From the Research
Metformin can be taken long-term, often for many years or even lifelong in people with type 2 diabetes, as long as it remains effective and is well-tolerated. The decision to continue metformin is based on its effectiveness in controlling blood sugar levels, as well as its potential benefits beyond glycemic control, such as improvements in endothelial dysfunction, hemostasis, and oxidative stress 1. Most patients start with a low dose (typically 500 mg once or twice daily) which may be gradually increased to a maximum of 2000-2500 mg daily, divided into two or three doses.
Regular monitoring by healthcare providers is essential while taking metformin, including kidney function tests, as the medication is cleared by the kidneys and may need dose adjustment or discontinuation if kidney function declines 2. Common side effects include gastrointestinal issues like nausea, diarrhea, and abdominal discomfort, which often improve over time. Taking metformin with meals can help reduce these side effects. Metformin works by decreasing glucose production in the liver, improving insulin sensitivity in muscles, and reducing intestinal absorption of glucose, making it effective for long-term blood sugar control without causing weight gain or hypoglycemia when used alone 1.
Some key points to consider when taking metformin long-term include:
- Regular follow-up with healthcare providers to ensure continued effectiveness and safety
- Monitoring of kidney function to adjust the dose as needed
- Management of potential side effects, such as gastrointestinal issues
- Consideration of the potential benefits of metformin beyond glycemic control, such as improvements in cardiovascular risk factors and endothelial function 1, 2.
Overall, metformin is a well-established and effective treatment for type 2 diabetes, and its long-term use is supported by a strong evidence base 1, 2.