Gastrointestinal adverse effects such as abdominal pain, nausea, dyspepsia, anorexia, and diarrhea are common and widely accepted when occurring at the start of metformin therapy. Diarrhea occurring long after the dosage titration period is much less well recognized.
Diarrhea is common with metformin. You're not alone if you've experienced diarrhea from taking it. In clinical trials, diarrhea occurred in more than half of people who took metformin. Unfortunately, some people find this to be an inconvenient and limiting side effect that disrupts their daily routine.
If you're taking metformin to help control your blood sugar, it's important to take it as prescribed. If you stop taking it, your blood sugar levels could get too high. If this happens, you may experience symptoms like dry mouth, feeling thirsty, or needing to pee more.
GI AEs typically encountered with metformin therapy include diarrhoea, nausea, flatulence, indigestion, vomiting and abdominal discomfort, with diarrhoea and nausea being the most common.
Metformin is an oral medication used to treat type 2 diabetes that is generally well tolerated. GI upset, especially diarrhea, is the most common side effect. This typically decreases over time. Although rare, lactic acidosis, hypoglycemia, and vitamin B12 deficiency can occur.
As much as possible, avoid white bread, white rice, white pasta, candy, soda, desserts, and snacks like chips or crackers. Eating foods that can spike your blood sugar will not necessarily make the metformin not work, however, it will increase the burden it has to work against.
It typically resolves within a few days or few weeks once the body adjusts to the medication. If diarrhea from metformin does last longer, your healthcare provider can help to determine if it is being caused by metformin or something else.
Metformin must be consumed with meals to assist lower stomach or bowel side effects that might happen during the initial few weeks of treatment. The tablet or extended-release tablet must be taken whole with a full glass of water.
The administration of metformin, as glucophage retard, at bedtime instead of supper time may improve diabetes control by reducing morning hyperglycemia.
In patients taking metformin (right), the intestine appears black, which indicates that FDG (sugar) is accumulated in the intestine.
Physiologically, metformin acts directly or indirectly on the liver to lower glucose production, and acts on the gut to increase glucose utilisation, increase GLP-1 and alter the microbiome.
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.
It's best to take metformin tablets with, or just after, your evening meal to reduce the chance of getting side effects. Swallow your metformin tablets whole with a drink of water.
“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 with or after a meal can curb side effects
Metformin can be taken with or without food. However, if you're prone to its side effects, such as nausea, upset stomach, diarrhea, or vomiting, it is best to take metformin with or after a meal.
An effective substitute for Metformin is a compound known as berberine or berberine hydrochloride, which is obtained from many plant species, including goldenseal, barberry, Oregon grape, and turmeric.
As already discussed, metformin can result in sleep disturbance, and this might affect normal dream patterns. Nightmares are reported in patients receiving metformin. [7] However, they are less frequent than insomnia.
Sulfonylureas or SFUs [DiaBeta, Glynase, or Micronase (glyburide or glibenclamide) Amaryl (glimepiride) Diabinese (chlorpropamide) Glucotrol (glipizide)] Usage: This is a good alternative to metformin and works well to lower blood sugar levels.
Metformin doesn't cause kidney damage. The kidneys process and clear the medication out of your system through your urine. If your kidneys don't function properly, there's concern that metformin can build up in your system and cause a condition called lactic acidosis.
The American Diabetes Association recommends that people with diabetes consume fruit in moderation, including bananas. This doesn't mean you should ignore those carbohydrates, but you should consider how many carbs you need daily.