Metformin side effects

Hi @lora52, nice picture. I hope you'll add it to your profile.

Let me see if I'm understanding correctly. For the past 15 years you were able to manage your numbers well with metformin and experienced no side effects. However, metformin is no longer working for you, so you've started insulin. Getting things regulated with insulin has been a challenge and your numbers are all over the place. Do I have that right?

@cehunt57, I see that you were worried that @lora52 might be experiencing a hypoglycemic reaction as she was replying to a few members. Don't you hate it went autocorrect misspells metformin to things like "my foreman" or "met a foreman"?

Thanks for being there last night to check in on Lora. Do you have any tips about starting insulin and regulating sugar levels?

@lora52, you might also wish to check out these related discussions:
- https://connect.mayoclinic.org/group/diabetes-and-endocrine-problems/

I was on insulin for about 30 days at one point and I was not properly prepared.

See if you can get a diabetes counselor on the phone ASAP. Of course the doctor (endocrinologist?) would be better (but getting a doctor on the phone in short order is nearly impossible in the US). Even going to an urgent care facility (again, assuming US) might be a good idea.

The need for hand-holding for new insulin users is ignored by US medical standards, and it's a travesty. Changes in dosing and timing can be needed, even if you're doing everything right!

I got through mine OK but there was a lot of luck involved ...

Should I ask also, are you following any recommended dietary guidelines?

“Tips about starting insulin and regulating (blood) sugar levels”:

1) Learn the symptoms of hypoglycemic (low blood sugar) / insulin reaction. They can include hunger; sweating; feeling faint, dizzy, light headed; trembling, shaking; slurred speech; agitation; confusion; senses goofed up such as tunnel vision, ringing in the ears tingling feeling on the skin; loss of fine & gross motor coordination; seizures and worst of all loss of consciousness.

2) Have a way to check blood sugar such as a glucose meter, test strips and lancets accessible at all times. When in doubt test! You could be just “hangry” but it is better to test, know for sure and correct if needed than to run the risk of getting into a serious low blood sugar trouble. If you are headed in that direction your judgement could be off. JUST TEST! Better safe than sorry.

3) Always have a source of sugar available to treat a low blood sugar. At home fruit juice is a good option such as orange or grape juice. (Learn to read the nutrition labels.) About 15 grams of carbohydrate is a good place to start. This is about 1/2 - 1 cup of juice (4 - 8 ounces) depending on the juice. I have a particular bottle of juice and specific cup that I know will do the trick so I don’t have to figure it out when the time I need it comes. Learn to read nutrition labels ahead of time before you shop for groceries. You can keep hard candies in your pockets, purse, glove compartment of your car for when you are away from home. When Life Savers candies were first invented it was for the purpose of treating low blood sugar and that is how they got their name.

(DON’T DRIVE UNLESS YOU KNOW YOUR BLOOD SUGAR IS OK!)

In addition to juice and hard candies there are glucose tablets and glucose gel from a pharmacy. It is a consistent amount of carbohydrate which helps prevent over treating the low blood sugar but is more expensive and not really necessary. There are also injections (Glucagon) and a nose spray treatment (Bacsimi sp.?) that require prescriptions. This is for extreme lows when the person isn’t able to swallow.

4) It is helpful to have a family member, friend, roommate, neighbor know your medical condition to assist you as needed. My husband has “saved” me many times. My kids grew up aware of my situation and what to do if necessary. It is good for trusted friends to know these basics also. You should also have a bracelet or necklace with medic alert ID on it. In my community there is something called Smart 911 where you can have your important medical information on file with the paramedics and EMT’s.

5) Last but not least (this is my personal opinion) it is better to treat a diabetic emergency as a low blood sugar rather than a high blood sugar. I say this because if testing is not available for some reason a low can happen quickly and be life threatening if not dealt with. A high blood sugar is bad also but takes longer to become life threatening and also longer to correct. A real life example was in a parking lot going into a restaurant I had a low blood sugar incident. My parents were with us and my mother mentioned to concerned people parked next to us that I was diabetic. Some well meaning woman commented “Oh she needs her insulin!” NOT! that could have killed me. My husband emphatically said “NO” and one of my daughters was already fetching juice from the restaurant. Same thing happened at an apartment complex in my neighborhood. I happened to be taking a walk when I saw one of the tenants down on the lawn. He had a diabetic medical alert tag on him. His friend was heading into the apartment building to get the insulin. I gave the guy some of my trusty hard candies and told his friend to bring his meter instead. The friend didn’t know what a meter was and EMT’s (that someone had called) showed up. They tested the guy, administered some more sugar and thanked me for my action.

All of these recommendations are general things for insulin dependent diabetics. Each person’s provider should set the target blood sugar range, prescribe insulin &/or medication doses, make testing requirements and give referrals to other providers such as diabetes educators, nutritionists, therapists etc. to help meet the needs of a diabetic to live as full and healthy as possible life as possible.

I was on ER metformin 500 mg morning and night for about 6 weeks when my dietician told me to take two pills in the morning. I started that a week ago. I became sick the first afternoon after increasing it to two tablets. In addition to feeling slightly nauseated and some diarrhea, I have been having muscle pain in most of my torso, especially in my back above my waist, but also in my upper and lower back. I have also had headaches and just a general feeling of malaise. The worst is the pain in my back because even when I try to walk normally I have sharp pain in my back. I also feel light headed and a little trouble focusing. I stopped taking metformin on the advice of my doctor two days ago. I am not feeling better. My doctor ordered blood tests and my white blood cells are very normal, so not a virus or bacteria. Nothing unusual for me except that my B-12 was just slightly lower, so for the past two days I have been taking a supplement of 1000 mcg. I am waiting to see my doctor in a week, but meantime was wondering if any of you have had any similar reactions? I am a 74 year old woman and the only other medication I take is 60 mg of pravastatin. I normally feel very well and do fast walking aerobics 3 miles every day. I am feeling so bad currently, I am unable to do anything but stay in bed or sit in a chair. I would appreciate any information. Thank you.

Hello. I started with both Metformin 500mg once a day and pitavastatin 1mg. Both gave me bad side effects. I fell down twice and the first fall I tore my tendons in my ankle and I felt miserable for months with an orthopedic boot and so much treatments. Now I am feeling great with no issues. I am an active 73 yrs old woman who goes to the gym and eat healthy. Never fell down before. I will never forget how weak I felt my legs. It was really bad.
After I talked to my PCP she told me not to discontinue my two meds because those side effects were temporary. She was absolutely wrong. The weakness on my legs were caused by the statin and the Metformin. Both affect muscles and Metformin affects the pancreas. I decided to stop both meds by myself and since then I have been feeling great and stronger. This happened last year but to be honest with you the muscle issue stays for a while even after stopping the statin. I was feeling tired. Statins affects muscles big time, the heart is a muscle so it is affected too no matter what the cardiologists say. The statins slows heart function. I am keeping now my good weight, eating super healthy, I don’t drink alcoholic beverages at all nor I smoke and I go to the gym 6 days a week. I don’t eat sweets unless it is a special occasion I eat them very moderately. I have been reading a lot about statins and Metformin written by well known cardiologists and endocrinologists, they recommend to be cautious with both meds. As a matter of fact the PCP who told me to keep taking Metformin prescribed it to me because she said I was prediabetic with an A1C of 5.6, borderline. I changed my PCP after stopping both Meds and the new PCP told me that Endocrinologists never prescribe Metformin to prediabetics, neither she does, they recommend healthy diet and exercise. I am still keeping myself away from these meds. Before you decide anything consult your doctor before any further action. Stay well.

@nvc , hi. You didn't give us your numbers on blood glucose or cholesterol. On what basis did your dietician recommend changing/increasing your dosage? Were there any changes to your diet, and what kind of diet are you on? I'm just saying that even with the coincidence of timing, it doesn't have to be a problem with the metformin. Two 500mg pills in the morning and one at night, is still just about an average dose. (Were you on any metformin before six weeks ago?)

I'm always skeptical of statins and might suspend that for a while, and when you feel better (soon, we hope!) you can try reintroducing one or the other and see if you can figure it out. Pravastatin is at least water soluble so it clears out of your body quickly - so does metformin, even ER.

I could not take statins. Heart Dr gave me fenofibrate and I am not having issues. I take janumet for diabetes am & pm and am not having issues. Ask your Doctor to try other meds for diabetes & cholesterol.

Thanks. I am prediabetic according to my former PCP but mu A1C is normal now. No Metformin for me. My lipidd are going down without meds. Glad that you are not having any issues with your new meds. Stay healthy.

@nvc There is a known side effect of Metformin called "Metformin Fatigue". I was on 500mg tabs, 2 in AM and 1 in PM. My PCP wanted me on 2 tabs in PM also, but it made me too sick. I started feeling major fatigue which grew to debilitating proportions where I could not get out of bed from the time I got home from work on Friday to when I had to literally drag my body out of bed to go to work on Monday. I could not think straight and was groggy and foggy all the time. None of my doctors had any answers so I started researching and found proven reports in both JAMA and NIH describing the "Metformin Fatigue" side effect. It's a real thing. It described every single symptom I had developed. I stopped the Metformin on my own and within 2 weeks was back to my normal active self. Hang in there, it takes a while for the drug to get out of your system and your body to recover and turn to normal. Best wishes for feeling better soon!