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Is Metformin Slow Release As Effective As Normal Metformin?

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Posted on Thu, 13 Nov 2014
Question: Is metformin slow release 500mg just as effective as the normal metformin?
doctor
Answered by Dr. Panagiotis Zografakis (36 minutes later)
Brief Answer:
Yes!

Detailed Answer:
Hello,

extended-release metformin (ERM) is the same - regarding its effectiveness - with the normal metformin.
The differences are:
- price: ERM is more expensive.
- gastrointestinal effects: ERM causes less abdominal discomfort.
- patient adherence: ERM is easier to take (once daily).
I hope I've helped you!
If you have further questions, please ask.
Otherwise, please don't forget to rate my answer.

Kind Regards!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Panagiotis Zografakis (36 minutes later)
Whats the differnece? Intake it once aday but find that my sugars dont immediately go down. Does this work over 24 hours or something simialr?
doctor
Answered by Dr. Panagiotis Zografakis (14 minutes later)
Brief Answer:
There is no difference in efficiency

Detailed Answer:
Hi,
blood sugar levels won't go down "immediately" after taking it either as an extended-release or a regular tablet. This is because of the drug mechanism of action. It will prevent subsequent blood glucose increases though.
The only difference regarding its efficiency involves the first dose of the drug because it takes more time for the drug levels to rise. The drug needs to be taken on the same time each day, so that drug levels won't fluctuate a lot. If your blood sugar is not under control then perhaps you need a higher dose or even a second drug. Glucosylated hemoglobin A1c levels will be very helpful to guide treatment. Self-measurements of fasting blood glucose and postprandial blood glucose (2 hours after meals) will help as well.
I couldn't give a specific advice about that because you haven't provided many details about your medical history. A general but always useful advice is to try to maintain a healthy body weight and exercise every day if you can. If you lead a sedentary life then even walking for 30 minutes every day will help a lot. If you already do exercise more then keep on exercising.
If you'll require more detailed advice on blood sugar control please provide the following details:
- body weight and height
- self-measurement results
- glucosylated hemoglobin A1c
- other medical problems
- drugs
I'll be glad to help you with sugar control.

Kind Regards!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Panagiotis Zografakis (14 hours later)
My hbac1 were at little raised hence the metformin induction.

My sugars stay around the 7-8 mark after 2-3hours of food.

I take my metformin at night beofre bed.

Is that the wrong time to take?

I am sticking to a low carb diet and also excersing as much as i can in the gym.
doctor
Answered by Dr. Panagiotis Zografakis (16 minutes later)
Brief Answer:
Please read on...

Detailed Answer:
Hi,

The exact number of HbA1c would be very helpful. If it is 7.5% then you definitely need to change your regimen.
7 mmol/L 2 hours after meals is not too high, although lower values would be better. 8 is not very high either. If you're taking only 500mg per day then you can increase the dose. The maximum daily dose for metformin is 2500mg, although not usually recommended because the additional benefit of higher dosages is lower than the anticipated side-effects risk.

Possible reasons for bad glucose control despite treatment:
(1) wrong diagnosis: if it's diabetes type 1 then metformin won't help. How was your type 2 diagnosed? Younger patients have more type 1 than older ones.
(2) wrong diet: your body weight is good indicator. Increased body weight=bad glucose control
(3) insufficient treatment: if you're close to the HbA1c target then increased dosages of the same drug can be attempted. If you're not that close then it'd be better to add a new drug to your regimen.

I hope I've given you some direction.
If you need more information or details, you can ask me again.

Kind Regards!
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Panagiotis Zografakis (24 minutes later)
Type 2 was diagnosed via a 3 monthly blood test. I was diagnosed around 3 years ago. But was a diet controlled diabetic until last 2 months.

My hba1c was 8.1 DCCT around 1 month ago.

My lifestyle wasnt very good. Now i have changed.

Am i taking the correct steps?
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
Need more information

Detailed Answer:
Hi,

thank you for your input, but more information is needed!
For example, did you have an oral glucose tolerance test with insulin measurements along with the glucose measurements? This would have proved insulin resistance which is one of the most important elements of type 2 diabetes.
Despite that I'll take as granted that type 2 is the correct diagnosis and comment on your HbA1c.
Diet and exercise can lower your HbA1c enough to get it within the target range which is lower then 7% and preferably close to 6.5%.
Metformin can lower it less than 1%.
If your HbA1c (8.1%) reflects your status AFTER treatment and diet change and exercise then this is too high, particularly for a young patient and you'll need a new regimen.
If this is your starting point then you could probably "fix" it with current treatment.
Regular self-measurements would be needed to check if everything goes as expected and a HbA1c every three months.
Important self-measurements include the fasting glucose early in the morning and glucose 2 hours after meals.
You should write down the values so that both you and your doctor can evaluate your progress.
If you've done so already then it would be helpful if you could provide the results for me.
Kind Regards!


Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Panagiotis Zografakis (7 minutes later)
Like i said this measure ment is before i started metformin.
This reading was done last month.

So i have been taking metformin only 3 weeks.

But since then my lifestyle has changed for the better.

I just wanted you advice.

Should i increase mu dosage to 2 tablets a day ( 1 at night and 1 in evening)?

Or shall i wait until my next hbac1 test in december?

Yes you are correct i had a oral and blood test to determine type 2.

Its only in the last month my hba1c has risen. But like i have said i am now taking metformin 500mg once aday.
doctor
Answered by Dr. Panagiotis Zografakis (51 minutes later)
Brief Answer:
Increasing the dose would be appropriate

Detailed Answer:
Hi again,

500mg of metformin is a low dosage. Since your last HbA1c is high and your postprandial measurements could be (and probably should be) better I suggest you double the dosage. You can take it all at once or twice daily.
I have to repeat that I take for granted the type 2 diagnosis. For young patients like you I prefer to document the diagnosis as much as I can by measuring insulin levels along with the oral glucose tolerance test. High insulin values denote insulin resistance. Low values are compatible with type 1 diabetes.
I'm sure your doctor is not wrong but I don't have the necessary data to be sure.
Please try to record your self-measurements, because they're helpful. Remember that blood glucose varies depending on a lot of factors, so don't expect that every day will the same as the previous one.
So you can try the double dose and check your blood sugar at home until you do the HbA1c. You'd better check the HbA1c 3 months after changing the dose, so it will reflect the latest changes.
And if you want, I can comment on your results.
I hope I've helped!

Kind Regards!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Panagiotis Zografakis (16 minutes later)
Ok last question.

Does carbs increase sugar? Or does the metformin stop that happening?

Or do i have to be careful in what carbs i have and not too much?

Appreciate your time on this last and final questionx
doctor
Answered by Dr. Panagiotis Zografakis (36 minutes later)
Brief Answer:
Yes they do

Detailed Answer:
Hi,

carbs definitely increase blood sugar. Simple carbohydrates like sugar will increase blood sugar faster while the more complex ones will do so slower and will give your body the time to react. One of diabetes type 2 elements is a slow reaction to high blood sugar. So you'll have to watch the carbohydrates in general but be more careful with the simpler ones.
The glycaemic index is a useful marker to identify food that will increase your blood sugar sharply.
For example glucose itself has a glycaemic index of 100. Oranges have a glycaemic index of 40 (when compared with glucose). This means that if you eat sugar your blood sugar will rise more quickly than if you ate an orange with the same amount of carbohydrates.
I don't know if it sounds complex or simple but this is it! You should be careful with carbohydrate quantity AND quality.
Metformin helps your body need less insulin for the same amount of food and also decreases fasting blood glucose by regulating glucose production in the liver. A recent onset diabetes benefits more from metformin. When diabetes is more advanced metformin helps but won't be enough by itself.
I hope this is more clear to you now!
Please ask, if you need further clarifications.

Kind Regards!

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Panagiotis Zografakis (5 minutes later)
Thanks.

I am working hard to lose weight and determined to change things.
doctor
Answered by Dr. Panagiotis Zografakis (1 hour later)
Brief Answer:
Nice decision!

Detailed Answer:
Loosing weight will help you a lot in many ways. Your diabetes will definitely get better! Remember that this is the right time to introduce changes to your life-style, before diabetes complications ensue. When they do, they're irreversible!
Please don't forget to rate my answers.
Best wishes!
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Panagiotis Zografakis

Internal Medicine Specialist

Practicing since :1999

Answered : 3809 Questions

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Is Metformin Slow Release As Effective As Normal Metformin?

Brief Answer: Yes! Detailed Answer: Hello, extended-release metformin (ERM) is the same - regarding its effectiveness - with the normal metformin. The differences are: - price: ERM is more expensive. - gastrointestinal effects: ERM causes less abdominal discomfort. - patient adherence: ERM is easier to take (once daily). I hope I've helped you! If you have further questions, please ask. Otherwise, please don't forget to rate my answer. Kind Regards!