Individuals aiming to manage their type 2 diabetes through medication might be advised to consider metformin for enhancing their health. Metformin, an antidiabetic medication in use since 1994, continues to be a recommended choice by many healthcare professionals within diabetes care plans.

At present, the American Diabetes Association suggests metformin for individuals who:

  1. Exhibit prediabetes and fall within the age range of 25 to 59.
  2. Have an HbA1c level of 6% or above.
  3. Possess a BMI of 35 or higher.
  4. Experience a fasting plasma glucose level of 110 mg/dL or more.
  5. Have a history of gestational diabetes.
  6. Have received a diagnosis of type 2 diabetes.

To gain a deeper understanding of how this medication functions, it is advisable to explore its mechanisms further, enabling more informed discussions with your primary care physician about potential treatment options.

How Long Does It Take for Metformin to Work?

Fundamentally, Metformin operates by diminishing the absorption and production of sugar in the body. While its effects can start to manifest within 48 hours of the initial dose, it may require a minimum of 6 to 12 weeks to achieve maximum effectiveness.

The active components of metformin necessitate time for the body to synergize with them. These components instruct the liver to decrease its typical glucose production while enhancing the body's responsiveness to insulin. These substantial alterations demand time, particularly in cases of severe diabetes, where the patient's condition may necessitate a more extended period for noticeable changes to occur.

Signs Metformin Is Working

Curious about how metformin functions and the potential positive impacts on daily life? Here are six indicators suggesting that metformin is effectively reducing symptoms of hyperglycemia:

  1. Balanced Blood Sugar Levels: Health experts recommend monitoring blood sugar levels frequently for individuals with diabetes. Post-commencement of a metformin prescription, blood tests should reflect improved balance within a few days. Over time, metformin becomes more adept at lowering blood glucose levels, reducing the occurrence of drastic spikes in subsequent weeks and months.
  2. Increased Energy: As blood sugar levels stabilize long-term, metformin contributes to heightened energy levels. With improved glucose absorption, your body efficiently utilizes sugar, providing increased energy to your mind and organs. This boost may also lower the risk of cancer by enhancing cell activity against cancer-causing free radicals.
  3. Glycemic Control: Better control over high blood sugar spikes is a positive outcome of metformin usage. The medication enhances the body's ability to restore glycemic control, ensuring a more balanced natural glucose-insulin relationship.
  4. Weight Loss Management: A slight to moderate weight loss is indicative of metformin's efficacy. By improving sugar processing, the medication reduces sugar storage in fat cells. This effect is particularly encouraging for individuals struggling with obesity or weight gain associated with other medications.
  5. Reduced Bathroom Trips: In diabetes, improper glucose processing leads to increased glucose in the blood, prompting additional urine production by the kidneys. Metformin's side effect includes less frequent urination, as reduced blood glucose levels result in decreased urine production, subsequently reducing thirst.
  6. Decreased Hunger: Metformin's impact on glucose processing becomes evident in reduced hunger signals. While it may take a few days for metformin to exhibit its effects, you'll notice diminished hunger as your body more efficiently converts glucose into energy, reducing the need to eat frequently.

Read Also: Flexeril Tablet - Uses, Side Effects, and More

Pros and Cons of Metformin

Pros of Metformin

  • Effective Blood Sugar Control
  • Low Risk of Hypoglycemia
  • Weight Loss
  • Cardiovascular Benefits

Cons of Metformin

  • Gastrointestinal Side Effects
  • Lactic Acidosis Risk
  • B12 Deficiency
  • Takes Time to Reach Full Effectiveness

Differences Between Metformin and Hydroxyzine


  • Metformin is primarily used to treat type 2 diabetes. It helps control blood sugar levels by improving the body's response to insulin and reducing the amount of glucose produced by the liver.


  • Hydroxyzine is an antihistamine that is used to relieve symptoms of allergic reactions, such as itching, hives, and skin rashes. It can also be used to treat anxiety and tension, and as a sedative before surgery.

Alternative to Metformin

GLP-1 Receptor Agonists

  • Medications like exenatide (Byetta, Bydureon), liraglutide (Victoza, Saxenda), and dulaglutide (Trulicity) mimic the action of a gut hormone, increasing insulin secretion and slowing down digestion to reduce blood sugar levels.

Signs Metformin Is Not Working

Metformin is associated with potential side effects, but their occurrence does not necessarily imply the medication is ineffective. If you encounter any of the following side effects, and they persist or worsen over a few weeks, it is advisable to consult your healthcare provider:

  1. Nausea
  2. Vomiting
  3. Diarrhea
  4. Decreased appetite
  5. Weight loss
  6. Metallic taste in your mouth
  7. Heartburn
  8. Bloating
  9. Constipation
  10. Stomach pain

Moreover, here are some signs that metformin might not be functioning optimally in your body. If you notice any of these symptoms affecting your quality of life, it is crucial to discuss them with your doctor:

  1. Blood Sugar Spikes: Despite adhering to a low-to-no-sugar diet and regular physical activity, persistent blood sugar spikes may indicate a need for discussion with your doctor.
  2. Fatigue: If you experience fatigue after starting metformin, it could suggest that the medication is not achieving its intended effects on glucose conversion.
  3. Hunger: Consistent feelings of hunger may signal that your body isn't obtaining sufficient energy from glucose. Discuss any concerns with your doctor to evaluate the appropriateness of the medication or its dosage.
  4. Weight Gain: Despite maintaining the same diet and exercise routine, unexpected weight gain could imply that your glucose sensitivity has not improved as anticipated.
  5. Headaches: Metformin is expected to reduce headaches by stabilizing blood sugar levels. If headaches persist or increase after starting the medication, consulting your doctor is advisable.
  6. Increased Thirst: Metformin should decrease thirst by enhancing glucose absorption. If you find yourself drinking more fluids than usual, it may indicate that the medication is not achieving the desired effect. Discuss this with your doctor for further evaluation.

What if Metformin Is Not Working?

The initial dosage of metformin may prove ineffective, possibly due to it being too low for optimal results. In such cases, your doctor might choose to incrementally raise your dosage once or twice to identify the most suitable amount for your body.

Additionally, based on your health history, your doctor can explore and discuss alternative treatment options. It's important to note that if metformin doesn't yield the desired outcomes, it doesn't necessarily signify a negative outcome. Instead, it indicates that alternative approaches may offer more effective solutions for your specific situation.

What to Do if Metformin Has Stopped Working

Metformin is commonly prescribed following lifestyle adjustments such as changes in diet, regular exercise, and weight loss. If metformin proves ineffective in controlling blood sugar levels, it may result in the accumulation of excess glucose in the bloodstream, leading to potential complications including high blood pressure (hypertension), coronary artery disease, peripheral artery disease, stroke, chronic kidney disease, diabetic retinopathy, diabetic neuropathy, glaucoma, and/or cataracts.

Should metformin cease to be effective, your doctor may consider increasing the medication dosage. Starting with a lower dose and allowing a few weeks for it to take effect can be beneficial before considering a prescription strength adjustment.

If higher dosages do not produce the desired changes or exacerbate symptoms, your primary care provider might recommend alternative medications. Some common options include:

  1. Actos (Pioglitazone)
  2. DPP-4 Inhibitors: Januvia (sitagliptin), Tradjenta (linagliptin), Onglyza (saxagliptin), and Nesina (alogliptin)
  3. GLP-1 Agonists: Bydureon (exenatide), Byetta (exenatide), Saxenda (liraglutide), Mounjaro (tirzepatide), and Adlyxin (lixisenatide)
  4. Injectable Insulin
  5. SGLT2 Inhibitors: Invokana (canagliflozin), Farxiga (dapagliflozin), Jardiance (empagliflozin), and Steglatro (ertugliflozin)
  6. Sulfonylureas: Amaryl (glimepiride), Glynase (glyburide), and Glucotrol (glipizide)

If metformin or other medications are not deemed suitable, your doctor may suggest other treatment options. Insulin therapy, which acts quickly within 30 minutes, or incretin-based therapies, effective after meals, are potential alternatives to consider.


While metformin serves as a valuable tool in managing type 2 diabetes, its effectiveness may vary among individuals. The medication is often recommended after lifestyle adjustments, such as diet, exercise, and weight loss, have been explored. Monitoring for signs of its efficacy, such as balanced blood sugar levels, increased energy, and improved glycemic control, is crucial.

If metformin proves insufficient in controlling blood sugar or if side effects become challenging, a thoughtful and collaborative approach with your healthcare provider is essential. Adjustments in dosage, considering alternative medications, or exploring other treatment options may be necessary to achieve optimal outcomes. It's important to communicate openly with your doctor, addressing any concerns or symptoms that may arise during the course of treatment.

In the broader context, the goal remains effective diabetes management to mitigate potential complications. Regular follow-ups with your healthcare provider allow for ongoing assessment and adaptation of the treatment plan, ensuring the best possible outcomes for your unique health needs.


My name is Wisdom Bassey, I'm a blog content writer and graphic designer who provides support and services for brands and different companies. I'm young and versatile, A tech enthusiast. I carry out deep research on every topic I choose to write about. You can reach me through my social media handles, I'm always available and ready to connect.

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