This is an update based on a Facebook discussion about how successful Metformin is, overall, at reducing weight in the general diabetic population.
Note: Studies don't show consistent weight loss with metformin use, that's for sure. My hypothesis is that in order to experience successful weight loss on Metformin, you have to meet some very specific conditions. First, you have to be euglycemic virtually all of the time before starting the metformin. This is hard to do, especially when you're on insulin. You also have to remain euglycemic as you continue to take the metformin. And insulin dependents have to do this by adjusting (read: reducing) basal and bolus dose calculations. This is not easy. But starting metformin while euglycemic and remaining euglycemic throughout the treatment will, I hypothesize, result in weight loss, because it results in less sugar in the blood, which means less required insulin, which means less fat storage. I am a sample size of one, of course. And my experiment is driven by personal curiosity, not scientific inquiry. I would like find some research on whether metformin has caused weight loss in people withOUT diabetes. I'm sure it's out there, and that I just haven't found it yet.
Now, continue on to the article below.
Every once in awhile, when I get bored or curious, I experiment with drugs (legally prescribed ones, that is). And, since so many new diabetes drugs have hit the market in the last few years, and since my blood sugars have been mostly stable since the birth of baby George in December, I’m ready to resume my drug experiments.
The next drug I’m going to try is Metformin. Now, I know a LOT of people take Metformin, but not everyone knows how it works.
Most doctors will tell you that Metformin (of the drug class biguanide) is a medication that “makes your body less insulin resistant” or “improves how your body handles insulin.” Which is true, but, have you ever wondered HOW Metformin does this?
Well, in order to understand how Metformin works, we have to understand something very important about our liver. Your liver (and everyone else’s liver) stores a bunch of glucose.
In addition to storing glucose, your liver releases a fairly steady stream of glucose into your body throughout the day to give you energy.
Your liver also releases *extra* glucose into your body as a reaction to other stimuli (at last count, I had a list of 24 non-food events that can cause your liver to release glucose into your blood).
So basically everyone (diabetic or not) gets a steady drip of glucose squirted into their blood thanks to the liver.
Well, Metformin’s job is to suppress the release of glucose by the liver, which, of course, lowers the amount of sugar “hanging around” in your blood, thereby lowering your “baseline” blood sugar levels.
Metformin is good stuff for type 2 diabetics. But, it can also be good for type 1s and for non-diabetics, too!
Here’s what Metformin would do for you, based on your circumstance:
- Metformin can help people with type 2 diabetes who have high blood sugar by lowering overall baseline blood sugar levels. If you get diagnosed with Type 2 diabetes and you’re prescribed Metformin, the drug will suppress hepatic glucose release (doesn’t that sound fancy? Hepatic means “of or relating to the liver), causing *less* sugar to get squirted into your bloodstream, ultimately resulting in lower blood sugar levels. For you, Metformin is a blood sugar lowering drug.
- If you’re type 1 (like me), you take insulin. Well, Metformin does for you the same thing that it does for people with Type 2 diabetes - it suppresses hepatic glucose release (causes less sugar to get squirted into your bloodstream), and, if your blood sugars were already under control before you started taking metformin, the metformin will cause your body to need *less* insulin. This will cause your cells to soak up less glucose, which means less fat storage. So for you, the end result isn’t lower blood sugar. It’s weight loss. You slowly start to shed pounds. For you, Metformin is a weight loss drug. Also, if you pay cash for insulin or if you don’t have insurance, you can save a lot of money because you won’t need so much insulin if you take Metformin. Metformin is about $5 per month and insulin is at least $520/month. For you, Metformin is also a money saving drug.
- If you are type 2 diabetic and your baseline blood sugar levels are within target range and you’re not already taking Metformin, you can start taking Metformin and you will probably shed pounds. For you, Metformin is a weight loss drug. If you are on insulin, Metformin can also save you money because you won’t need so much insuilin.
- If you are NOT diabetic, you can start taking Metformin and you will probably shed pounds (remember, Metformin causes your liver to release less glucose into your blood, thereby causing your body to require less insulin, which is a fat storage hormone). For you, Metformin is a weight loss drug.
- (Important) If you are AT RISK of getting type 2 diabetes due to a family history of type 2 diabetes, you can start taking Metformin at any age (the earlier, the better) and significantly reduce (and, in some cases, potentially eliminate) your chances of getting type 2 diabetes in the future (more on this, later). For you, Metformin could be a preventive drug.
Why am *I* trying Metformin?
Well, as it turns out, my liver squirts an obscene amount of sugar into my blood throughout the morning (this has always been the case), requiring lots of insulin (which equals lots of fat storage), and, my liver squirts even MORE sugar into my blood when I exercise.
I started a new fitness program three months ago and as a result of the hepatic glucose release during my high intensity exercise, I’m having to take extra insulin after my workouts.
I’ve been working out pretty intensely for the last three months (minimum 3.5 hours per week) and have put on 6 pounds, despite keeping the same diet. Now. I have very detailed data on working out and why it’s good and why I’m going to keep doing it, but that deserves its own article topic, as does the “Why the hell aren’t we diagnosing insulin resistance at its onset, instead of 15-30 years later, once it’s full-blown diabetes” article.
But for now, I’m going to see if I can continue to exercise withOUT gaining any more weight. Stay tuned, you guys. And stay well. And for goodness sake, can someone start a change.org petition to add Metformin to the water supply?