Importantly, metformin does not stimulate insulin secretion so although there is a small risk of hypoglycaemia if taken without food, this is minimal compared with other antidiabetic drugs. Metformin can, however, increase the risk of hypoglycaemia if used in combination with other antidiabetic medicines.
Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the tablet or extended-release tablet whole with a full glass of water. Do not crush, break, or chew it.
This medicine is usually taken within 15 minutes before a meal but may be taken up to 30 minutes before a meal. If you skip a meal, you should skip your dose for that meal.
Foods to Consider While Taking Metformin
Complex carbohydrates: Unrefined grains such as brown rice, whole grain oats, whole-grain bread, and quinoa contain fiber. Fiber slows the rate at which your body converts carbs into glucose, leading to more stable blood glucose levels.
"In light of our study, we highly recommend that those with type 2 diabetes not skip breakfast," Dr. Jakubowicz says, ''because it causes major damage to the beta cell function and leads to high sugar levels, even if they don't overeat at lunch and dinner."
Breakfast is important for people with diabetes. It enables a person to feel full and can help keep blood glucose levels stable. Insulin sensitivity is often higher in the morning than in the evening, so an eating schedule that includes breakfast and minimizes late-night eating is preferable.
In short, the “second meal effect” is the phenomenon where skipping breakfast results in a higher glucose spike at lunch than it would for the same meal if you had eaten breakfast. Or: Eating breakfast will ensure a lower glucose response at lunch.
If you eat a lot of sugar while taking Metformin, your body will have to work harder to keep your blood sugar levels within a healthy range, and the Metformin will not be as effective for weight loss. However, if it happens infrequently, you should not suffer too many negative side effects. The key is moderation.
Some simple and refined carbohydrates
Metformin helps limit blood glucose levels. Simple and refined carbs boost those blood sugar levels, which can increase weight gain and cause metformin not to work as well as it should.
Metformin does not usually cause low blood sugar. But you may get low blood sugar when you take metformin and you exercise hard, drink alcohol, or do not eat enough food. Sometimes metformin is combined with other diabetes medicine. Some of these can cause low blood sugar.
The boost in sugar is your body's way of making sure you have enough energy to get up and start the day. If you have diabetes, your body may not have enough insulin to counteract these hormones. That disrupts the delicate balance that you work so hard to keep, and your sugar readings can be too high by morning.
“If someone isn't following healthy habits, then taking metformin will not result in weight loss,” she says. “It's important to follow a healthy diet low in refined sugars and carbohydrates if [you are] prone to high insulin levels so that maximum benefit from the medication is received.”
Taking metformin can cause vitamin B12 deficiency if you take it for a long time. This can make you feel very tired, breathless and faint, so your doctor may check the vitamin B12 level in your blood. If your vitamin B12 levels become too low, vitamin B12 supplements will help.
Metformin may have an adverse effect on renal function in patients with type 2 DM and moderate CKD.
How long to take it for. Treatment for diabetes is usually for life. But if your kidneys are not working properly, your doctor will tell you to stop taking metformin and switch you to a different medicine.
In general, for diabetes medications including oral hypoglycemic agents (e.g., metformin) and insulin, if you miss one dose, take the next one as soon as you remember it. However, if you remember close to the time of the next dose, then skip it and take the next dose instead. Do NOT double the dose.
Taking certain other medications with metformin may increase the risk of lactic acidosis. Tell your doctor if you are taking acetazolamide (Diamox), dichlorphenamide (Keveyis), methazolamide, topiramate (Topamax, in Qsymia), or zonisamide (Zonegran).
Acarbose, metformin, and SGLT2 inhibitors are considered a class of drugs that can directly excrete glucose. The effects of these antidiabetic drugs are expected to be a mechanism that not only improves the condition but also mimics caloric restriction by excreting glucose directly.
According to Amy Goodson, MS, RD, CSSD, LD author of The Sports Nutrition Playbook and member of our Expert Medical Board, one of the most crucial things you can do at breakfast to help you manage your blood sugar levels is to pair a high-fiber carb with some protein.
For most people with diabetes, mealtimes should space out through the day like this: Have breakfast within an hour and half of waking up. Eat a meal every 4 to 5 hours after that.
Some people even experience headaches, blood sugar dips, faintness and difficulty concentrating when they skip breakfast. Studies suggest that eating breakfast can also help keep blood sugar and blood pressure levels steady and improve cholesterol levels, provided you select healthy options (not pastries and donuts).