How fast does metformin work?

[qwerty123]

Newly diagnosed diabetes T2 here. Been on metformin the last couple of days and just got a blood glucose test kit. How fast does metformin start to work and have a noticeable effect on bg?

 

[harbottle]

You could see some effects in a couple of days, which is I think when it reaches the ‘steady state’ in your system. A couple of weeks for max effect.

 

[qwerty123]

You could see some effects in a couple of days, which is I think when it reaches the ‘steady state’ in your system. A couple of weeks for max effect

Sorry , what do you mean by steady state? My BG is still very high at 14.5 a couple of days after dinner, but I have no baseline to compare

 

[Drummer]

Newly diagnosed diabetes T2 here. Been on metformin the last couple of days and just got a blood glucose test kit. How fast does metformin start to work and have a noticeable effect on bg?

Are you sure that Metformin works to reduce glucose levels?
I used to get into trouble for suggesting that it doesn't lower glucose levels, but from all I have read - it doesn't work that way. It interferes with the release of glucose from the liver, reduces the amount of glucose absorbed from food and improves the bodies response to insulin.
It gave me the most horrible faecal incontinence - jet propelled - so no amount of benefit could ever compensate for that, but fortunately I responded well to eating a low carb diet, so I stuck with that.

 

[goodybags]

Newly diagnosed diabetes T2 here. Been on metformin the last couple of days and just got a blood glucose test kit. How fast does metformin start to work and have a noticeable effect on bg?

Here’s a link (if I’ve done this right) it will give you an idea of how Metformin works

It can help us T2 Diabetics better control Diabetes, I’ve been taking it for over 30 years, we’re all different but for me Metformin on its own was never enough to give me a good control

you will see on there, Metformin can help your body better respond to the insulin your body is producing

Metformin and diabetes

Metformin is a diabetes medication that helps the insulin you produce work better. You usually take it as a tablet.

www.diabetes.org.uk

 

[Leadinglights]

As you have a monitor you could do some strategic testing of your meals to see if you are still eating too many carbohydrates for your body to cope with. You say after meals, I assume that is after 2 hours is 14 but what was it before you ate. Your aim is for that difference to be no more than 2-3mmol/l , once that is happening consistently then your overall levels should start to come down. That metformin only helps a smidgen.
It is early days for you.
Have you also made some dietary changes, this link may help you https://lowcarbfreshwell.com/ but if you don't need to lose weight then you need to make sure you have plenty protein and healthy fats.

 

[everydayupsanddowns]

I don’t have any personal experience, but from reading around over a lot of years I get the impression that some Drs feel that 1500mg is the dose at which Metformin starts to have an appreciable effect (though some forum members report seeing positive effects on just the one 500mg tablet!).

Metformin seems to ‘ramp up’ over a number of weeks, gradually soaking into your system. It doesn’t really work on a meal-by-meal basis, but more in the background helping your body use insulin more effectively.

If you are seeing high readings after a meal, the most direct way to change that is often by reducing the portion size of carbohydrates in that meal, or by switching to a different source of carbs - or a mixture of lowering the carb content, and choosing slower-release sources.

One of the tricky things about diabetes is how individual all this can be - so it can take a bit of experimentation to find meals and combinations that work for you.

Good luck!

 

[harbottle]

Sorry , what do you mean by steady state? My BG is still very high at 14.5 a couple of days after dinner, but I have no baseline to compare

It's when the active ingredient reaches its max concentration in your system (Based on the dose.) The reason you have to keep taking the tablets it to keep it at that level.

 

[harbottle]

Are you sure that Metformin works to reduce glucose levels?
I used to get into trouble for suggesting that it doesn't lower glucose levels, but from all I have read - it doesn't work that way. It interferes with the release of glucose from the liver, reduces the amount of glucose absorbed from food and improves the bodies response to insulin.
It gave me the most horrible faecal incontinence - jet propelled - so no amount of benefit could ever compensate for that, but fortunately I responded well to eating a low carb diet, so I stuck with that.

What a strange question.

The action it performs helps lowers glucose levels, and it's quite effective at doing so, in particular with T2D in people who are overweight in which hyperglycaemia is contributed to by runaway hepatic glucose production and insulin resistance.

All anti-diabetic (No insulin) drugs interfere with pathways to lower glucose, just in different ways. Whether that's the pathway to stimulate more insulin, the pathway to release it from the blood via the kidneys, and the others than inhibit hormones and whatnot.

 

[Martin.A]

I think it would help if HCPs explained to people how Metformin works, as many seem to leave their appointment under the impression that they can just take it and carry on as normal.

 

[harbottle]

I think it would help if HCPs explained to people how Metformin works, as many seem to leave their appointment under the impression that they can just take it and carry on as normal.

Absolutely.

It can be quite effective, but won't dent a hba1c of 83 (Which was mine.) I was told to take the tablets and make some lifestyle changes (Low carb and exercise) in a quite blunt manner!

When I was diagnosed I read quite a few papers on the effects of Metformin, and they were all done a set of people who didn't change lifestyle or lose weight. (Someone mentioned 1500mg, and it was one of the papers I read that showed hba1c improved with this dose after a period of time, but with lower doses it got worse, but not as bad as the control group who were on a placebo.)

 

[Drummer]

What a strange question.

The action it performs helps lowers glucose levels, and it's quite effective at doing so, in particular with T2D in people who are overweight in which hyperglycaemia is contributed to by runaway hepatic glucose production and insulin resistance.

All anti-diabetic (No insulin) drugs interfere with pathways to lower glucose, just in different ways. Whether that's the pathway to stimulate more insulin, the pathway to release it from the blood via the kidneys, and the others than inhibit hormones and whatnot.

What I mean is that glucose in the blood is not actively removed by Metformin - some medication gets it out through the kidneys for instance, but Metformin seems to keep carbs in the gut or the liver or the cells.
To me it is rather like having a full rubbish bag in the kitchen full waste paper bin in the living room, shelf of empty bottles in the bathroom - presumably waiting for the day they get hauled out to the dustbin.

 

[indio02]

It can be quite effective, but won't dent a hba1c of 83 (Which was mine.) I was told to take the tablets and make some lifestyle changes (Low carb and exercise) in a quite blunt manner!

My HbA1c on diagnosis was also 83 after 6 months of a healthy lifestyle and 2000mg of slow release metformin it had come down to 51.

 

[rebrascora]

Newly diagnosed diabetes T2 here. Been on metformin the last couple of days and just got a blood glucose test kit. How fast does metformin start to work and have a noticeable effect on bg?

If you have only been taking Metformin for a couple of days then it has not had time to have much impact. I assume you have been started on a low dose and gradually building it up, so you will start to see some benefit in a few weeks when you are up to full dose and it has reached optimum levels in your body. If you have been started on the full dose straight away, then you should see results quicker but you might also experience digestive upset. It is generally started at 500mg once a day for the first week and increasing by another tablet each week up to 4 a day by the 4th week and the 3rd week you should be starting to see some improvement, BUT dietary changes will have a much more powerful impact on reducing your levels during that time and they are as, if not more important, than taking the Metformin.

 

[harbottle]

What I mean is that glucose in the blood is not actively removed by Metformin - some medication gets it out through the kidneys for instance, but Metformin seems to keep carbs in the gut or the liver or the cells.
To me it is rather like having a full rubbish bag in the kitchen full waste paper bin in the living room, shelf of empty bottles in the bathroom - presumably waiting for the day they get hauled out to the dustbin.

No T2 medication 'actively' removes glucose, though. They just make changes to existing physiological pathways that help lower it.

Flozins stop the kidneys from reabsorbing it by inhibiting a channel, so it's passed out in urine. Sulfonylureas make the pancreas produce more as they tickle beta cells in some magical way. Metformin does all sorts of stuff, including improving insulin sensitivity in muscles to make them suck it up.

The only medication that actively removes glucose is exogenous insulin, as that's what insulin does.

 

[harbottle]

My HbA1c on diagnosis was also 83 after 6 months of a healthy lifestyle and 2000mg of slow release metformin it had come down to 51.

1000mg for me + lifestyle charges. Down to 36 in three months. After I stopped Metformin this year it was 37.