What is Metformin?

• Metformin is a pill that helps the body use insulin.

How does Metformin work?

• Metformin is called an "insulin sensitizer." It helps our cells recognize insulin.
• When we have Type 2 Diabetes our liver, fat, and muscle cells tend to ignore insulin. This makes our pancreas produce more insulin so that sugar can get into these cells and out of the bloodstream. The pancreas gets overworked and eventually can't make enough insulin to keep up with the demand.
• When the cells don't recognize insulin, we call that "insulin resistance." In a normal pregnancy, some increased insulin resistance is normal. As the placenta grows it produces more hormones that block the work of insulin to insure that sugar gets to the baby. The baby needs sugar so he (or she) can grow.
• When you have diabetes during pregnancy, insulin resistance is worse and your tired pancreas can't keep up with the demand for insulin. Blood sugar levels rise. Metformin helps your cells to recognize and use the insulin you have.

How does Metformin affect my baby?

• Metformin crosses the placenta, but research thus far has not shown any adverse effects on the baby.
• Metformin is also considered okay for use during breastfeeding.

How do I take Metformin?

• Metformin is started at a low dose (usually 500mg once or twice per day) then is increased as tolerated until you reach a dose that works.
• When used to lower the fasting blood sugar, Metformin is best taken at bedtime, but you may be instructed to take Metformin after every meal. Your provider will tell you how you should take Metformin.
• If insulin resistance is too strong, Metformin alone may not be enough and Insulin injections, or other medications, may be needed.

Are there any side effects with Metformin?

• Common side effects include nausea, vomiting, diarrhea, loss of appetite, stomach fullness, constipation, and heartburn.
• An extremely rare but dangerous side effect can occur called Lactic Acidosis.
• While taking Metformin, if you experience chills, diarrhea, muscle pain, slow heartbeat, sleepiness, trouble breathing, and weakness, get emergency help immediately.
• Metformin should be discontinued prior to major surgery or radiological studies involving contrast materials.

What should I remember when taking Metformin?

• Before taking Metformin, tell your health care provider if you have any other health problems such as heart or kidney problems, liver disease, severe infection, stroke, or recent surgery.
• You may need to get a blood test (Creatinine level) to be sure your kidneys are working okay before starting Metformin.
• When you are taking Metformin it is important to follow the meal plan provided by your health care team, to exercise at least 30 minutes per day, and check your blood sugar as directed.

One week after you start Metformin, you should call the office to report your blood sugar results. Based on that information, your provider can make any adjustments to your Metformin dose.

Information provided by "Sweet Success" Diabetes & Pregnancy Program