What is metformin?

Metformin may be the best diabetic medication to protect your heart. A major review of forty studies, published in the Archives of Internal Medicine in 2008, showed that Metformin reduced cardiovascular risk by 26 percent. Rosiglitazone (Avandia), another more expensive antidiabetic medication, actually showed a possible higher risk of heart disease.

Holistic doctors have used Metformin, an excellent, old, and inexpensive medication, for years to treat diabetes and insulin resistance. It can also help you lose weight when insulin resistance is present. Metformin can cause vitamin B12 deficiency, so be sure to take vitamin B12 with it.

Metformin (Glucophage) is a biguanide. Biguanides lower blood glucose levels primarily by decreasing the amount of glucose produced by the liver. Metformin also helps to lower blood glucose levels by making muscle tissue more sensitive to insulin so glucose can be absorbed. It is usually taken two times a day. A side effect of metformin may be diarrhea, but this is improved when the drug is taken with food.

Metformin is literally in a class by itself, at least in the United States, where no other member of this family of drugs is available. It is the medication that is used most as a first-line drug treatment for diabetes, and for good reasons. The medication is very effective in many people, an inexpensive generic is available, and, unlike many diabetes medications, it tends to promote weight loss rather than weight gain. Metformin works by reducing the amount of glucose that is produced by the liver.

Unlike the certain diabetes medications, metformin does not have to be taken before meals to be effective. The major problem with metformin is that it causes significant gastrointestinal side effects in many people, especially bloating, gas, and diarrhea. These side effects can be reduced by (1) starting at a low dose and gradually working up to a larger one; (2) taking the medication with food or even after eating; and (3) using the extended-release form of the medication. Sometimes people who have tolerated the drug for a long time get a stomach flu or something similar and find that they can no longer take metformin without experiencing lots of gastrointestinal symptoms. In these cases, the medication can be stopped temporarily and then restarted, sometimes at a low dose, and increased as tolerated.

Even though the extended-release form is tolerated better, many physicians prefer to start with the regular form because it is often associated with more weight loss. Some of the weight loss may relate to gastrointestinal symptoms, and it may be that the people who lose weight most effectively are those with mild queasiness -- not enough to be a problem but just enough to reduce the appetite.