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Does Metformin cause hypoglycemia?

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Posted on Thu, 21 May 2015
Question: I was recently dx w pcos/insulin resitance. I am supposed go on Metformin. Can that medication cause blood sugar problems like hypoglycemia?
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Answered by Dr. Noble Zachariah (15 minutes later)
Brief Answer:
Not usually

Detailed Answer:
Hello,
Welcome and thanks for your query
I have several patients with PCOS on metformin. Some of them have pre diabetes and others have normal blood sugar . In the pre diabetes person I start with a higher dose than in the normal sugar person.
Metformin brings down the blood sugar to the normal levels in the pre diabetes people . In the person with normal blood sugar, it may bring the sugar down a little but not to hypoglycemic levels.
Do get back to me if you have more queries.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Noble Zachariah (12 hours later)
My blood sugar is normal, A1C is 4.2, but my insulin serum is high (21) should be no higher than 14 in lab. I gained 35lbs for no reason dr thinks i need met but what are common side effects
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Answered by Dr. Noble Zachariah (1 hour later)
Brief Answer:
Details follow

Detailed Answer:
Your higher than normal Insulin level is due to Insulin resistance, considered as the main reason for PCOS. Metformin has helped several of my patients to have regular periods and to become pregnant. Since your blood sugar and A1c are normal, I would advise to start with a small dose like 500 mg of extended release Metformin once a day. It's advisable to monitor your blood sugar even though some believe that Metformin will not produce hypoglycemia. If there is no drop in the blood sugar, metformin dose can be raised to the desired level gradually.
The common side effects are
Abdominal or stomach discomfort
cough or hoarseness
decreased appetite
diarrhea
fast or shallow breathing
fever or chills
general feeling of discomfort
lower back or side pain
muscle pain or cramping
painful or difficult urination
sleepiness
There is a fear of lactic acidosis in some people. This is extremely rare in people who are otherwise well and do not suffer from kidney, liver or heart disease.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Noble Zachariah (10 hours later)
Why does it cause stomach upset
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Answered by Dr. Noble Zachariah (46 minutes later)
Brief Answer:
Motility disturbance

Detailed Answer:
It is a common side effect and is due to a motility disturbance from the short acting version of the medicine. This is reduced greatly by the extended release version.
It is not a gastric irritant like NSAID.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Noble Zachariah (21 hours later)
How long for the body to adjust and for the medicine to begin lowering my insulin serum
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Answered by Dr. Noble Zachariah (2 hours later)
Brief Answer:
Starts in 2 weeks

Detailed Answer:
Metformin takes a couple of weeks to start reducing the Insulin resistance and this reduction will parallel the insulin level to some extent. The maximum effect is seen in three months in my experience. So you can check your insulin level after 3 months to see how effective it is for you.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Noble Zachariah

Internal Medicine Specialist

Practicing since :1974

Answered : 2276 Questions

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Does Metformin cause hypoglycemia?

Brief Answer: Not usually Detailed Answer: Hello, Welcome and thanks for your query I have several patients with PCOS on metformin. Some of them have pre diabetes and others have normal blood sugar . In the pre diabetes person I start with a higher dose than in the normal sugar person. Metformin brings down the blood sugar to the normal levels in the pre diabetes people . In the person with normal blood sugar, it may bring the sugar down a little but not to hypoglycemic levels. Do get back to me if you have more queries.