An anti-diabetic drug called metformin is used to treat and prevent type 2 diabetes. It is a member of the biguanide medication class, which aids in lowering blood sugar (glucose) levels. Since diabetes is a potential threat to our lives, it is really important to check whether medication is working or not. If you are taking metformin and want to know about the signs metformin is working, this write-up will assist you with that along with impacting factors and dosage.
Signs metformin is working
While the effects build slowly over weeks to months, certain signs will become apparent that indicate metformin is having a positive effect. Here are 10 signs in greater detail:
1. Lower fasting blood glucose
Metformin reduces excessive glucose output by the liver in the morning before you eat. So the first check is your fasting blood sugar levels (checked before breakfast). Levels decreasing from highs of 180-200+ mg/dL down to 130-140 mg/dL show metformin is lowering your basal glucose.
2. Drop in HbA1c
This lab test gives your 3-month average blood sugar. As metformin takes effect, your HbA1c dropping from 7.5-8.5% down to 6.5-7% demonstrates better glucose control over time. Your doctor will check this every 3-6 months.
3. Weight loss
Although Metformin is not a weight loss drug, losing body fat is one of the important signs metformin is working. Losing belly fat is especially likely as less glucose is stored. Any weight loss (when combined with nutrition and exercise) indicates metformin is working.
4. Less insulin resistance
Your cells become more insulin resistant the longer you have diabetes. Metformin counters this. Your doctor may test your insulin resistance score before and after starting metformin. A lower score means metformin is making your cells more sensitive to insulin.
5. Lower insulin needs
If you inject insulin, you may require less daily units on metformin. For example, going from 50 units down to 40 units daily shows metformin is improving your natural insulin response. Less insulin needed is a good indicator.
6. Improved lipid profile
Metformin can decrease LDL “bad” cholesterol and triglycerides while increasing HDL “good” cholesterol. Your doctor will order blood tests to monitor this. Better lipid numbers show metformin’s whole-body effects.
7. Lower blood pressure
Next in our list of signs metformin is working is lower blood pressure. Metformin mildly lowers blood pressure (120/80 down to 110/70 for example). This takes stress off blood vessels. Reduced hypertension demonstrates metformin’s vascular benefits.
8. Increased energy
With lower blood sugar levels, many notice higher energy levels. Less fatigue encourages being more active which circles back to better diabetes management. Feeling energized is a positive sign.
9. Better appetite control
Metformin may result in feeling fuller sooner while eating. This reduces calorie intake and contributes to weight loss. Eating less while feeling satisfied is an excellent indicator.
10. Ovulation returns
For women with PCOS, metformin helps restore ovulation and normal menstrual cycles. Regular ovulation restarting is another one of the most important signs metformin is working to correct hormone imbalances.
Impacting factors
Now that you know about the signs metformin is working, let’s check out the factors that impact its work function. Being aware of these factors allows you to get the most benefit from metformin.
1. Diet
Metformin is absorbed through the intestines, so diarrhea and other GI issues can affect absorption. Avoiding high fiber foods around dose times can help. Low carb diets may work against metformin, while moderate carbs and healthy fats optimize its effectiveness.
2. Weight changes
Metformin works better at healthier weights. Weight gain can contribute to increased insulin resistance and reduced metformin activity. Losing even 5-10 lbs can significantly improve metformin’s blood sugar lowering action.
3. Other medications
Some drugs interact with metformin, either increasing or decreasing its efficacy. Medications like steroids, SSRIs, and NSAIDs may interfere with metformin absorption or excretion. Keep your doctor informed of all medications to watch for drug interactions.
4. Vitamins and supplements
High doses of certain vitamins like B12 and folate may decrease metformin’s effectiveness. Calcium and iron supplements can also impede its absorption if taken simultaneously. Time your doses appropriately.
5. Kidney function
Metformin depends on the kidneys to excrete it from the body. Impaired kidney function requires dose adjustment. Kidney disease and dehydration can both impact clearance. Staying hydrated helps avoid buildup.
6. Liver function
The liver is where metformin reduces glucose production. Liver dysfunction from conditions like fatty liver disease can impair its glucose lowering actions. Improving liver health may boost metformin efficacy.
7. Age
Metformin works less effectively as we age, likely due to reduced kidney function and more insulin resistance. Older patients may need higher or more frequent dosing. Work with your doctor regarding age-appropriate regimens.
8. Genetics
Subtle genetic differences in how metformin is processed in the body can affect patient responses. Genetic testing may reveal if standard doses work for your biology or if dose adjustments are needed.
Metformin Dosage
Besides knowing signs metformin is working, it is also very important to know about the dosage of the medicine. Metformin dosage is individualised based on each patient’s situation, but there are general guidelines for the average adult.
1. Adult Women
For adult women with type 2 diabetes, the starting dose of metformin is usually 500 mg taken twice per day or 850 mg taken once per day. This lower dose allows the body to adjust and reduce gastrointestinal side effects. The dose can be increased gradually every 1-2 weeks up to a common target maintenance dose of 1000-1500 mg twice per day. The maximum daily dose used for women is typically 2500 mg per day.
2. Adult Men
For adult men, metformin dosage also starts at a lower dose of 500-850 mg per day but often increases more rapidly to 1500-2000 mg per day divided into 2 doses. Men tend to tolerate higher doses more easily. The maximum effective dose for men with diabetes is usually 2000-3000 mg per day, though some men may take up to 3500 mg per day if tolerated.