Metformin is a cornerstone in the treatment of type 2 diabetes, long used for its effectiveness in managing blood sugar levels. But its usefulness extends beyond this traditional role, offering potential benefits for a variety of people living with diabetes.
As we explore the experiences of people like Kat Schroeder, we uncover the ways in which metformin is effective not just for type 2 but also for type 1 diabetes in some individuals.
Schroeder, who has lived with type 1 for the past 29 years and is a software engineer living outside of Washington, DC, has been taking metformin for her diabetes management for the past seven years.
She sat down with us to share her story.
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How did you get started taking metformin?
“Back in 2017, I noticed my blood glucose (sugar) control and A1c (a measure of glucose control over the previous 2 to 3 months) plateauing, mostly due to insulin resistance. My doctor recommended that I start taking metformin to help improve my diabetes management.”
While she was initially hesitant to start taking the medication, Schroeder wanted to address her insulin resistance — a condition in which the body does not use insulin efficiently — and rising blood sugar levels, so she decided to give metformin a chance.
Why did your doctor want you to take metformin?
While insulin resistance is commonly associated with type 2 diabetes, there can also be a genetic predisposition for the condition in some people with type 1 diabetes, particularly those who have had diabetes for an extended period or who have factors such as obesity or a sedentary lifestyle that contribute to its development.
However, resources and medications aren’t always readily available, simply because many people do not understand that those with type 1 diabetes also experience insulin resistance.
Schroeder explains it this way: “We had been steadily working on improving my glucose control and A1c, but I was still running high quite often and my A1c had plateaued in the 7s, so [my healthcare provider] recommended starting metformin to address that without increasing my risk for lows.”
Simply increasing the amount of insulin you take in a day can increase the risk of hypoglycemia, or lows, while not doing anything to address the underlying cause of insulin resistance.
Accordingly, many doctors are now prescribing metformin and other diabetes medications to people with different types of diabetes to help address the underlying causes of their high blood sugar levels and insulin resistance.
Did you experience any side effects?
Schroeder did experience some of the typical side effects from taking metformin. She says, “I had the GI side effects that seem to be quite common: upset stomach, more frequent bowel movements, some diarrhea. They seemed to wear off after about six to eight weeks as my body adjusted.”
Learn more about some of the gastrointestinal side effects in: Can Metformin Cause Diarrhea?
Side effects are normal when taking metformin, especially when you first begin taking the medication.
For some people, including Schroeder, the side effects may be severe enough that they stop taking the medication.
She notes, “Recently I had to stop taking it for about four months, and when I restarted it I experienced a decreased appetite and some nausea, but I expect that to wear off as well.”
Read about side effects in: Metformin Side Effects (Common and Serious).
Has your diabetes management improved since taking metformin?
Schroeder says that without a doubt her diabetes management is both better and easier with the addition of metformin.
“With my CGM [continuous glucose monitor] data, I can see quite clearly that my blood sugar is more responsive to insulin. Instead of fighting to chase a high for hours that I didn’t bolus appropriately for, I can usually head it off within a reasonable time frame. Also, I have fewer spikes in general.”
Using metformin for diabetes management can mean better blood sugar and A1c levels without increasing the amount of insulin you take.
Additionally, addressing the underlying causes of insulin resistance can also prevent excess weight gain in people with both type 1 and type 2 diabetes.
Read more in: Signs Metformin Is Working (Or Isn’t Working).
How long did you take metformin? Are you still taking the medication?
Aside from a few pauses, Schroeder has been taking metformin steadily since 2017. She says, “I’m still taking it now and plan on taking it into the future!”
Did anything surprise you about taking metformin?
Schroeder says she didn’t realize that people with type 1 diabetes could take metformin.
“When it was prescribed to me, I thought it was only for [people with type 2], but every [person with diabetes] can end up dealing with insulin resistance for one reason or another. Metformin is so helpful in addressing that. That perception continues amongst a lot of doctors who don’t have as much experience with diabetes, so you may have to manage their ignorance when seeking healthcare.”
Metformin was first approved by the U.S. Food and Drug Administration (FDA) for treating type 2 diabetes in 1994.
However, many doctors are aware of how effective this medicine is for combating insulin resistance and so prescribe the medication “off-label” (without FDA approval) to people with other conditions, including type 1 diabetes, prediabetes, and PCOS (polycystic ovary syndrome).
Learn more in: Metformin for Prediabetes: The Pros & Cons and Metformin for PCOS (Benefits and Side Effects).
There may be some health insurance hurdles to clear if you do not have type 2 diabetes and wish to take metformin and have it covered by your insurance. But if your doctor has prescribed it to you for treating insulin resistance, they have good reason to do so.
Find out more about the use of metformin in type 1 in: Metformin for Type 1 Diabetes: Pros and Cons.
Is the medication affordable for you?
Because Schroeder has type 1 diabetes and not type 2, the question of cost vis-à-vis insurance coverage is top of mind. Thankfully, she says that metformin is affordable under her insurance.
“My insurance considers it a generic medication, so the copay is very attainable and affordable for me.”
Do you have any tips or advice for people looking to take metformin?
Schroeder wholeheartedly believes in adapting your diabetes management plan to your individual needs and health goals, and not letting anything get in your way of achieving good health.
She says, “I think it’s helpful to educate yourself about the side effects before you begin taking metformin, as some doctors tend to gloss over them, but also keep in mind that your body should adjust with time. If it doesn’t, you may want to consider other options with your doctor’s guidance.”
Metformin works for her, and this effective and affordable medication may also work for you, especially if you’re dealing with stubborn high blood sugar and A1c levels and insulin resistance.
Final thoughts
Metformin is a common prescription medication in the United States that is FDA-approved for treating type 2 diabetes. However, the medicine may be appropriate for treating underlying insulin resistance in people with any type of diabetes.
It is affordable, accessible, and extremely effective for lowering blood sugar and A1c levels. You may experience adverse side effects, including nausea, vomiting, and diarrhea when you first start taking the medication, but those side effects should decrease over time.
If you do not have type 2 diabetes, check with your insurance plan to see if it will cover the medication. That said, because metformin is generic, people find that it is still relatively affordable even if they must pay the cash price. (The cost for metformin oral tablets [500 mg] is around $11 for a 30-day supply without insurance.)
Speak with your doctor if you’re curious about taking metformin, the pros and cons of the medication, and whether including it in your diabetes regimen is appropriate for you.
Learn more about this medicine in: Everything You Need to Know About Metformin.
