When using metformin to treat diabetes, you need to take it "enough". How much should you take?

A diabetic patient left a message to Huazi, saying that he was always worried about the dosage of metformin. He was taking 0.5g of metformin, and used to take 1 tablet a day, but his blood sugar was not well controlled, so the doctor asked him to increase the dosage to 4 tablets a day. He asked Huazi, is 4 tablets of metformin a large dosage, and how to increase the dosage?

Huazi said that one should listen to the doctor's advice. Four tablets of metformin per day is the "optimal dose". When taking metformin, only when this dose is reached can the maximum blood sugar-lowering effect of metformin be exerted.

1. First choice and full course of medication People with diabetes are no strangers to metformin, which is almost the "favorite" of all endocrinologists. Metformin can inhibit liver gluconeogenesis and reduce liver glucose output; it can inhibit the absorption of glucose by intestinal wall cells and increase the level of glucagon-like peptide-1; it can reduce the level of free fatty acids in peripheral muscle, fat and other tissues and reduce insulin resistance; it has cardiovascular protection and anti-tumor effects.

Metformin has multiple pharmacological effects. Although there are new drugs such as "Gliptin" and "Gliptin" for the treatment of diabetes, metformin has not stepped down from its "godly throne" and is still recommended in various treatment guidelines as the first choice for patients with type 2 diabetes and the medication for the entire course of the disease.

2. Use metformin in sufficient amounts. The minimum effective dose of metformin is 0.5g per day, the maximum dose is 2.55g per day, and the optimal effective dose is 2.0g per day. When using metformin, patients with type 2 diabetes are advised to start with the minimum dose. If they can tolerate it and there are no obvious side effects, they need to gradually increase the dose to the optimal effective dose. A more prudent approach is to increase the dose by 0.5g per week, and increase it to the optimal dose of 2.0g per day in one month.

It should be noted that metformin comes in different dosage forms and the time of taking it is not the same.

Metformin regular tablets: 2 to 3 times a day, take with meals or 15 minutes after meals.

Metformin enteric-coated tablets: Take 2 to 3 times a day, 30 minutes before meals. The tablets should not be broken or chewed.

Metformin extended-release tablets: Take once a day at dinner. Do not break or chew the tablets.

3. Pay attention to the side effects of metformin. The main side effects of metformin are mainly digestive tract reactions. Common indigestion symptoms such as diarrhea, bloating, nausea, vomiting, and nervous system symptoms such as fatigue and headache mainly occur in the early stage of medication (the first 8 weeks). Therefore, when taking the medicine, start with a small dose and gradually increase the dose to adapt to the side effects of the drug. Most people will gradually tolerate it with continued medication, and the adverse reactions will be reduced or disappear.

Metformin does not damage the liver or kidneys and has good safety and tolerance. However, people with liver dysfunction, kidney dysfunction, and heart failure are prone to lactic acid accumulation in the body when taking metformin, increasing the risk of lactic acidosis. When taking the drug, it is necessary to weigh the pros and cons and take it in a reduced dose under the guidance of a doctor.

4. Metformin can be used in combination with other drugs. When taking metformin, you need to control your diet and exercise regularly to help control blood sugar. When the optimal dose is reached but blood sugar is still not controlled to the standard range, or when you cannot tolerate the adverse reactions of metformin and cannot take the optimal dose, resulting in poor blood sugar control, it needs to be used in combination with other hypoglycemic drugs.

Metformin can be used in combination with any glucose-lowering drug, including insulin secretagogues (such as glibenclamide, glimepiride, repaglinide, etc.), insulin sensitizers (such as rosiglitazone, pioglitazone, etc.), α-glucosidase inhibitors (such as acarbose, voglibose, etc.), SGLT-2 inhibitors (glifenac), DPP-4 inhibitors (glitadin), GLP-1 agonists (such as liraglutide, benaglutide, etc.), and combined with insulin.

There is no risk of hypoglycemia when metformin is used alone, but it is necessary to be wary of the adverse reaction of hypoglycemia when it is used in combination with insulin secretagogues, insulin and other drugs.

In summary, metformin has low side effects and has a reliable blood sugar lowering effect. Relevant studies have confirmed that it can reduce glycosylated hemoglobin (HbA1c) by 1-2% when used alone. If blood sugar is still poorly controlled after 3 months of adequate use, a second hypoglycemic drug may be considered.

The medicine must be used under the guidance of a doctor. If you have any questions about the use of the medicine, please consult a doctor or pharmacist in time.

I am pharmacist Huazi. Welcome to follow me and share more health knowledge.