What Is Metformin and What Is It Used For?

How Does Metformin Work?

Metformin is a generic drug approved by the Food and Drug Administration for the treatment of type 2 diabetes. The brand name of Metformin is Glucophage. Doctors prescribe Metformin to help reduce and control blood sugar levels in diabetic patients. They typically recommend that patients with type 2 diabetes make lifestyle changes as well such as eating a healthier diet, increasing activity levels, and weight loss if overweight or obese.

Understanding Type 2 Diabetes

Your pancreas produces insulin, which is a hormone that helps to deliver glucose (sugar) to your body’s tissues and cells. The cells convert glucose into energy that allows you to meet the physical and mental demands of everyday life.

When the pancreas does not produce insulin properly, your blood sugar levels become elevated and you may receive a diagnosis of type 2 diabetes. It is also possible to develop type 2 diabetes when your liver does not produce glucose correctly. Some people with this condition develop insulin resistance where the body struggles to use the glucose produced by the pancreas or liver at all.

A fasting blood sugar reading above 125 mg/dL or a blood sugar reading of 200 mg/dL within two hours of eating a meal indicates that you have type 2 diabetes. Doctors also rely on a hemoglobin A1C level to diagnose type 2 diabetes, which is your average hemoglobin level over the past three months. Any number over 6.5 percent indicates an issue with high blood sugar and results in a diagnosis of type 2 diabetes.

Some of the biggest risk factors for developing type 2 diabetes include a poor diet, sedentary lifestyle, high blood pressure, high cholesterol, and sometimes hereditary factors. Even if you were not overweight or obese when your doctor diagnosed type 2 diabetes, committing to healthy lifestyle changes is important to keep your blood glucose numbers under control.

Type 2 Diabetes by the Numbers

Also known as non-insulin-dependent diabetes or adult-onset diabetes, type 2 diabetes is significantly more common than type 1 diabetes that frequently develops during childhood. According to the American Diabetes Association (ADA), 34.2 million Americans have diabetes, which is just over 10 percent of the population. Of this number, only 1.6 million have a diagnosis of type 1 diabetes while the remainder has type 2 diabetes. Unfortunately, the 34.2 million figure also includes 7.3 million Americans who are unaware that they have type 2 diabetes or prediabetes.

Controlling blood sugar is essential to minimize the effects of type 2 diabetes. Some people are fortunate to reduce their blood sugar with lifestyle changes alone, but most require prescription medication as well. Serious complications, including blindness and loss of digits or limbs, can occur with ongoing high blood sugar levels. Complications of type 2 diabetes can also cause death. The American Diabetes Association reports that type 1 diabetes or type 2 diabetes was the 7th leading cause of death in 2017, claiming the lives of 83,564 people that year.

How Metformin Works to Control Blood Sugar Levels

Metformin works to stabilize blood sugar by reducing glucose production in the liver, decrease the absorption of glucose by the gastrointestinal (GI) tract, and increase insulin sensitivity in the cells. Weight loss helps to improve the intended effects of Metformin. However, the medication does not cause weight gain. Metformin is available as immediate-release and extended-release tablets and as an oral solution. Each type of Metformin has three dosing options available.

Common Side Effects of Metformin

Every diabetes treatment has common, less common, and rare side effects. Some of the most common side effects associated with Metformin include:

  • Abdominal pain
  • Body chills
  • Chronic hoarseness or cough
  • Decrease in appetite
  • Diarrhea
  • Fast breathing
  • Fatigue
  • Fever
  • Lower back pain
  • Muscle cramps
  • Painful urination or difficulty initiating urine stream
  • Side pain
  • Shallow breathing

These side effects often lessen or disappear as your body adjusts to Metformin. The Mayo Clinic recommends that diabetic patients speak to their healthcare provider if any of these symptoms continue to persist:

  • Decreased appetite
  • Feeling bloated, with or without belching
  • Feeling full after not eating much food
  • Flatulence
  • Heartburn
  • Indigestion
  • Metallic taste in your mouth
  • Stomach pain
  • Vomiting
  • Weight loss

People with kidney disease should not take Metformin as it increases the risk of lactic acidosis. This condition comes on quickly and can cause kidney failure, heart disease, or a heart attack. Low blood sugar can occur when taking Metformin with certain medications, so be sure to inform your healthcare provider of all prescription and non-prescription medication you take. You could also develop hyperglycemia, another name for high blood sugar, if you miss a dose of your diabetes medication, eat too much, eat unhealthy foods, or have an infection or fever.

FDA Voluntary Recall of Metformin

In late 2019, drug manufacturers outside of the United States reported that some batches of Metformin contained an unacceptably high amount of N-nitrosodimethylamine (NDMA), a chemical linked to cancer in humans. By May 2020, the FDA announced its first voluntary recall of the popular diabetes medication. The first announcement alerted healthcare professionals and patients to an impurity of nitrosamine in some batches of extended-release Metformin.

By October 2020, hundreds of batches of Metformin and several drug manufacturers appeared on the FDA list of recalled Metformin products. Besides Glucophage, other names for Metformin products include Glumetza, Fortamet, and Glucophage XR. If you took a Metformin product and later developed cancer, you may be eligible to obtain financial compensation by filing a lawsuit against the drug manufacturer.