Hypoglycemia also called low blood sugar, occurs when the level of sugar (glucose) in your blood falls below normal. Glucose is the primary source of energy for the body. It comes from the food we eat and is stored in the liver.
Alcohol can be a major contributor to high blood sugar levels. When alcohol is consumed, the body breaks it down into sugar. This sugar can then contribute to high blood sugar levels, especially if someone is diabetic or prediabetic. In addition, alcohol can also interfere with diabetes medication and cause blood sugar levels to become dangerously high. For people with diabetes, it is important to be aware of the effects that alcohol can have on blood sugar levels and to take steps to avoid any potential problems.
Hypoglycemia may be caused by:
- Not eating enough food or the right kind of food
- Taking too much insulin or other medicines that lower blood sugar levels
- Not taking enough Glucophage/metformin (this may be used when you do not eat for some time)
Hypoglycemia Symptoms
- Hunger (feeling very hungry)
- Shakiness (tremor)
- Anxiety ( feeling worried, nervous, or uneasy)
- Sweating
- ale skin
- A heartbeat that feels fast or irregular
- Headache
- Dizziness
- Weakness
- palpitations
- anxiety
- weakness
- hunger
- tingling lips or fingers
If you have any of these symptoms, drink a glass of fruit juice or regular soda, eat a small snack such as four or five crackers, or take half of your Glucophage/metformin. If you still have symptoms, drink another glass of juice or soda, eat another snack, and then take the other half of your Glucophage/metformin. Seek medical help if you do not feel better.
If you have symptoms of severe hypoglycemia, such as trouble speaking or understanding or seizures, seek help immediately.
Alertness can be helped by eating something sweet, so if you think that the problem is due to hypoglycemia because of your Glucophage/metformin, eat something sweet.
Does Metformin Cause Hypoglycemia?
Metformin rarely causes hypoglycemia (low blood sugar levels) because it does not alter insulin production by the pancreas and does not induce substantial insulin increases. Hypoglycemia caused by metformin toxicity or overdose has been linked to lactic acidosis. Increased glucose consumption due to anaerobic metabolism, combined with a decreased oral intake of food and carbohydrates, reduced liver glucose production, and restricted glucose absorption is considered to be the reasons.
Hypoglycemia can also be caused by Metformin taking with a poor diet or other medicines that trigger hypoglycemia, such as sulfonylureas. Metformin does not induce hypoglycemia when taken as directed by a physician.
What is Metformin?
Metformin (Glucophage, Fortamet, Glumetza, Riomet) is a prescription drug used to treat type 2 diabetes. It helps control blood sugar levels by decreasing the amount of glucose made by the liver and increasing the body’s response to insulin. Metformin belongs to a class of drugs known as biguanides.
Metformin is typically taken twice a day with meals. In some cases, your doctor may recommend that you take medicine only once a day at bedtime instead of with breakfast and lunch. Metformin should be taken around the same time each day, and it can be taken either with or without food.
Metformin is sometimes taken in combination with other diabetes medications, such as glyburide (Diabeta, Micronase), glipizide (Glucotrol), or rosiglitazone (Avandia). Your doctor will determine the exact dosage of Metformin that’s right for you.
What is Glucophage?
Glucophage (Metformin) is a prescription drug used to treat type 2 diabetes. It works by decreasing the amount of glucose made by the liver and increasing the body’s response to insulin. Metformin is a biguanides. Glucophage is taken by mouth. It may be used with insulin and other medications, but it is not for treating type 1 diabetes.
It’s important to discuss all other medications you’re taking with your doctor before beginning treatment with Glucophage, like certain drugs that may also lower blood sugar (glucose).
How Does Metformin Work?
Metformin is a biguanide, which is a class of anti-diabetic medications. Metformin works by decreasing the amount of glucose made by the liver and increasing the body’s response to insulin. That decrease in liver production is one reason why it’s not a good idea to take Metformin with acetaminophen (Tylenol). Metformin can compete with the acetaminophen for elimination in the liver and could cause too-low an acetaminophen level, leading to an overdose.
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How Should I Take Metformin?
You should begin taking Glucophage at the dose prescribed by your doctor. You may be asked to start Glucophage with a low dose and increase the dose gradually. Glucophage is usually taken 2 or 3 times a day with meals. You may be asked to take it at bedtime instead of during the daytime. If you miss a meal, do not take your Glucophage dose.
Glucophage can be taken with or without food.
Your doctor will determine the exact dosage that’s right for you based on your medical condition and response to treatment. You should continue taking Glucophage even when you feel well. Do not stop taking Glucophage without talking to your doctor first, as this could be a severe medication mistake.
What Are the More Usual Side Effects of Metformin?
The more usual side effects of Glucophage include:
- Heartburn
- Stomach pain
- Nausea
- Vomiting
- Bloating
- Diarrhea
- Constipation
- Weight loss
- Gas
- Headache
- Metallic taste in the mouth
These symptoms are not usually severe and should go away as your body adjusts to the medication. Call your doctor if you continue to have these symptoms and do not go away.
What Are the Severe Side Effects of Metformin?
Lactic acidosis is a rare but severe side effect of Metformin when kidney or liver problems. People who have liver problems often have difficulty processing Metformin. This can cause high levels of Metformin in the blood and potentially severe side effects, such as lactic acidosis. Lactic acidosis is when too much lactic acid is in the blood. It is more likely to happen when you are dehydrated from not drinking enough fluids. Your doctor will monitor your kidneys and liver while taking Glucophage, especially if you have other medical conditions such as heart failure, liver disease, or kidney disease.
Symptoms of lactic acidosis:
- muscle pain or weakness
- numbness or tingling in your arms and legs
- severe tiredness
- difficulty breathing
- stomach pain with nausea and vomiting
- diarrhea
- unusual fast heart rate
- metallic taste in your mouth
- glossitis (inflammation of the tongue)
- poor appetite
Other serious side effects of Metformin include:
- severe allergic reaction, including anaphylaxis
- low blood sugar (hypoglycemia)
Side Effects of Metformin During Pregnancy
There have not been many studies on the use of Metformin during pregnancy. However, some research suggests that taking Metformin during pregnancy may not increase the risk of congenital disabilities. However, pregnant women should only take Metformin if prescribed by their doctor.
Metformin can cause low blood sugar levels in newborns if the mother takes the drug while breastfeeding. Newborns of mothers who take Metformin should be monitored for low blood sugar levels.
Managing the Side Effects of Metformin
Metformin’s most frequent adverse effects are on the digestive system. You can reduce your chance of suffering from side effects by following these steps:
- Begin with a small amount. It’s best to start at a low dose and work your way up over time to minimize the chance of adverse effects. A typical starting dosage is 500 milligrams.
- Taking Metformin with food can help you avoid an upset stomach or gastric discomfort.
- Taking Metformin in a long-term, extended-release form. Extended-release Metformin might be appropriate for you and should be discussed with your doctor. This type of Metformin takes time to release fully and typically has less severe side effects. Make sure you talk about the FDA’s recall of certain metformin extended-release to ensure you’re getting a safe version.
- Taking pills as they are. Pills should not be crushed. Doing so may cause the medicine to be absorbed more quickly.
- If you experience adverse symptoms, it’s a good idea to contact your doctor. They may advise increasing the dose of the metformin type you’re taking. During stress, you could discover that your dosage needs to be adjusted.
- When you drink too much alcohol, it’s also a good idea to limit yourself to one drink per hour when taking Metformin since this can raise your chances of developing lactic acidosis.
Risk Factors for Experiencing Side Effects
When you take Metformin, several factors put you at risk of lactic acidosis. If any of these variables apply to you, make sure to discuss them with your doctor before beginning treatment.
Kidney Problems
Metformin is eliminated from the body by your kidneys. If your kidneys are damaged, metformin levels in your system will rise. Lactic acidosis is a potentially fatal condition caused by this.
If you have mild or moderate kidney issues, your physician may begin you on a lower dose of Metformin.
If you have severe kidney problems or are 80 years old or older, Metformin may not be the best medicine for you. Your doctor will check your kidney function before and after you start taking Metformin to determine whether it’s a good fit for you.
Heart Problems
Individuals should not take Metformin with acute heart failure or recent myocardial infarction. Your heart’s ability to pump blood to your kidneys may be reduced. This would keep your kidneys from excreting Metformin at the usual rate, increasing the likelihood of lactic acidosis.
Liver Problems
If you have severe liver issues, do not take Metformin. Your liver removes lactic acid from your body.
A buildup of lactic acid might result from severe liver difficulties. Lactic acid accumulation raises your risk of lactic acidosis. Metformin also increases your chance of developing Metformin, so it’s not a good idea to take it if you have liver issues.
Alcohol use
When you drink alcohol while taking Metformin, your danger of hypoglycemia rises. It also increases the risk of lactic acidosis because it raises lactic acid levels in your body.
While taking Metformin, you should not consume large amounts of alcohol. Long-term alcohol consumption and binge drinking are examples of situations that fall into this category. If you drink alcoholic beverages, talk to your doctor about the amount of alcohol permissible for you while on Metformin.
What foods or beverages should I avoid while taking Metformin?
You should avoid drinking large amounts of grapefruit juice while taking Metformin. Grapefruit juice can increase the amount of Metformin in your blood, which increases the risk for lactic acidosis.
Metformin can interact with many other medications, including:
- Pain relievers such as aspirin,
- Ibuprofen (advil, motrin),
- Naproxen (aleve),
- Celecoxib,
- Diclofenac,
- Indomethacin,
- Meloxicam, and others.
Can I drink alcohol while taking Metformin?
You should not drink alcohol if you are taking Metformin. Alcohol can cause low blood sugar levels.
How long does Glucophage/Metformin stay in your system?
The length of time Metformin stays in your body system will depend on its taking. The most common type of Glucophage usually (Metformin) remains in the system for about 4 to 5 hours after being taken as directed by a doctor.
Is Invokana the same as Metformin?
No, Invokana is a type of diabetes medicine class called SGLT2 inhibitors. This type of medication helps the kidneys get rid of glucose from the body through urination.
Can you take Metformin and phentermine together?
Metformin pills (Glucophage) can be taken with phentermine pills. If you are currently taking Metformin, your doctor may want to start you on a lower dose of phentermine. Be sure to follow your doctor’s instructions carefully.
Can I take Metformin with antibiotics?
Yes, there is no problem taking antibiotics and Metformin together. However, contact your doctor if you are experiencing side effects such as stomach pain, nausea, or vomiting.
Does Metformin cause weight loss?
Some people who take Metformin have experienced undesired weight loss. Talk to your doctor if you have trouble gaining the weight you need while taking this medication.
Can I take Metformin if I have kidney disease?
People with kidney disease or problems with kidney function, liver disease, cancer, stomach/abdominal surgery should not take Metformin without first talking to their doctor.
When should Metformin be stopped?
If you are experiencing symptoms of lactic acidosis, such as nausea, vomiting, stomach pain, decreased appetite, trouble breathing, tiredness, dizziness or drowsiness, feeling cold, especially in your arms and legs.
What is Glucovance?
Glucovance is a combination drug that contains both Metformin and glyburide. It is used to treat type 2 diabetes.
Can Metformin cause pancreatitis?
There have been rare cases where people taking Metformin have developed pancreatitis, a condition that causes the pancreas to become inflamed. If you experience any following symptoms while taking Metformin, stop taking the medication and contact your doctor right away: upper abdominal pain radiating to the back, nausea, vomiting. Keep in mind that these symptoms can also signify lactic acidosis.
Can Metformin cause anemia?
Long-term use of Metformin (Glucophage) can lead to a vitamin B12 deficiency. This will cause you to develop anemia, making you feel weak or tired. Your doctor should monitor your vitamin B12 levels while taking this medication.
Is there any difference between Metformin and Glucophage?
Glucophage and Metformin are the same things. They both refer to a type of drug known as Metformin, used to treat high blood sugar levels caused by a type of diabetes mellitus known as Type 2 Diabetes Mellitus.
Ref Paper: https://www.tandfonline.com/doi/abs/10.3109/15563650.2013.784774
