Type 2 diabetes mellitus is treated with the oral prescription drug metformin, which belongs to the biguanide drug class. Diabetic patients typically have other clinical symptoms such as hypertension, high cholesterol, and cardiovascular disease.
The two kinds of diabetes are type 1 and type 2. To address their hyperglycemia, several oral and injectable treatments are available for type 2 diabetics.
Haemoglobin A1C, a serum lab result, is commonly used to assess long-term blood sugar management (HbA1C). The first line of therapy for Type 2 diabetes control is metformin. In general, it is a wise, efficient, and economic decision.
Metformin lowers blood sugar levels by reducing the liver's synthesis of glucose. Hypoglycemia, or severely low blood sugar, is an uncommon side effect.
The insulin resistance brought on by polycystic ovarian syndrome is also treated in patients using metformin. Sadly, not everyone will qualify for metformin treatment.
Anyone who has previously had a hypersensitivity reaction to metformin or any other biguanides cannot take it (a group of oral diabetes medications that work by preventing glucose production in the liver). Patients with significant renal impairment (kidney damage) should also avoid using metformin.
How should this medication be taken?
The oral forms of metformin include liquid, tablet, and extended-release (long-acting) tablets. The usual tablet is taken with meals twice or thrice daily, and the drink is often consumed with meals.
One dose of the extended-release medication is frequently taken with supper. Take metformin at approximately the same time(s) each day to make it easier for you to remember to take it. Ask your physician or pharmacist to understand the instructions on your medication label that you need clarification on. Follow the metformin directions properly.
Only take it in smaller or fewer amounts or more frequently than directed by your doctor. Do not split, chew, or crush the extended-release metformin tablets; swallow them whole.
Diabetes is not cured by metformin, although it may be managed. Although if you feel good, keep taking metformin. Without consulting your doctor, do not discontinue taking metformin.
Metformin natural alternatives
People with insulin sensitivity problems, such as diabetes or PCOS, could look for a natural metformin substitute. Remember that before quitting any prescription drugs, you should always talk to your doctor.
There are several natural metformin alternatives to take into account, including:
People frequently utilize the plant chemical berberine as a natural metformin substitute for PCOS and diabetes. According to studies, it can help lower blood triglyceride levels & waist measurement, which are two indicators of insulin resistance, while also increasing insulin sensitivity.
Berberine could help people lose weight. Participants in the same trial who took berberine also experienced lower blood pressure, which is significant because diabetes raises the risk of cardiovascular disease.
Experimental research directly examined the ability of berberine and metformin to treat type 2 diabetes. The scientists discovered that berberine had the same beneficial effects on blood glucose metabolism as metformin.
With the treatment of berberine, A1c, rising blood sugar, gastric blood sugar, and sugar levels all improved. In this trial, 500 mg was administered three times each day. When lowering blood lipids like cholesterol and triglycerides, berberine exceeded metformin.
2. D-chiro inositol and myo-inositol
These vitamin-like compounds resemble the effects of insulin. Myo- and D-chiro inositol were investigated for their potential to increase insulin sensitivity, and they are frequently suggested to PCOS patients to reduce symptoms and boost fertility.
In persons with PCOS and diabetes, inositol can lower blood sugar levels, and it has even been investigated for its ability to reduce the occurrence of type 2 diabetes in children. In studies involving insulin-resistant women, inositol and metformin have been directly compared.
The favourable effects of metformin and Myo-inositol on insulin, fasting blood sugar, and PCOS-related hormone levels were comparable. According to a different study, inositol was superior to metformin at lowering excessive testosterone in PCOS-afflicted women, which is frequently the cause of irregular menstrual periods and infertility.
3. N-acetyl-cysteine (NAC)
N-acetylcysteine is used by the body to create antioxidants. Little research found that NAC increases insulin sensitivity in women with PCOS and insulin resistance.
More blood sugar may reach the cells where it is required when insulin sensitivity increases, which lowers the high amounts of sugar in the blood. NAC reduces inflammation and functions as an antioxidant.
Inflammation contributes to the development of type 2 diabetes, which is another reason it could be helpful as a natural metformin substitute in people with type 2 diabetes.
Cinnamon consumption can considerably lower triglyceride, total, and LDL (low-density lipoprotein) "bad" cholesterol levels while raising HDL (high-density lipoprotein) "good" cholesterol.
Cinnamon is a potentially safe and well-tolerated natural metformin alternative.
Turmeric's key ingredient, curcumin, gives it its deep, golden colour. Since it has shown strong antioxidant capabilities, it is a well-liked supplement among those looking to enhance general health and minimize inflammation.
Research on curcumin in diabetic rat models shows that it may be advantageous for lowering insulin resistance, enhancing blood lipids, and enhancing blood sugar levels.
But before it can be firmly advised as a natural metformin substitute, the researchers emphasize that studies on human subjects must be conducted to evaluate its potential effectiveness in people.
6. Herbal Remedies
People are using a rising range of medicinal plants to cure diabetes. These consist of the following:
These have been used as traditional diabetic treatments for a long time, and research indicates that some may help lower blood sugar. Researchers point out that there needs to be more data on their interactions with other therapies.
Switching medications or utilizing natural remedies to manage diabetes is risky without consulting a doctor.
How to swap to a Metformin Alternative
Talk to your doctor if you think metformin is not the best diabetic medication. Metformin is a first-line therapy since it is both highly effective and inexpensive. Stop taking metformin only after consulting your doctor for medical advice.
Metformin immediately stopping might result in hyperglycemia. You should only stop taking metformin suddenly if you experience an allergic reaction. A few factors call for an alternative to metformin to be considered.
To allow your doctor to monitor your kidney function, you should ensure your test results are current. This includes kidney disease and chronic GI side effects. Your doctor will discuss your alternatives depending on your physical results if the choice to change is made.
Precose is an alpha-glucosidase inhibitor that prevents the small intestine from converting sucrose to fructose and glucose. It also adds to delayed digestion, absorption, and uptake of carbohydrates.
Precose is only clinically useful when eating a diet rich in complex carbs and needs to be consumed before a meal. Precose comes in oral tablet form with 25, 50, and 100 mg dosages.
2. Onglyza, Januvia, Tradjenta, and Nesina
The medications known as dipeptidyl peptidase four inhibitors include Januvia, Tradjenta, and Onglyza (DPP-4 inhibitors). Glucagon-like peptide 1 (GLP-1) is a hormone that enhances insulin release in the digestive system.
The likelihood of hypoglycemia is relatively minimal. Unfortunately, it is easily broken down, but DPP-4 inhibitors prevent this from happening in the stomach, prolonging the effects of GLP-1 and improving glucose management. DPP-4 inhibitors are available in a range of strengths and are taken orally once daily.
3. The Glucagon-Like Peptide-1 receptor (GLP-1 RAs)
In the search for the best therapy for Type 2 diabetes, GLP-1 RAs have been a significant advancement in medical science. To mimic the effects of GLP-1 and trigger the release of insulin in response to the presence of glucose, these medications attach to the GLP-1 receptors in the stomach.
They are known to reduce appetite, decrease stomach emptying, and stop the post-prandial (after-meal) glucose rise. Indications for GLP-1 RAs include a decrease in cardiovascular events such as heart attack, heart failure, and stroke.
While Ozempic, Trulicity, and Bydureon Bcise are given once weekly, Victoza is prescribed once daily. These medications come in a range of doses and are injectable. Amounts are typically raised gradually to reduce GI adverse effects, including nausea and diarrhoea.
4. Thriazolidinediones: Actos, Avandia
Actos and Avandia are thiazolidinediones that attach to receptors in fatty tissue to encourage fat cell development and fat deposition in peripheral tissues.
Reducing circulating lipid complexes improves insulin sensitivity. Thiazolidines, unfortunately, have a side effect known as weight gain and increased body fat mass. Thiazolidines are oral drugs used once or twice a day, and they come in various strengths.
5. Prandin (repaglinide)
This reduces blood sugar levels fast, but in people who have never used comparable medications, it might cause weight gain and a lack of blood sugar control, which may result in hypoglycemia.
Additionally, it could interact with other drugs. According to the Food and Drug Administration, individuals with severe renal issues may be required to start with a lower dosage than others (FDA).
6. Canagliflozin (Invokana)
This medication decreases blood sugar and lowers the risk of developing cardiovascular disease. However, it also raises the possibility of amputation need.
The condition, known as peripheral arterial disease, affects the hands and feet's blood vessels. Neuropathy, or nerve damage, can lead to trouble with the entire body, including the feet.
7. Dapagliflozin (Farxiga)
It may be helpful for people with diabetes who run the risk of complications of this nature since it decreases blood sugar and lowers the risk of atherosclerosis or cardiovascular disease.
8. Empagliflozin (Jardiance)
This can be used alone or in combination with other medications, such as metformin. It lowers blood sugar without needing insulin and might lower blood pressure and body weight.
It doesn't put you at greater risk of amputation or bone fracture, but it can help preserve your renal and cardiovascular health.
Metformin is a common medication for treating diabetes and other disorders like polycystic ovarian syndrome linked to insulin resistance. As you'll see, there are several alternative drugs that you might be able to try before having to start taking insulin, even though metformin and lifestyle changes are still the first-line treatments for type 2 diabetes.
Before switching to insulin injections, utilizing a GLP-1 receptor agonist or an SGLT-2 inhibitor is frequently more beneficial, depending on your sensitivity to problems like heart or renal illness. Some people prefer to look for a natural metformin substitute to assist their health concerns.
There may be alternative solutions that might help you better control your diabetes, as there is no direct route from metformin to insulin. Inositol, berberine, N-acetyl-cysteine, cinnamon, and curcumin are possible natural metformin substitutes. If one of these medications may help you, discuss it with your doctor or nurse.
Despite these warnings, it's fascinating to see evidence of natural metformin alternatives that may successfully treat diabetes and insulin sensitivity.