Metformin: what is it for? Does it cause weight loss?

In use by the pharmaceutical industry since the 1950s, metformin hydrochloride is one of the most commonly used active ingredients by people with diabetes , especially type 2.

However, metformin can be indicated by doctors in other situations and can bring benefits that go beyond improving the performance of the hormone insulin in the body. Therefore, learn more about the medicine in the course of this text.

What is metformin hydrochloride?

Metformin hydrochloride is an anti-diabetic active ingredient used in the treatment of people who need to control the blood sugar level and, consequently, prevent the onset of complications resulting from this condition.

Due to this purpose, metformin hydrochloride belongs to the class of biguanides, a group of drugs that have antihyperglycemic action, but that do not affect the release of insulin (the hormone responsible for controlling blood sugar). Therefore, metformin is widely prescribed by doctors, especially in cases of type 2 diabetes. When it comes to type 1 diabetes, the drug is indicated only as a complement to insulin therapy .

In addition, metformin can be indicated in situations where there is no diabetes, but the performance of insulin is unregulated (which can lead to the condition), as occurs in Polycystic Ovary Syndrome.

The use of the component is extremely contraindicated for patients who have kidney failure or severe liver disease. Therefore, it is necessary to undergo medical evaluations before starting to use the drug.

Diabetes (type 1 and 2, pre, gestational): see the care

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What is it for: is it a medicine for diabetes?

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Metformin can be included in the treatment of those who have type 2 diabetes and also as a complement to insulin therapy in the case of type 1 diabetes.

In general, metformin hydrochloride is prescribed by a doctor for the treatment (or prevention) of type 2 diabetes, and also serves as a supplement to the treatment of type 1 diabetes together with insulin.

Type 1 diabetes

The term diabetes is used to refer to a chronic condition that makes the body unable to control the level of glucose in the blood, either due to the lack of the hormone insulin (responsible for this action) or the inability of this substance to act.

Type 1 diabetes (also called insulin-dependent diabetes, childhood diabetes or immune-mediated diabetes) occurs when there is a change in the patient’s immune system, causing pancreatic cells to fail to produce insulin, which consequently results in increased blood pressure. sugar levels in the body.

This problem happens due to a process of self-destruction, since the immune system sees pancreatic cells as harmful to the body, thus promoting the fight against these cells.

According to the Brazilian Diabetes Society, people diagnosed with type 1 diabetes correspond to between 5% and 10% of the total cases of the disease and are more common in children and adolescents.

Typically, people who have type 1 diabetes start treatment before adulthood, with daily use of insulin injections (insulin therapy) to replace the hormone that is not naturally produced and, in some cases, with antidiabetics such as metformin to help ensure insulin efficiency.

Type 2 diabetes

Type 2 diabetes is the most expressive classification, since it represents, according to the Brazilian Diabetes Society, 90% of the cases of the disease. In general, this type of diabetes develops due to genetic factors or due to bad habits in the routine, such as excessive sugar consumption and not practicing physical activity.

Unlike type 1, type 2 diabetes does not occur due to a lack of insulin, but due to the misuse of the substance by the body.

In an attempt to reverse the situation, the pancreas begins to produce the hormone in high quantities, but when it realizes that insulin still finds it difficult to penetrate cells and regulate sugar, the organ stops producing the substance.

When the body reaches this point, it is concluded that the patient is resistant to insulin and, in contrast to receiving injections of the hormone, must use drugs that help control blood glucose, such as metformin.

In that case, metformin will cause the liver to release less glucose (stored in the form of glycogen) into the blood and will also reduce the resistance of the tissues (especially muscles) to the action of insulin. This allows the hormone produced to be better used.

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects the female reproductive system, causing the formation of numerous cysts in the ovaries. The symptoms that characterize this disease are enlarged ovaries, irregular menstrual cycle, overweight, increased hair, acne and difficulty in becoming pregnant.

However, each case is unique, so it is necessary to consult a gynecologist who will confirm the condition and indicate the best treatment. According to the Brazilian Diabetes Society, due to the disease, there are greater chances for the condition of diabetes.

Thus, the use of metformin, in this situation, will be prescribed for patients who are more resistant to insulin as a symptom of PCOS and, consequently, may develop type 2 diabetes.

What does metformin do?

Metformin is popularly known as an antidiabetic, because its mechanism of action is very effective in the treatment and prevention of this disease. In general, it helps as follows:

  • Reducing glucose production:   the regular use of metformin helps to inhibit the biochemical processes called gluconeogenesis and glycogenolysis, responsible for the accumulation of unused glucose in the liver tissues;
  • Slowing the absorption of glucose: the medication also acts on the process of absorption of sugar molecules by the intestine, slowing it down, which helps to maintain adequate glucose levels in the body;
  • Increasing the efficiency of insulin: metformin hydrochloride allows cells (muscle) to absorb glucose better, especially the peripheral one, ensuring a good use of sugar and greater sensitivity to the action of insulin.

What dosages are available?

Metformin hydrochloride can be taken in several ways, which vary according to the disease being treated.

The dosages available for the use of metformin are usually individualized, since some factors interfere with the exact amount for treatment, such as, what type of disease will be treated and which other drugs will be used. Therefore, it is essential to follow medical guidelines.

In general, metformin can be prescribed in doses of 500mg, 850mg and 1g, and the patient can start by taking a pill of a certain dose that can increase or decrease as the treatment progresses.

In relation to the schedule, it is recommended to take metformin in the morning , during the first meal of the day, if a single dose is prescribed per day .

Those patients who received an indication to  take 2 tablets , should do so during breakfast and also at night, at dinner. And finally, patients who need 3 servings daily , should take it during the 3 main meals of the day, breakfast, lunch and dinner .

It is important to note that the daily dose of metformin is 2500mg , so regardless of taking 1, 2 or 3 times a day, this amount should never be exceeded.

How to take metformin?

The correct way to take metformin hydrochloride varies according to the needs of each patient. Therefore, only a specialized doctor will know how to guide the appropriate dosage for treatment. However, it is generally common to take metformin as follows:

Type 1 diabetes

For adult people who have type 1 diabetes, in which it is necessary to use daily insulin injections (according to medical recommendations), metformin hydrochloride is a medication administered to complete the treatment.

Therefore, when starting, a metformin tablet is recommended 2 to 3 times a day, depending on the quantity (there are 500mg and 850mg tablets).

Type 2 diabetes

Those who have type 2 diabetes, in other words, there is no need to use insulin injections in most cases. insulin from beta cells in the pancreas).

In some cases, the patient begins treatment by taking metformin in tablets of 500mg or 850mg, 2 or 3 times a day, which increases if the doctor considers it necessary.

Polycystic Ovary Syndrome

As in cases of diabetes, metformin hydrochloride is one of the drugs that make up the treatment for Polycystic Ovary Syndrome, along with those that treat common symptoms (acne, irregular menstruation, infertility) such as contraceptives and medications that stimulate ovulation.

In general, it is common for women to start taking low doses of metformin (on average 850mg), which gradually increase over time. Usually, the daily dose is 1500mg (total sum of doses).

What is the best time to take metformin?

In general, there is no specific schedule considered to be the best time to take metformin, however it is always recommended to take it, initially, after meals (regardless of whether it is breakfast, lunch or dinner), as this way it is possible to guarantee that the adapt more easily to the medication.

Side effects: what can metformin cause?

Usually, metformin does not cause side effects (considering that the person is following the dosage correctly), however, in some cases, some patients may be more sensitive to the drug and have reactions after taking it. The most common symptoms are nausea, nausea, diarrhea and metallic taste in the mouth.

These symptoms, in general, do not persist for a long time, since they usually appear when you start using metformin. Therefore, it is expected that after a few weeks, when the body is already adapted to the drug, the reactions will cease.

However, if this does not occur (or the symptoms worsen), it is necessary to consult a doctor and perhaps discontinue the medication.

Why does metformin lose weight?

It is suspected that weight loss occurs due to the mechanism of action of metformin, which by stimulating the efficient action of insulin (a hormone that in addition to controlling the glycemic rate also increases the formation of fat) , ends up causing the insulin to stop accumulating in the blood and, as a consequence of intensifying the production of fat, helping in weight loss.

It is worth mentioning that not all diabetic patients who use metformin will have reduced measures.

Those who will have this benefit, usually, will not be immediately, as the weight reduction is gradual and tends to occur after the period of 1 to 2 years. In addition, the amount of weight lost varies from person to person.

Who does not have diabetes can take metformin to lose weight?

It is contraindicated, according to the Brazilian Diabetes Society, the use of metformin hydrochloride by people who are not diabetic or have diseases that increase the blood sugar rate. Therefore, it is not healthy to use metformin hydrochloride in order to lose weight, since the drug does not have this purpose and can cause unexpected side effects.

It is important to highlight that the best way to lose weight is to follow an adequate diet and practice regular physical activities and, if possible, with the guidance of trained professionals.

Brands and prices

The active ingredient metformin hydrochloride can be found in generic versions (without commercial name) or in brands, such as:

  • Diaformin
  • Dimefor
  • Glifage
  • Metformed

In the case of price, it is common for there to be variation between the values, since factors such as the laboratory in which it was manufactured, the dosage and the mechanism of action (prolonged or not) interfere in the final price of the drug. On average, the price * of the antidiabetic metformin is between R $ 5 and R $ 100.

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