I was prescribed metformin 500 three times a day but had dreadful nausea and cramps and couldn't eat. As my bms also didn't seem to be responding, gp changed it to Sr and added in gliclazide 80 twice a day. Few days later my bm spiked to 26 so he spoke to cons endocrinologist who advised doubling the meds. The nausea that had improved when I first switched to Sr has returned but don't know which drug is causing it. Bms have come down but very very unpredictable... Then a eureka moment. I have an ileostomy and saw that the metformin had gone right through me! This means rather than the meds not working, it maybe an absorption issue but if I go back to normal metformin I will have all the awful gut effects (and I am underweight so need to eat). If I can find a metformin I can tolerate and absorb then maybe I don't need as much gliclazide. Does such a prep exist? Has anyone else with a stoma had this problem?