From the Guidelines
Metformin is a highly effective medication for treating insulin resistance, and it should be considered as the first-line treatment for type 2 diabetes due to its ability to reduce microvascular complications, cardiovascular events, and death. The medication works by decreasing liver glucose production, increasing muscle glucose uptake, and improving insulin sensitivity, making it an ideal choice for patients with insulin resistance or prediabetes 1.
Key Benefits of Metformin
- Reduces risks of microvascular complications, cardiovascular events, and death 1
- Effective in lowering A1C, weight neutral, and does not cause hypoglycemia compared to sulfonylureas 1
- More effective than dipeptidyl peptidase 4 (DPP-4) inhibitors in lowering A1C and weight when used as monotherapy 1
- Available in an immediate-release form for twice-daily dosing or as an extended-release form that can be given once daily 1
Important Considerations
- Common side effects include gastrointestinal intolerance due to bloating, abdominal discomfort, and diarrhea, which can be mitigated by gradual dose titration and/or using extended-release formulation 1
- Should be used cautiously in patients with kidney disease, and vitamin B12 levels should be monitored during long-term use 1
- Lifestyle modifications including regular exercise, weight management, and a balanced diet low in refined carbohydrates should accompany metformin treatment for optimal results in managing insulin resistance
Dosage and Administration
- Typically starting at 500 mg once daily with meals and gradually increasing to 1000-2000 mg daily in divided doses as tolerated
- Extended-release formulations may cause fewer digestive problems and can be given once daily 1
From the FDA Drug Label
Metformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes mellitus, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization Metformin hydrochloride tablets help control your blood sugar in a number of ways. These include helping your body respond better to the insulin it makes naturally, decreasing the amount of sugar your liver makes, and decreasing the amount of sugar your intestines absorb.
- Improves insulin sensitivity: Metformin improves insulin sensitivity by increasing peripheral glucose uptake and utilization.
- Helps the body respond to insulin: Metformin helps the body respond better to the insulin it makes naturally.
- Does not increase insulin production: Metformin does not cause the body to make more insulin. Metformin is used to treat type 2 diabetes mellitus and helps control blood sugar levels by improving insulin sensitivity and decreasing glucose production 2.