Doctor's Corner: Your Questions About Metformin Answered By A Doctor

UK Meds spoke with Dr Ibrahim Rabi to get answers to the common questions you’ve asked us about the diabetes and PCOS treatment, Metformin. You’ll find the answers to all of your frequently asked questions below.

Metformin FAQs

Below are a selection of your most common questions about Metformin that we asked Dr Ibrahim:

How does metformin help with diabetes? 

Metformin helps manage blood sugar by reducing glucose absorption from the gut,  it also increases insulin sensitivity, reduces hepatic glucose production and has beneficial Effects on Lipid profile.

How does metformin help with PCOS?

Metformin helps with PCOS by improving insulin sensitivity, lowering androgen levels, restoring ovulation, aiding in weight management, reducing the risk of type 2 diabetes, and improving Lipid profile.

When will I start feeling better after taking metformin?

The timeline for feeling better after starting metformin can vary depending on the individual and the condition being treated:

For Diabetes: 

You might notice some improvement in blood sugar levels within a few days to a week. Full effects usually take 4-8 weeks, as the dose is gradually increased.

For PCOS: 

It can take a few months to see changes. Many women start to notice improvements in menstrual regularity and ovulation within 3-6 months.

Are there any long-term side effects of taking metformin?

Metformin is generally safe and well-tolerated for long-term use, but it can have some side effects:

• Some people might have mild symptoms like nausea, diarrhoea, or stomach discomfort. These can usually be managed by adjusting the dose or taking the medication with meals.

• Vitamin B12 Deficiency

• Lactic Acidosis

Other Considerations:

Since metformin is cleared through the kidneys, regular kidney function tests are important to ensure the medication remains safe.

Keep up with regular appointments to monitor your blood sugar, kidney function, and overall health to ensure metformin is still appropriate for you.

What other medicines are available to treat type 2 diabetes?

There are several types of medications for managing type 2 diabetes, each working in different ways. They can be used alone or together based on individual needs. 

Examples of type 2 diabetes medications include: 

• Sulfonylureas

• DPP-4 Inhibitors

• GLP-1 Receptor Agonists (such as Ozempic and Wegovy)

• SGLT2 Inhibitors

• Thiazolidinediones (TZDs)

• Meglitinides

• Alpha-Glucosidase Inhibitors

• Insulin

Can I take metformin before surgery?

Whether or not you should take metformin before surgery depends on several factors, including the type of surgery, the duration of the procedure, and your overall health.

• For minor surgeries or outpatient procedures, metformin is often continued, especially if you are eating and drinking normally before the procedure.

• For major surgeries, especially those requiring general anaesthesia, your doctor may advise skipping the morning dose on the day of the surgery.

Will metformin affect my contraception?

Metformin does not interfere with the effectiveness of most contraceptives. However, you might need a small adjustment in your metformin dose after starting contraceptive pills.

Can I drive or ride a bike while taking metformin?

Yes, you can generally drive or ride a bike while taking metformin

Can I drink alcohol while taking metformin?

Yes, you can drink alcohol while taking metformin but try to keep to the recommended guidelines of no more than 14 units of alcohol per week

Is there any food or drink I should avoid while taking metformin?

For the best results in lowering blood sugar, take metformin with a balanced diet. Eating well and avoiding high sugar and fatty foods is a good idea.

Can lifestyle changes improve diabetes and PCOS?

Yes, lifestyle changes can significantly improve both diabetes and polycystic ovary syndrome (PCOS).Key changes include:

• Eating a healthy diet

• Losing excess weight

• Not smoking

• Limiting alcohol to no more than 14 units per week

• Exercising 30 minutes a day, 5 times a week

Should all type 2 diabetics take metformin?

Metformin is often considered the first-line medication for managing type 2 diabetes due to its effectiveness, safety profile, and other benefits. However, not all individuals with type 2 diabetes are required to take metformin. 

Can young diabetics take metformin?

Yes, young individuals with type 2 diabetes can take metformin. In fact, metformin is often used as the first-line medication for managing type 2 diabetes in children and adolescents. 

How much metformin should I take? 

The dosage of metformin can vary based on several factors, including the specific condition being treated, your overall health, and how you respond to the medication. Your doctor might start you on 500 mg once daily and increase it to up to 2 grams a day.

If I take metformin, can I stop dieting and exercising?

While metformin can be highly effective in managing blood sugar levels and supporting diabetes control, it is not a substitute for a healthy lifestyle. Diet and exercise play crucial roles in managing type 2 diabetes and should not be discontinued simply because you are taking medication. 

What is lactic acidosis?

Lactic acidosis is a condition where there is an excess of lactic acid in the blood, leading to a decrease in blood pH (making it more acidic). This can result from various factors, including certain medical conditions, medications, or intense physical exercise.

What are the symptoms of lactic acidosis?

Symptoms of lactic acidosis include Rapid Breathing, Confusion or Drowsiness, Muscle Pain or Weakness, Abdominal Pain, Nausea or Vomiting, Fatigue, Sweating and Faster Heart Rate

I am pregnant and taking metformin, what should I do?

Metformin is generally considered safe during pregnancy. However, it’s important to manage your diabetes carefully to ensure both your health and the health of your baby. You should immediately Inform your healthcare provider about your pregnancy. They will assess whether metformin is the best option for you and may adjust your treatment plan as needed.

Key Takeaways from Dr Ibrahim

How Metformin Helps:

• For diabetes: Metformin helps manage blood sugar by reducing glucose absorption, increasing insulin sensitivity, and decreasing liver glucose production.

• For PCOS: It improves insulin sensitivity, lowers androgen levels, restores ovulation, aids in weight management, and improves lipid profiles.

Effectiveness and Side Effects:

• You might see improvements in blood sugar levels within days to weeks for diabetes and menstrual regularity in a few months for PCOS.

• Common side effects include nausea, diarrhoea, stomach discomfort, and potential vitamin B12 deficiency. Regular kidney function tests are important.

Lifestyle and Additional Information:

• Metformin is effective but should be paired with a healthy lifestyle, including a balanced diet and exercise.

• It is generally safe to take metformin while driving or consuming moderate alcohol but it should be avoided where possible.

• Metformin does not interfere with most contraceptives and is often the first-line medication for type 2 diabetes, even in young people.

Disclaimer: 

You should always consult with your doctor and refer to the patient information leaflet provided with the medication for any questions you may have, to ensure that the medication is suitable for your individual needs.

Medically Reviewed by:
Dr. Ibrahim Alrabi
GMC reference no: 7733243
LinkedIn