How do I take metformin when fasting

Martin5555 · Mar 4, 2020

Hi,

I have been trying to control my type 2 diabetes with diet but nit succeeding. My blood glucose has been between about 9 and 10 for many months. Recently it has been 11.1.

The most effective diet I have found (I haven't lost any weight but it seems to have stabilised it - before, it just kept going up) is one where I eat all my protein (and the minimal amount of carb that I eat - usually under 40g per day) within a six hour window. During the other eighteen hours I allow myself fat - mostly in the form of coffee made with double cream - but nothing else. This diet puts me into ketosis.

I've finally decided to go on metformin and will be building up to four tablets per day and have been told to take twoin the morning with food, and two with my evening meal.

As I do not eat till 18:00 hours I do not know whether to take me first two in the morning with my first cup of coffee or whether to take my first two at 18:00 with my first proper meal, followed by my second two at midnight with my last meal.

I suppose it depends on how the drug works. If I take it with meals to prevent it irritating my stomach, maybe I can take it with my morning coffee. If it is to spread the drug over the day I should presumably have my first dose in the morning. But if it is to prevent the protein I eat being turned to glucose in my liver from the meal I eat with the pills, presumably there is no point in taking the pills until I start eating at 18:00.

Any advice would be greatly appreciated especially from anyone with pharmacological knowledge of how metformin works and why it should be taken with food.

Thanks

Martin

EllieM · Mar 4, 2020

First question, have you had any medical checks to confirm you are are t2 and not T1/lada?

Member496333 · Mar 4, 2020

I believe Metformin works mostly on a cumulative basis rather than per dose. After the initial side effects abated, I was able to take it on an empty stomach with no issues. But that is obviously just my own experience and shouldn't be taken as medical advice

Rachox · Mar 4, 2020

As @Jim Lahey says Metformin works on a cumulative basis. Taking it with food is to help with tolerance rather than any direct effect on the food it is taken with. I take three tablets a day, I used to space them evenly throughout the day, one with breakfast, one with lunch and the last one with dinner, but often forgot my lunch time one. My GP said to instead just take two with breakfast and one with dinner. This made no difference to my levels. We can’t advise on dosing on the forum so may be check what you decide with your nurse or GP.

Martin5555 · Mar 4, 2020

EllieM said:
First question, have you had any medical checks to confirm you are are t2 and not T1/lada?

Yes, my blood glucose has been going up since first noticed when I was forty five. I kept it under control with diet for about ten years then went on metformin. Came off for another couple of years trying to control by diet but now gone back on at age fifty eight. I've never needed to take insulin or anything like that.

Martin5555 · Mar 4, 2020

Jim Lahey said:
I believe Metformin works mostly on a cumulative basis rather than per dose. After the initial side effects abated, I was able to take it on an empty stomach with no issues. But that is obviously just my own experience and shouldn't be taken as medical advice

Thanks Jim, I think you're probably right.

Martin5555 · Mar 4, 2020

Rachox said:
As @Jim Lahey says Metformin works on a cumulative basis. Taking it with food is to help with tolerance rather than any direct effect on the food it is taken with. I take three tablets a day, I used to space them evenly throughout the day, one with breakfast, one with lunch and the last one with dinner, but often forgot my lunch time one. My GP said to instead just take two with breakfast and one with dinner. This made no difference to my levels. We can’t advise on dosing on the forum so may be check what you decide with your nurse or GP.

Thanks Rachox, I think you are both probably right, its probably just to aid tolerance.

AttilaN · Mar 4, 2020

Hello Martin
I am take the Metformin two years initially dosage is always only 500 mg when your body use the medication and not so help the low dose need lift up that.
If your stomach disturbing this is normal the first weeks or later take it with food. This medication slow your digest in the narrow bowel that’s the reason puffed feelings at the start time. Do not take with coffee more stomach ache happen. Just try reduce morning time coffee and drink regular tea or later return coffee but no added sugar and sweetness even the tea also too. Eat reduced carbohydrates and more veggies. You use long waiting time between breakfast and dinner. You need eat snack food too more times small portion eating. Always on your plate have halfway greens! Look after what is tasty for you have lot of choices! Metformin not prevent the diabetes and not cure it the diabetes! and not balancing the blood sugar level just prevent the diabetic side effects look after what is it if you don’t know. You need balancing your blood sugar level with your intake food. You need eat fruit too best is pear and apple look after which is the best Glycemic Index best! If your blood sugar level is still high before go to bed drink two dl hand warm water with two spoon 5% apple cider vinegar and you feel later start feeing sleepy this drink normalize your glucose level and dropping dine and keeping normal level. Start metering your blood glucos level with glucose meter before and after eat start knowing what is the beat food for you what is not lift up to high your glucose in your blood. If not enough the Metformin after measuring three month HC1AC value need take more dose and more listen what you eat and drinks. Do it sport daily every day minimum 30 minutes best is the regular walking not so hard rhythm or anything you can do it just move muscle work use it the sugar in your body like energy don’t forget the to hard sport lift up the glucose in your body. By time you know easily what is the best for you with food and with sport just start watching carbohydrates in the food and drinks. Best drink is the water and any drink without sugar or sweetness. Alcohol is the best little wine other is or more alcohol dropping down to lower your sugar level Hypoglycemia occurs. Good luck with your carbohydrate war! All is you need often eat small portions and drink healthy and do it sport regularly!
Have fun and take care! Million peoples living with Diabetes! Have question let me know! See you!

Martin5555 · Mar 5, 2020

AttilaN said:
Hello Martin
I am take the Metformin two years initially dosage is always only 500 mg when your body use the medication and not so help the low dose need lift up that.
If your stomach disturbing this is normal the first weeks or later take it with food. This medication slow your digest in the narrow bowel that’s the reason puffed feelings at the start time. Do not take with coffee more stomach ache happen. Just try reduce morning time coffee and drink regular tea or later return coffee but no added sugar and sweetness even the tea also too. Eat reduced carbohydrates and more veggies. You use long waiting time between breakfast and dinner. You need eat snack food too more times small portion eating. Always on your plate have halfway greens! Look after what is tasty for you have lot of choices! Metformin not prevent the diabetes and not cure it the diabetes! and not balancing the blood sugar level just prevent the diabetic side effects look after what is it if you don’t know. You need balancing your blood sugar level with your intake food. You need eat fruit too best is pear and apple look after which is the best Glycemic Index best! If your blood sugar level is still high before go to bed drink two dl hand warm water with two spoon 5% apple cider vinegar and you feel later start feeing sleepy this drink normalize your glucose level and dropping dine and keeping normal level. Start metering your blood glucos level with glucose meter before and after eat start knowing what is the beat food for you what is not lift up to high your glucose in your blood. If not enough the Metformin after measuring three month HC1AC value need take more dose and more listen what you eat and drinks. Do it sport daily every day minimum 30 minutes best is the regular walking not so hard rhythm or anything you can do it just move muscle work use it the sugar in your body like energy don’t forget the to hard sport lift up the glucose in your body. By time you know easily what is the best for you with food and with sport just start watching carbohydrates in the food and drinks. Best drink is the water and any drink without sugar or sweetness. Alcohol is the best little wine other is or more alcohol dropping down to lower your sugar level Hypoglycemia occurs. Good luck with your carbohydrate war! All is you need often eat small portions and drink healthy and do it sport regularly!
Have fun and take care! Million peoples living with Diabetes! Have question let me know! See you!

@AttilaN Thanks for taking the time to give me this advice, it is much appreciated. I'll try with the diet but I must admit I'm a bit lazy when it comes to exercise but I'll try to do at least a little a few times per week. Regards, Martin

marzak · Mar 7, 2020

Martin5555 said:
@AttilaN Thanks for taking the time to give me this advice, it is much appreciated. I'll try with the diet but I must admit I'm a bit lazy when it comes to exercise but I'll try to do at least a little a few times per week. Regards, Martin

I think the advice from AttilaN is spot on. You must overcome your reluctance to exercise! You can do biceps curls in the house with full bean tins (kidney beans or other in water of course!!) and work your way up to other heavier things. You can do planks and sit ups and press ups on your own. Just start and build up. Running is free, walking is free (some diabetics have very happy dogs!) and cycling is an option too. Outside is so good for us too. I'm a big fan of apple cider vinegar and a v small occasional glass of red wine. The exercise will help with your insulin resistance. I agree that being permanently hungry for 18 hours a day is not ideal and certainly not pleasant. I try to stop any eating at 8pm but if I've been out running earlier after work I have to have a few nuts/hummus and raw carrot to make sure I can sleep. I always walk dog after dinner whatever time that is and/or do a few little weights and floor exercise in house. I am same age as you... That exercise needs to worm its way into your life and stay there!!! You can do it. Sorry I know nothing about metformin and would rather I never do! Hope this is encouraging for you though.

How do I take metformin when fasting

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