1. Get the Diabetes Forum App for your phone - available on iOS and Android.
    Dismiss Notice
  2. Guest, we'd love to know what you think about the forum! Take the Diabetes Forum Survey 2021 »
    Dismiss Notice
  3. Diabetes Forum should not be used in an emergency and does not replace your healthcare professional relationship. Posts can be seen by the public.
    Dismiss Notice
  4. Guest, stay home, stay safe, save the NHS. Stay up to date with information about keeping yourself and people around you safe here and GOV.UK: Coronavirus (COVID-19). Think you have symptoms? NHS 111 service is available here.
    Dismiss Notice
Dismiss Notice
Find support, ask questions and share your experiences. Join the community »

Is timing of Metformin intake important?

Discussion in 'Type 2 Diabetes' started by LezLezLez, Oct 11, 2016.

  1. LezLezLez

    LezLezLez Type 2 · Member

    Messages:
    17
    Likes Received:
    6
    Trophy Points:
    23
    I have just been reading the thread at "Can anyone tell me ..." which talks about "spiking" of blood sugar levels (http://www.diabetes.co.uk/forum/thr...name=DCUK+-+11/10/2016#diabetes-discussion.12)
    and thought a new thread might be best.
    As a T2 I am prescribed 3 tablets of Metformin 500mg each day and wonder if it is better to take them with meals, or whether it does not matter as long as I take the total 1500 mg spread out within each 24 hours.
    I think the real question is what is the purpose of Metformin? Is it to keep the peaking of blood sugar levels down (in which case concurrency with meals would seem to be the best) or is it to provide a cumulative ongoing impact on insulin levels (in which case timing might not be important).
    Your inputs will be welcomed.


     
    • Like Like x 2
  2. Freema

    Freema Type 2 · Expert

    Messages:
    7,315
    Likes Received:
    17,388
    Trophy Points:
    178
    welcome LezLezLez :)

    I have been wondering the same ... when I started taking metformin some 3,5 month ago I tried to take them early in the day and later as late as possible to try to prevent my high numbers in the mornings... but found it didn´t do much difference in my case...


    but maybe some others have another experience ....
    I did have no troubles /sideeffects yet by taking metformin , except from rumbeling in my stomack the first 3 weeks.. so can actually take them on an empty stomack... was a bit scared to take them together with my levothyroxine, but it seems my metabolism har gone up and not down so now I take them together in the mornings - 1 metformin and 150 mircrograms of levothyroxine
     
    • Informative Informative x 1
    #2 Freema, Oct 11, 2016 at 8:12 PM
    Last edited: Oct 11, 2016
  3. Daibell

    Daibell LADA · Master

    Messages:
    12,128
    Likes Received:
    7,222
    Trophy Points:
    298
    Hi. Read the leaflet with the Metformin and what the prescription says. The plain version is best taken with food but it does not appear to critical how many you take within the total at any specific meals, but don't let me override anything in the leaflet or prescription. The Slow Release (SR) version is even less critical. Metformin has no direct effect on your insulin production. It reduces the liver's output of glycogen (glucose) a little and help with insulin resistance a little. I understand the effects of metformin build-up over a few days/weeks but are never that high. There are other tablets such as Gliclazide which are more critical on timing and dose and do make the pancreas produce more insulin but are only used if the pancreas is not producing enough e.g. with LADA. If you happen to have any excess weight then the most important thing is diet and keeping the carbs under control.
     
    • Like Like x 1
    • Agree Agree x 1
    • Informative Informative x 1
  4. dbr10

    dbr10 Type 2 · Well-Known Member

    Messages:
    2,237
    Likes Received:
    1,183
    Trophy Points:
    198
    Always take them with food.
     
    • Agree Agree x 1
  5. Emg23

    Emg23 Type 2 · Active Member

    Messages:
    26
    Likes Received:
    224
    Trophy Points:
    48
    I try to take metformin two × 500mg straight after breakfast and evening meal. Em
     
    • Agree Agree x 2
    • Like Like x 1
  6. Robbity

    Robbity Type 2 · Expert

    Messages:
    6,312
    Likes Received:
    16,110
    Trophy Points:
    198
    As far as I know part of the reason for taking metformin with meals is to help prevent any upset tum issues that might be caused by taking it on on an empty stomach. All the leaflets with the tablets I've had do say to take with evening meal, but I can't remember seeing any explanations for this.

    I found when I was on standard metformin changing from full dose with evening meal to split dose with morning and evening meals made not the slightest difference to morning levels. I still do a morning evening split with the SR version as apparently some brands may not spread over the full 24 hours, so I do "belt and braces" just in case. GP is OK with this. Again either way I
    've nort seen any difference.

    For me the best way to avoid spikes has been with diet: testing and avoiding starch and sugary foods that will cause them.

    Robbity
     
    • Agree Agree x 2
    • Like Like x 1
  7. Pura Vida

    Pura Vida Type 2 · Well-Known Member

    Messages:
    637
    Likes Received:
    1,964
    Trophy Points:
    178
    I have take one 500 mg every 8 hr works well for me ,
     
    • Like Like x 1
    • Winner Winner x 1
  8. AnnMcD

    AnnMcD Type 2 · Member

    Messages:
    18
    Likes Received:
    66
    Trophy Points:
    53
    I take two a day. So i take one with breakfast which is usually at 8 or half 8 and the other one with my dinner around half six. my thinking is having around 10 to 12 hrs in between each dose so that it is spread evenly throughout the day. seems to be working for me. Hope it helps
     
    • Like Like x 1
    • Winner Winner x 1
  9. mo53

    mo53 Type 2 · Expert

    Messages:
    7,543
    Likes Received:
    28,889
    Trophy Points:
    198
    @AnnMcD snap that's exactly what I do and for the same reasons
     
    • Like Like x 1
  10. Japes

    Japes LADA · Well-Known Member

    Messages:
    1,574
    Likes Received:
    3,374
    Trophy Points:
    178
    I have 4 tablets of Metformin (500mg) and go for as close to six hourly spacing of meals as I can manage. Certainly the later I can make my last one of the day, the better my morning reading is...
     
    • Like Like x 2
  11. Oldvatr

    Oldvatr Type 2 · Expert

    Messages:
    6,147
    Likes Received:
    3,505
    Trophy Points:
    198
    Metformin needs to dissolve and move through the stomach before it does its stuff. This takes between 20 and 30 minutes, Once in the small intestine it starts its work by blocking the metabolism of sugars and starches thus reducing glucose transfer to the liver, So I found that taking it 30 mins before a meal gives an improved bgl result for me. This is using the standard release tabs, I found the XR version did not act like this, since the enteric coating meant it took a lot longer to dissolve, (as it is designed to do), but I had reduced effect on my bgl, so I went back to standard release.

    The taking with food is advised so as to reduce tummy upset, I am lucky in that I am not badly affected in this respect, and I take 2000 mg a day. As I normally only have 2 meals a day, I split my dose in half to cover them both, and it seems ok to me,

    Metformin is a long term med, so needs to build up gradually, and the other part to its action occurs when it is absorbed into the blood, where it then works on the liver to produce further magic by reducing IR. Most of it passes like a cloud or cottonwool wad and exits via the exhaust system in the normal way. Frightened the life out of me when I discovered 'foreign matter' in the pan. Thought I had tapeworm!.
     
    • Winner Winner x 2
  12. Cindylover1969

    Cindylover1969 Type 2 · Member

    Messages:
    16
    Likes Received:
    21
    Trophy Points:
    23
    I was told to have them before food...
     
    • Like Like x 1
    • Winner Winner x 1
  13. ickihun

    ickihun Type 2 · Master

    Messages:
    13,565
    Likes Received:
    18,436
    Trophy Points:
    298
    I've found my bgs are better if I take 1000mg at breakfast and then another 1000mg at late lunchtime. I then rely on insulin more for late evening meal/snack for lower fbgs. Metformin isn't enough for my huge insulin resistance. Although I am working on it and so is research. ;)
     
    • Winner Winner x 1
  14. AnnMcD

    AnnMcD Type 2 · Member

    Messages:
    18
    Likes Received:
    66
    Trophy Points:
    53
    Great minds think alike ;)
     
    • Like Like x 1
    • Winner Winner x 1
  15. Rob Green

    Rob Green · Newbie

    Messages:
    1
    Likes Received:
    0
    Trophy Points:
    1
    I'm glad this question has been asked as it's been on my mind recently. I've only been on metformin for a few months, building up to 4 x 500mg a day. I was advised to take 2 twice a day with meals which I have been doing - the morning ones are fine, but shortly after the evening dose I suffer a lot of abdominal discomfort including a lot of gurgling and bubbling in the gut (often accompanied by far more wind than is strictly necessary!) which persists through the night. Also I have been suffering from the feeling of wanting to "go" all the time with nothing happening and periodic constipation. As an experiment I tried leaving out my evening dose and everything was fine.

    My question is this - would it be as effective to spread the metformin dose, only taking one at a time four times a day, or might it be better to request the slow release version of metfirmin?
     
    • Agree Agree x 1
  16. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

    Messages:
    3,846
    Likes Received:
    2,190
    Trophy Points:
    198
    I take 2 in the morning and 2 in the evening.

    I've given up synchronizing them with meals because I only have one meal a day (plus coffee, cream and butter in the morning)
    so just take two with morning coffee and two in the evening when I remember.

    I understood that it was a long term medication which wasn't short term acting so the main thing was to take them regularly to maintain the levels in the body.
     
    • Like Like x 1
    • Agree Agree x 1
  17. Dudette1

    Dudette1 Type 2 · Well-Known Member

    Messages:
    155
    Likes Received:
    115
    Trophy Points:
    83
    My personal experience:
    When I was diagnosed in the hospital and given metformin, they just gave them me in a morning,and same at tea time, would usually be before food came round.
    I carried on for months doing this but after testing noticed my sugars wouldn’t come down.
    After a while of doing this, I tested later on in day after I ate and my levels would come down quickly.
    I spoke to my nurse about this and she said, why aren’t you taking them with food, so I explained I did it like the hospital nurse gave them me.
    Anyway, I started taking them with food and my levels start to come and are much better. So on personal experience, definitely take them with food, as taking them without food when not eating my sugars stayed high and never moved. I’d suggest testing and see how your sugars react
     
    • Like Like x 1
    • Useful Useful x 1
  18. ickihun

    ickihun Type 2 · Master

    Messages:
    13,565
    Likes Received:
    18,436
    Trophy Points:
    298
    Well for a few days now ie been taking 2x regular 500mg morning (with breakfast), and the same with evening food. In total 2000mg and my fbg is excellent. I help it along with a protein nibble before sleep. I'm on hugely/massively less insulin with no novarapid for weeks now but just 3+3units of insulatard daily. I'm tipping below 15st mark.
    I have no weight loss from increasing metformin..... yet. I'd love to though.
    Since a full gastric bypass 2yrs ago I could only tolerate 1000mgs.
    I'm very very swollen in the abdomen but not surprising since I've just had my gallbladder out (just 3weeks ago - tomorrow). So more weight loss will come. Hence less insulin resistant than I used to be but hba1c still saying I'm not close to no longer being diabetic. Still.
    I've read after removal of gallbladder then BMI increases. However that could be more muscle mass not just fat like they presume.
    I'll be surprised if I do as my gallbladder hasn't been working for some time by the shape and being restricted by thread like wrappings from adhesions from previous abdominal surgeries.
    I know my dieticians linked to the weight loss team at Sunderland are delighted with my weight loss and hinted/suggested I no longer need them. I'd agree. Their team use Cals and Carbs for to guide some of their patients. I'm absolutely delighted. :) :) :)
    I feel at last I can truly enjoy my weight loss now.
    Maybe I don't have IBS and maybe maximim level of Metformin doesn't work well in reducing swellings in abdomen but I will reduce back down and up my high protein even more. I'll see. I get chest pains if I go too low carb. It's always about finding and using what works for you. Enjoy finding out more about how metformin works for you.
    I most likely need to say if more weight due to irritation of the digestive system then I cannot see how that helps with insulin resistance. However some would argue fat is the resistance part of IR but I feel any obstruction whether water or fat increases IR. Metformin is great at softening body fat so exercise can disperse the fat cells from around the organs. I have yet to see any help with water retention from too much metformin or metformin not used efficiently. Maybe room for more research on Metformin is needed.
    Metformin is used in many more departments other than Endocrinology now. It is even mentioned in papers on Covid-19.
     
    • Winner Winner x 1
  19. ickihun

    ickihun Type 2 · Master

    Messages:
    13,565
    Likes Received:
    18,436
    Trophy Points:
    298
    Try it out for your body. You will know your body better than anyone. Test test and test though. I'm guessing your aim is goo blood levels or is weight loss your biggest need? (which in turn will help with diabetes).
     
  20. Sarah69

    Sarah69 Type 2 · Well-Known Member

    Messages:
    1,199
    Likes Received:
    242
    Trophy Points:
    123
    I take 2 twice a day but I don’t take them with food.
     
    • Winner Winner x 1
  • Meet the Community

    Find support, connect with others, ask questions and share your experiences with people with diabetes, their carers and family.

    Did you know: 7 out of 10 people improve their understanding of diabetes within 6 months of being a Diabetes Forum member. Get the Diabetes Forum App and stay connected on iOS and Android

    Grab the app!
  • Tweet with us

  • Like us on Facebook