Metformin absorption, fasting and digestive enzymes

ThePenguinPimp said:

Hi, I'm actually a T1 diabetic but I figured there are going to be way more T2 diabetics on metformin than T1 so I put it in this catagory.

My questions are:
1. What counts as actual food to take with metformin?
2. Would half a digestive enzyme do the same job as food to aid absorption?

My problem is that I regularly do not eat anything until teatime, most of the time this is due to feeling sick due to gastroparesis. On the rare occasion I eat earlier and take my metformin ER with the food it has a greater effect later in the day. This is not practical for me on a daily basis (right now the thought of food is making me nauseous). I have read lots of different views but I am thinking the reason for the better result is because the correct enzymes are only produced when actual food is eaten thus aiding absorption..

It is marketed as being extended release over a 24 hour period but if I take it in the evening by the following afternoon it will have pretty much stopped having an impact and then only starts working a while after taking it at tea time so my bs spikes out of control with a small amount of carbs. So I need to find a way to aid apsorption with minimal food or drink before I actually have proper food. I was wondering if digestive enzymes would have the same effect as food but am worried about that causing acid and/or causing more side effects or damage to my gut.

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I have sometimes taken mine with only a small handful of nuts? About 5 Brazils or Pecan nuts

Metformin does not work on a meal by meal basis and does not ameliorate spikes. As far as I am aware the advice to take Met with meals is to ease the effects that can occur in the erm... bathroom area.

Metformin ER takes around 20 minutes to dissolve and pass into the duodenum, which is where it starts working. I try to take mine around 30 minutes before my meal. If I was not eating a meal, then perhaps this leads to increased transit time so the Metformin is still in the stomach and so will not capture the sugars.

The digestion process needs enzymes generated in the mouth which are the first response to food being eaten. The main one is amylase, which starts predigesting simple sugars while still in the mouth. It is this enzyme that also triggers the Stage 1 insulin rush to desl with the incoming sugars. In a T2D this response is often impaired and so T2D often do not get this process started till later on, and so suffer sugar spikes more readily. As a T1D this is irrelevant in your case, but you may still need the amylase to trigger the stomach emptying process too. So not eating may slow down the Metformin, and impair the effectiveness of the medication. You may find that taking the med earlier improves things - not something I have personal experience with.

The ER version has a half life of around 6 hours, so it will have lost most of its oomph by then, However, that said there are other mechanisms that occur in the blood that mean than Metformin takes time to build up and these effects are mainly protection for the heart and blood circulation rather than bgl control. This is why T1D find themselves on Metformin, since the bgl reduction is only 1 or 2 mmol/l at best so not going to make much impact for a T1D or T2D on insulin.

I'll hold my hands up, on "normal" metformin, 3*daily, only eat 2*day, one gets taken without food, with no problems

ThePenguinPimp said:

My questions are:
1. What counts as actual food to take with metformin?
2. Would half a digestive enzyme do the same job as food to aid absorption?

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1: I had took Metformin with big and small meals twice a day.
2: Never heard of those digestive thingies, I never had any problems with my gut taking Metformin.