomerular filtration rate (GFR) is an indicator of how efficiently your kidneys filter blood. Metformin is safe to use when the estimated GFR is greater than or equal to 45 milliliters per minute<\/a>. This means you might need to stop taking metformin<\/a> if your kidney function declines or if you have advanced kidney disease<\/a>.<\/p>\n\n\n\n RELATED: <\/strong>What Happens When You Stop Taking Metformin for Diabetes?<\/a><\/p>\n\n\n\n Diabetics can use sulfonylureas in addition to metformin. They are a popular second medication choice in addition to metformin since they can help lower blood glucose even more without needing to start injectable medications.<\/p>\n\n\n\n Sulfonylureas work by helping your pancreas secrete more insulin. Because they help increase insulin levels, sulfonylureas can cause low blood sugar<\/a>.<\/p>\n\n\n\n Some popular sulfonylureas include glipizide<\/a>, glyburide, and glimepiride. <\/p>\n\n\n\n Glucagon-like peptide (GLP)-1 is a hormone that increases insulin secretion after eating, helping to lower blood sugar levels. GLP-1 receptor agonists are drugs that help increase the amount of insulin secreted after eating by mimicking GLP-1. They come in the form of an injection.<\/p>\n\n\n\n GLP-1 receptor agonists\u2019 drug names end in -ide, such as exenatide (Byetta), liraglutide (Victoza), and dulaglutide (Trulicity)<\/a>. You inject them under the skin as often as twice per day or as little as once per week depending on the drug used and the response. GLP-1 receptor agonists don\u2019t usually cause low blood sugar on their own.<\/p>\n\n\n\n Dipeptidyl peptidase 4 (DPP-4) is an enzyme that destroys a type of hormone called incretins. Incretins help your body produce more insulin when it\u2019s needed but also tell the liver to release less sugar when it\u2019s not required. <\/p>\n\n\n\n DPP-4 inhibitors block the action of DPP-4, helping to increase insulin secretion and better regulate blood sugar levels.<\/p>\n\n\n\n DPP-4 inhibitors\u2019 drug names end in -liptin such as sitagliptin (Januvia)<\/a> and saxagliptin (Onglyza). They can also be combined with other medications like metformin and sitagliptin\/Januvia (Janumet). DPP-4 inhibitors don\u2019t cause low blood sugar.<\/p>\n\n\n\n SGLT2 inhibitors canagliflozin (Invokana<\/a>), dapagliflozin (Farxiga)<\/a>, and empagliflozin (Jardiance<\/a>) help increase the amount of sugar excreted in your urine by your kidneys. <\/p>\n\n\n\n These medications are a bit newer and were FDA-approved in 2013 for the treatment of diabetes. Another benefit of these medications is that they can help promote weight loss, which can improve blood sugar levels if you have diabetes and are overweight or obese. SGLT-2 inhibitors may help reduce the risk of cardiovascular disease, including heart disease<\/a>.<\/p>\n\n\n\n Some of the potential side effects of SGLT2 inhibitors include increased yeast infections<\/a> and urinary tract infections from the extra glucose in the urine. <\/p>\n\n\n\n TZDs help lower blood glucose by improving insulin sensitivity. They aren\u2019t used very often due to their side effects and potential complications. <\/p>\n\n\n\n TZDs can cause fluid retention and weight gain, which can worsen health conditions like congestive heart failure, kidney disease, or liver problems.<\/p>\n\n\n\n Glinides help the pancreas produce more insulin, helping to lower blood sugars. They are to be taken within 15-30 minutes of a meal.<\/p>\n\n\n\n Glinides have a short action time (the time it takes for the medication to start lowering your blood sugar) and carry a risk of low blood sugar, but can be safe options for some people. Some examples of glinides are Prandin and Starlix.<\/p>\n\n\n\n Insulin<\/a> is the most efficient medication for treating diabetes since it mimics your body\u2019s ability to lower blood sugar levels. There are several types of insulin, and some can be combined to tailor to each patient\u2019s individual needs.<\/p>\n\n\n\n Insulin is the primary medication to treat type 1 diabetes<\/a>, which occurs when the insulin-producing cells (beta cells) in the pancreas are mistakenly destroyed by your immune system.<\/p>\n\n\n\nWhat is metformin?<\/h2>\n\n\n\n
3 benefits of metformin for diabetes<\/h2>\n\n\n\n
1. No hypoglycemia<\/h3>\n\n\n\n
2. Oral form instead of an injection<\/h3>\n\n\n\n
3. Financial considerations<\/h3>\n\n\n\n
Side effects and risks of metformin<\/h2>\n\n\n\n
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Reasons people may stop taking metformin<\/h2>\n\n\n\n
Metformin vs other diabetes medications <\/h2>\n\n\n\n
Sulfonylureas<\/h3>\n\n\n\n
Pros of sulfonylureas<\/h3>\n\n\n\n
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Cons of sulfonylureas<\/h3>\n\n\n\n
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GLP-1 receptor agonists<\/h3>\n\n\n\n
Pros of GLP-1 receptor agonists<\/h3>\n\n\n\n
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Cons of GLP-1 receptor agonists<\/h3>\n\n\n\n
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DPP-4 inhibitors<\/h3>\n\n\n\n
Pros of DPP-4 inhibitors<\/h3>\n\n\n\n
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Cons of DPP-4 inhibitors<\/h3>\n\n\n\n
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SGLT2 inhibitors<\/h3>\n\n\n\n
Pros of SGLT2 inhibitors<\/h3>\n\n\n\n
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Cons of SGLT2 inhibitors<\/h3>\n\n\n\n
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Thiazolidinediones (TZDs) <\/h3>\n\n\n\n
Pros of TZDs<\/h3>\n\n\n\n
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Cons of TZDs<\/h3>\n\n\n\n
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Glinides<\/h3>\n\n\n\n
Pros of glinides<\/h3>\n\n\n\n
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Cons of glinides<\/h3>\n\n\n\n
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Insulin<\/h3>\n\n\n\n
Pros of insulin<\/h3>\n\n\n\n