Pre-diabetic and worried about Metformin

[Metforminmum]

Hi all, hoping someone can help me make sense of things.

i’ve found out today i’m pre-diabetic and have been prescribed Metformin.

Can anyone tell me what side effects I can expect from Metformin - severity, longevity etc. i’m also worried about long term effects of taking this medication (if there are any!)

I’ve heard stomach issues are common?

Sudden bouts of diarrhoea, although better with a slow release version. They don't usually medicate prediabetes though, especially without trying diet and lifestyle changes first.

I had some blood tests recently and my level was 43. No information apart from a general letter and no advice from the doctor.
Is medication normally prescribed at this early stage?

I’m surprised that if you are prediabetic they have prescribed medication. My husband was diagnosed type 2 with Hba1c of 60 and turned it round within 3 months with dietary management (lost 2 stone on strict 1000 cals a day diet and maintains with low carb diet - 2 years of non diabetic readings and counting) In diabetic groups the main issue with metformin is gastrointestinal side effects but the bigger issue in my eyes is if you don’t address the underlying cause of the diabetes it will continue to progress. The Caldesi cookbooks, Michael Moseley Fast 800 or Jason Fung the Diabetes Code all helpful if you are interested in remission.

my level was 42. Have PCOS (and insulin resistance according to the Dr). 27 years old. Screened as part of PCOS investigations.

have been prescribed Metformin and referred to a community diabetic clinic/information group.

Reading online i’ve seen nausea, vomiting and diarrhoea as comment side effects… is there anything i can do to mitigate the risk of this happening?

Thanks for the info on diet - i’ve got a lot of research to do!

If you do have those side effects then speak to your GP and they may need to change the medication but you won't know until you take them.

There are thousands of patients on Metformin in this country, likely most without any complaints so if you have been prescribed them, it's best to take them.

Was very shocked to learn that I was type 2 diabetic. (87 level)
Been on the slow release metformin for 2 weeks and apart from a few stomach rumbles , which could be because of the sudden increase in veg eating, have had no other symptoms at all.
I am, however, sleeping better, having fewer "sweats" and spending less time "weeing"

So far it's all good for me. Hope its the same for you.

Could you try myo-inositol first? Recommended for pcos, and trials have shown positive results with gestational diabetes, which I know is not exactly the same. But inositol works by improving your cells' response to insulin, which I assume is beneficial for T2 diabetes too.

I don't have diabetes but I do have pcos. Inositol has enabled me to lose weight and maintain it like a 'normal' person - ie I still had to work hard and create a calorie deficit, but I lost about 1lb per week on a 500 cal deficit which is roughly what you'd expect. Prior to the inositol, it was more like 1lb every 3 weeks! It did take maybe 3 months to start working though. My periods became regular too, and I conceived easily. Inositol does not cause nasty side effects (your body actually makes it, so you're just topping up). Maintaining a healthy weight is vital for pcos and diabetes, and inositol really helps with that, in addition to helping regulate insulin.

I'm not advising you to go against your docs advice. But since pp mentioned that it's unusual to be prescribed Metformin with prediabetes I wondered if it was because you had pcos too, and just wanted to recommend the inositol. But you know your whole medical history, so you are the best person to decide whether to take your docs advice, or try lifestyle changes first. Good luck!

I am on Metformin for diabetes. Alongside I have lost 13kg, partly through low carb/eating smaller portions etc. But also partly through the medication: suppresses my appetite and can make me nauseous.

Initially it was ok but I had terrible gastric problems (chronic diarrhoea/stomach cramps) on slow release on max dosage. So dosage reduced, came off it for a while but blood sugars started rising, so back on it. It is an amazing drug, protects against some cancers etc and helps me so I want to be on it.

Found I can tolerate it better if I take the tablet during the meal or straight after. Good luck!

I'm prescribed Metformin solely for PCOS (no signs of diabetes). I had no issues after the first couple of days, with the following caveats:

• Always take it with food, or it's likely to give you the colossal shits.

• I was recommended to gradually up my Metformin intake up to my prescription level. I ignored that and just took the prescribed amount straight off the bat. The result? Colossal shits, but only for a few days.

I've been on it for something like 7 years now, no issues. Never had any nausea or vomiting until about six weeks in, but that's because I'd finally got pregnant after two years of trying (which is how I was diagnosed with PCOS and an underactive thyroid - we were having fertility consultations).

I suspect it is more for your pcos than pre diabetes.

I take metformin for PCOS and without it, i wouldn't have my DD. When i started taking it, i had none of the tummy upsets. I increased the dose slowly (from 500mg to 2000mg) over the space of 4 weeks. After coming off it whilst pregnant, when i went back onto it, it did upset my tummy so i switched to the slow release version and it has been absolutely fine.

Follow the instructions - take it after food and look at low carb / fast 800 style diet changes as well. I was doing really well until i had DD and let it all slide. Now trying to get back on it!

I take metformin for PCOS too. 1500mg a day. Been on it 4.5 years solid. After the initial getting over the ramp up situation I've been fine, no affects. I can take it without food without suffering also, whereas early on I'd have felt rough if I did that.

Pretty sure Metformin is meant to be good for your long term health.

Lifespan is quite an interesting book by a (slightly out there but clearly very clever) Harvard professor who is very pro Metformin.

Yes it protects against some cancers (not saying people who are on it don't get those cancers but offers protection).

Also supposed to be anti-ageing though I'm not sure about that! It is, by all accounts, bit of a wonder drug.

I've been on it for about 10 years. For me I built up slowly so 1 a week, then 2 etc. Always take with meals. I prefer to eat 75% of my meal then take 2 tablets and then eat the remainder. I find cushioning like this the most effective.

Also its recommended not to have more the 2 tablets per sitting.

I've been on it for about 10 years for type 2 diabetes. I take 2 x 500mg a day of the modified release, and always take after breakfast. Never had any issues since going onto the SR version and it controls my blood sugars admirably along with diet. No horror stories here.

Also came to suggest trying myo-inositol. I wouldn’t want to say instead of the metformin as that has been prescribed by HCP but myo inositol is certainly worth having a read up on (would suggest the powder format if you do go for it)

I’ve been on metformin for a couple of months now, I was worried about potential side effects, but after the first couple of weeks the occasional tummy ache and nausea went away.

I’ve found that if I eat too many carbs I get diarrhoea, but that may well be psychological!

I am finding it a bit of a miracle drug tbh.
I’ve low carbed off and on for years, but no matter how strict I am I don’t lose weight, or I do but very very slowly, and inevitably give up.
I’m low carbing now but it’s easier as metformin means I now feel full (I never used to) and can’t eat as much. Apparently this is due to increased sensitivity to insulin and leptin, which tell the brain you’re full (amongst other things) - I can’t remember a time in my life when I’ve felt full before. Since starting it I’ve been losing weight steadily and easily, and can finally envision a future where I’m not enormously fat!
Even if I reverse my diabetes I never want to come off metformin!

I had a horrible reaction to normal metformin but have been on Prolonged release metformin and have no significant side effects from that.

The metformin will help with your PCOS symptoms as well as the insulin resistance which might be why it has been prescribed earlier than it otherwise might have been. Take the tablet at the end of a large-ish meal to minimise side effects. I take my metformin after breakfast and after dinner to make two smaller doses rather than one large one. It does need to be a reasonably bulky meal so that it moves slowly from your stomach so plenty of roughage in the form of vegetables and whole grain carb helps. Having protein with every carb will help with blood glucose levels too. Taking the metformin with a small, easily digested snack like a banana won't work.

Build it up slowly and if need be go back to previous dosing if struggling to tolerate it ask go to change you to slow release