Disadvantages & advantages of Metformin

On diagnosis for some reason I looked up metformin and did some simple sums, I would not have questioned the medication suggested by a doctor in the past. If I went to the doctor with diarrhoea, stomach cramps, nausea and headaches I would hope that they would suggest that I had food poisoning in some form. From the figures released by the drug companies most people report experiencing at least one of these symptoms and some more than one (the percentage figures add up to over 100% and some people will not have any symptoms). Then I read that metformin works in the liver but quite how it works is not known but checks need to be kept on kidney function. I would like my liver and kidneys to carry on working for as long as possible and if my body responds as if it has been poisoned I take note. I have controlled my bg by lifestyle changes and without any medication for two years. Think how much money I have saved the NHS without risking my health, in fact improving my overall fitness. Then multiply that up by the number of people with early stage diabetes or pre diabetes and the saving could be substantial. I appreciate that it will not work for everyone and may not work long term, also that it is quicker and easier for a busy GP to prescribe a tablet, that most people will expect some form of medication as a result of an appointment. However a self help group set up attached to a surgery would encourage people to walk in the area, exchange food ideas, need not be onerous and would have more benefits. I made a choice, others have made a different choice depending on their circumstances, I am happy to live with my decision.

Grateful said:

I am not currently on meds, and generally agree with what you are saying. However, when I got my T2 diagnosis and the doctor mentioned that I would be put on drugs if diet/exercise did not do the trick, I researched Metformin because I assumed that would be the "first-line drug" if drugs were needed. What really reassured me is that Metformin has been around for a very long time, compared to most other diabetes drugs. Some people have been taking it for decades. My reasoning is that if there were are serious issue with that drug, it would have surfaced by now.

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Indeed. I had successfully managed my T2 for over 10 years with diet and exercise alone but after a sudden bereavement and a lot of stress, needed some extra help with managing the condition and was put on slow release Metformin (Glucophage brand). I have never had any problems with it and certainly no stomach problems. Like @Rachox I built up my dose gently and gradually over several weeks. I'm more than happy to remain on it for its extended health benefits and consider myself lucky that 13 years after diagnosis this is the only medication I take to manage my condition, while continuing with LCHF and exercise. Interestingly, I've been able to drop a lot of other meds I was taking for a different medical condition diagnosed around the same time as T2.

I also get my B12 checked annually as part of my routine blood tests. My liver and kidney function are tested every 3 months and each test so far has come back normal

Tannith said:

If it also lowers your IR and liver dumping, and reduces your appetite I think it has a lot going for it. As long as it doesn't give me the bum problems I think I would certainly try it.

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Even if it does give you ‘bum’ troubles, it’s be worth persevering. I did suffer for around a week but I’m absolutely fine on it now

This topic makes me a little defensive. It has been a good question as @Tannith now has a real world user relevant views on Metformin. I believe you should be provided with all of the downsides by your GP. Diabetes had damaged my Kidneys to the bottom of normal, and Metformin (a contraindication in this circumstance) was weakening my Kidneys even more; once I had stopped Metformin, my Kidney function improved. A few weeks ago I read about the possible B12 issues.

For me it is just about information and checking.

I reported all the side effects to the nurse, and assumed that some sort of report would be made, or at least something on my notes to ensure that it was known to cause me problems - but no - a few weeks later I was asked to go to the clinic and was put under pressure to resume taking the tablets.
It is no wonder it is considered a safe and effective drug if no record is made of what it can do to people.
At the very least doctors should ensure that people are aware of the possible consequences rather than just handing over a prescription with a blithe smile and going on to the next patient.

Resurgam said:

At the very least doctors should ensure that people are aware of the possible consequences rather than just handing over a prescription with a blithe smile and going on to the next patient.

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That was definitely not my experience. At the time of prescribing metformin, my GP told me of the possible side effects, and each time I collected a new prescription from the chemist, before he would hand over the meds, the pharmacist asked me for about the first 4 months, how I was getting on with it, and if I had any tummy problems, reminding me to build up gradually to the full dose. As it happened, by following the GP and pharmacist's advice I have never had any problems with it, and I'm not alone but sadly we tend to mainly read negative reports of it here from the small minority who haven't tolerated it.

poshtotty said:

That was definitely not my experience. At the time of prescribing metformin, my GP told me of the possible side effects, and each time I collected a new prescription from the chemist, before he would hand over the meds, the pharmacist asked me for about the first 4 months, how I was getting on with it, and if I had any tummy problems, reminding me to build up gradually to the full dose. As it happened, by following the GP and pharmacist's advice I have never had any problems with it, and I'm not alone but sadly we tend to mainly read negative reports of it here from the small minority who haven't tolerated it.

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Nobody has ever talked to me about it. Nobody mentioned b12 or kidney function. But quite a few family members take it.
I looked up the pros and cons and after initially deciding not to take it I changed my mind. I think that its not a big earner for the pharma companies, so there is no particular reason for them to big up its good side. And the other health benefits seem worth trying it.

I have been very lucky and nothad any side effects.

I would like to make a general statement about all diabetes drugs. I am lucky not to be taking any such drugs (or insulin) at all, but I did do quite a lot of research at diagnosis-time, in the (in the end, incorrect) expectation that I would be put on drugs.

There are all sorts of clever mechanisms used by these drugs to improve the blood glucose levels and therefore several classes of drugs. Indeed there is a whole sub-forum here, with a sub-sub-forum for each class of drug. But what struck me was how most of these drugs operate "at the margin." So for instance, in controlled studies Metmorfin was credited with an average improvement of 0.5 percentage points in the HbA1C. Other drugs were in the same ballpark: a very useful effect on A1C but nothing dramatic.

On the other hand, the few studies that I found seemed to indicate that diet alone, on average, could lower A1C by a full 1.0 percentage point (and exercise, by 0.5 percentage points).

Now of course all of these statistics from medical studies are averages. By definition (and rightly) they include the failures as well as the successes. So, for those who had a successful experience (with drugs, diet, exercise, whatever) did rather better than the average figures would indicate.

My "take" on this is that the drugs, including Metformin, are a useful part of the arsenal. But, taken in isolation, their effect is not dramatic. Therefore if I were prescribed one of these drugs and found big and unpleasant side effects, the personal cost/benefit analysis would not be clear, unless the drug in question turned out to be the only way to get the BG levels under control.

Edited to add: The big exception, the "wonder treatment," is insulin. But that's not a drug, it's a hormone.

I have to add as well that Metformin has been very helpful for me but had I not changed my way of eating the benefits would have been minimal.
It is just one tool i use to help me.

I had the usual problems when I was put on 1000 mg SR, one a day. I am now on 500 mg per day, just to shut them up! I have had stints without them, so know my life does not depend on them