Brand Names:

Glucophage, Glucophage XR (see cost information below), Glucovance (combination) , Avandamet(combination), Janumet(combination)

What is it?

Normally used for Type 2 Diabetes. This drug tells your liver to not make sugar. It keeps your overall blood sugar levels lower.

What’s In It For Me?

Controlling your blood sugar will help prevent a1c and it almost never causes low blood sugar. Another advantage is that, unlike most other diabetes meds, metformin does not cause weight gain. If anything it might cause a little weight loss (but don’t count on it)

The Bad

Metformin doesn’t do much for the blood sugar rise after you eat. It only works on the overall baseline blood sugar.

The the most common side effect with metformin is upset stomach and diarrhea. Metformin has a serious side effect called lactic acidosis. It is quite rare, but is more likely to occur if you have poor kidney function, or low blood oxygen due to heart failure or lung disease. Poor kidney function is the most common reason that people can’t use metformin.

The Controversial

Metformin is sometimes used to prevent Diabetes in people with fasting blood sugars between 100 and 125. It is our opinion that lifestyle changes are much more effective. The other controversy is whether to continue it after insulin is started. There is some evidence that is may prevent some of the weight gain from insulin.

Fact Box – Oral Diabetes Drugs

Drug

average A1c decrease

average blood sugar decrease

Causes hypoglycemia?

metformin

0.8 to 1.5

30 to 50

no

glipizide

1 to 2

50 to 70

yes

sitagliptin

0.6 to 0.8

20 to 30

not much

 

For The Cynic

Metformin really doesn’t offer much for the cynic to be cynical about. It is an inexpensive, effective drug with few side effects (if your stomach and intestines can handle it)

For The Cost

Metformin is very inexpensive. It is on the $4 list for those pharmacies that have a $4 list. Note that Glucophage XR is a brand with slow releas properties. It is convenient because you only have to take it once a day, but it is very expensive, and available as a generic. It is our opinion that the XR is not worth the price difference.

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