Metformin is a prescription medication used to manage TYPE 2 diabetes . The medication works by decreasing the amount of glucose the liver makes and reducing the amount of glucose absorbed from the patient’s diet. Additionally, metformin promotes increased insulin sensitivity, enabling the body to respond to and use insulin more effectively.
This medicine is taken by mouth, and it is available as a liquid, immediate-release tablet, and extended-release tablet. Patients using liquid metformin generally take it once or twice per day at mealtimes, and the immediate-release tablet is normally taken on the same schedule. Individuals who take the extended-release form are typically advised to take it once per day with their evening meal.
Doctors start patients on a low dose of this medication, gradually increasing the dose over one to two weeks. Patients are asked to monitor their blood glucose frequently during this period so the doctor will know how well metformin is working. Patients should continue to take their medication even if they feel well, and they should not stop taking metformin without talking to their physician first.
Some of the major side effects of metformin are discussed below.
Nausea And Vomiting
Nausea and vomiting are very common side effects associated with metformin, and they occur in an estimated twenty-five percent of patients taking this medication. Nausea is a feeling of unease in the stomach, and it may occur before vomiting. Some patients feel nausea more in the back of the throat or the chest. While uncomfortable, it is not painful.
Patients may be able to reduce nausea by avoiding strong odors and getting fresh air. Keeping a food diary could be beneficial in identifying potential dietary triggers if patients have had nausea for an extended period. Eating small meals every few hours is often recommended for patients who feel nauseous, and it is important to avoid eating any food that has not been properly refrigerated or is spoiled. Most cases of nausea resolve on their own within a maximum of twenty-four hours.
Vomiting is an involuntary, forceful release of stomach contents through the mouth or nose. It is the stomach’s attempt to rid itself of an irritant. If vomiting occurs, patients should make a note of how many episodes they have, and seek medical help immediately if the vomit contains blood or if it appears brown or black.
Green vomit could indicate the presence of bile, and this should be mentioned to the patient’s physician urgently. To treat vomiting at home, it can be helpful to have bland foods such as toast or crackers, and sipping water, flat ginger ale, and fruit juices could prevent dehydration.
Some patients like to consume foods and drinks with ginger to reduce both nausea and vomiting. A doctor should be consulted if vomiting lasts more than twenty-four to forty-eight hours or if it prevents the patient from keeping down liquids.
Patients may experience stool changes such as diarrhea or constipation while taking metformin. Diarrhea affects around fifty-three percent of patients on metformin, and constipation is less common. Diarrhea occurs when the patient has loose, watery stools three or more times in twenty-four hours, and stomach cramps may be present.
To reduce diarrhea, it may help to consume low-fiber foods and avoid dairy products and high-fat foods. Most cases of diarrhea related to metformin use are self-limiting and resolve without treatment; however, patients may wish to use an over-the-counter medication such as loperamide or bismuth subsalicylate to treat diarrhea at home. A physician should be consulted if diarrhea persists or if black stools occur as these may be a sign of a more serious condition.
Constipation develops if patients have stools that are dry, hard, or difficult to pass, and most doctors define constipation as having fewer than three bowel movements per week. Patients with constipation could experience pain during bowel movements, and there may be a constant sensation of fullness in the rectum.
To treat constipation, doctors recommend that individuals increase their dietary fiber intake, and it may be necessary to take over-the-counter laxatives. Severe constipation may require an enema, and surgery is necessary if untreated constipation leads to a bowel blockage. Patients who take metformin should check with their doctor about whether they need to take fiber supplements or other medicines to prevent constipation.
Lactic acidosis is a rare and potentially life-threatening potential side effect of metformin. The condition develops when there is an excessive amount of lactate in the blood, and it is also triggered by a low blood pH. Lactic acidosis is fatal in roughly fifty percent of cases, and metformin users who have liver or kidney issues such as liver failure, cirrhosis, or kidney failure are at an increased risk of this side effect.
Congestive heart failure patients taking metformin face an elevated risk as well, and individuals who struggle with alcohol misuse face a higher likelihood of developing it. Symptoms of lactic acidosis include abdominal pain, a slow or irregular heartbeat, persistent nausea, and shortness of breath. Patients may notice they feel cold all the time, and the hands and feet could turn blue. Muscle pain, weakness, and fatigue may be present.
Although lactic acidosis is rare, patients should let their doctor know immediately if they experience any of these symptoms. The primary treatment method for this condition is to discontinue metformin, and patients may need to be hospitalized to receive intravenous fluids and breathing support.
Patients taking metformin often report an increase in gas (flatulence). To help manage this side effect, doctors suggest that patients consider making dietary modifications. It is particularly beneficial to avoid spicy foods since these tend to excite digestive acids and may cause gas to be expelled throughout the digestive system.
Yogurt containing probiotics or active cultures may help to regulate digestion, and some individuals choose to add active probiotic supplements to their diets for this purpose. Reducing intake of fats is suggested to prevent the patient’s rate of digestion from slowing. High-fat meals are digested slowly, and this allows gas to build up in the empty spaces of the digestive system. Over-the-counter medicines such as simethicone can help reduce gas, and ginger is beneficial for some patients. If gas is bothersome or persistent, the patient should speak to their doctor about prescription adjustments that could reduce this side effect.
Stomach pain with metformin is most likely to occur in female patients who are at least sixty years old. It typically develops during the first six months of taking metformin, and those who have high blood pressure are at an increased risk for this side effect.
Using acetlsalicylic acid and metformin together raises the likelihood of experiencing stomach pain as well. Patients with stomach pain might notice bloating and indigestion too. To reduce the risk of these symptoms, doctors suggest taking metformin with meals, and they may be able to prescribe an extended-release version of the medication or adjust the dose to make side effects more tolerable. Patients should always let their doctor know if stomach pain lasts more than a few days, and emergency medical care should be obtained if the stomach is swollen or tender to the touch. Stomach pain accompanied by fever, bloody stools, or persistent nausea and vomiting also warrants emergency care.
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It can be overwhelming to know what to eat when you are first diagnosed with diabetes, or if you are preparing meals for a family member or friend with diabetes.
There are many foods that you should eat more of, and some of these are listed here.
Fill your plate with these ten great food ideas and you’ll never be short of healthy ingredients that fit your diabetes meal plan.
And there’s more good news – these foods will not only help with diabetes self-management, they’re also perfect healthy choices for all your family members and friends.
- Sweet potatoes and/or yams:
These healthy starches are a great addition to the diabetes meal plate. They are much lower on the glycemic index (GI) than regular potatoes, so they digest much more slowly. This means they take longer to raise blood sugar levels. They are also delicious, whether oven-baked as chips, slow roasted or pureed. They also make fantastic soup.
- Whole grain or rye bread:
These breads have a higher fiber content than white bread, and can help with blood glucose control. They are also the recommended choice for most people without diabetes.
- Brown rice or pasta:
These carbohydrates have a higher fiber content than their more refined white counterparts. They promote overall health as well as helping to maintain blood glucose level targets.
- Beans:
Beans and other legumes are an amazing source of soluble fiber, which slows down digestion and helps to avoid sudden climbs in blood glucose. Beans and pulses (like lentils, chickpeas and black-eyed peas) are also high protein, low-fat and rich in anti-oxidants. They are perfect for the whole family’s health goals.
- Avocado:
Avocados are another food with lots of soluble fiber to slow down digestion. They are good for blood glucose control and also have lots of heart-friendly omega fats. You need to remember that they are also quite high in calories, which needs to be taken into consideration for weight maintenance planning.
- Nuts:
Nuts offer great ways to get healthy fats and fibre into your diet. Most nuts are also good sources of the anti-oxidant vitamin E. Look for unsalted nuts for both snacks and meal ingredients. Good choices include almonds, peanuts, walnuts, brazil nuts, pecans, cashews and hazelnuts, amongst others.
- Oats:
Oats are a wonderful source of soluble fibre and are recommended to help lower blood glucose levels. They are also recommended to help achieve healthy blood pressure and cholesterol levels. Enjoy oat cereals or use in baking.
- Salmon, trout or mackerel:
These fish are great sources of omega 3. They are also high in protein and rich in essential vitamins and minerals. If fresh fish isn’t an option, buy cans of salmon. You will always have a healthy protein on hand in your kitchen!
- Deeply coloured vegetables:
Thee vegetables are rich in phytochemicals, which have antioxidant properties. They also contain lots of healthy vitamins. Look for choices like tomatoes, sweet peppers, beetroot and deep green vegetables like broccoli and spinach. Make sure you always have some available by adding a couple of packs of frozen chopped spinach to your grocery cart. To learn more about how much and what type of vegetables to buy,
- Low-fat cream cheeses, sour cream, yogurt and milk:
Low-fat dairy products are ‘must-haves’ in the fridge. You’ll find them a really useful addition to a variety of meals and snacks, and you’ll be getting healthy calcium and protein too.
SO MAKE SURE TO TAKE B COMPLEX VITAMIN PILL ONE A DAY if you are not allergic and this can help your metabolize and will give you the B9 dose in the pill and B 9 is folic acid. drink lots of water, walk, try to reduce your weight , control your cholesterol, add garlic to your diet and food. If you have any other question please ask me I can help you for free e mail me at drsteveramsey@gmail.com or post your question here in my blog , attention steve.
Thanks
Steve Ramsey, PhD-Public Heath. PgD-Natural medicine.
MSc medical ultrasound.