I've been taking metformin for eight years now and I think it's a fairly safe drug if you are aware of how it works and aware of potential side effects. Studies have shown that it can, if started early enough, effectively delay the secondary effects of diabetes and if started when insulin resistance first begins delay the onset of diabetes. With four generations of family history of T2 and early deaths from complications of T2, I am more than willing to do whatever I can to defy the odds.
When I started metformin I had reactive hypoglycaemia and insulin resistance but was not yet diabetic. I have since been classed as diabetic based on the results of a glucose tolerance test that was done two years ago. The test results put me just over the line and as long as I'm sensible my readings and HbA1C alaways stay well within the normal range.
What you should know--
Make sure you are prescribed extended release metformin. Don't let your GP bully you into accepting a prescription for generic metformin. There are some, like the one who originally started me on metformin, who will put saving money ahead of patient care especially with a condition they may ignorantly see as always being self inflicted. I took generic metformin for a year before changing GPs, I put up with the side effects but only because it was better than having a hypos everyday. The new GP immediately changed me to extended release and I haven't had any of the common side effects since.
Your body will take time to get used to metformin, be persistent, it's worth it. Start with a partial dose and work up to your full dose. Be aware that you may need to change how you eat and that it's better, no matter what you are told, to spread the dose out through the day. I have half with breakfast and half with my evening meal. The rest of the day I snack rather than having a large lunch. Avoid greasy foods, eat plenty of whole grains and fiber, and stay away from eating too much uncooked fruit and veg and large salads for the first few weeks, unless you are within sprinting distance of a toilet. At first I could only eat fresh fruit and raw veg only as part of a meal now I can eat them anytime.
Metformin can cause vitamin B12 deficiency (aka pernicious anemia). About 30% of people who take metformin will show signs of B12 defiency within four years. Your GP may not know that and it can take time before symptoms are recognised for what they are. Symptoms are vague and easily mistaken for secondary effects of diabetes -- mood swings, depression, tiredness, vision changes, loss of feeling in the extremities, diarrhoea, IBS, itchy skin, loss of the 'moons' in your fingernails, increased difficulty controlling blood sugar levels, and a host of other 'easily mistaken for something else' symptoms.
I made it seven years before my B12 levels dropped and despite presenting evidence from credible sources still had to demand a B12 test. It's important to insist that your B12 levels are tested yearly and that treatment for B12 deficiency is started if they are nearing the bottom of normal. Treatment for B12 deficiency caused by metformin should include a calcium supplement and need not be monthly injections, you can take a B12 supplement daily and achieve a good result. Since taking a combination of calcium and B12 all my symptoms have gone. I'll need to take supplements as long as I keep taking metformin, I can live with that.
I can understand why some people would try to avoid all medications, I used to think the same, but have since found that I can achieve a better quality of life and will probably have a longer life than if I had continued to think like that. Do your homework and make sure that you are making an informed choice whatever you decide.
I've read some really good stuff about it, as far as I'm concerned it's a wonder drug, I'm sure that's contentious though, just my opinion, and seeing as I have no choice I may as well like em.
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