Foods to Avoid While Taking Metformin

Last updated on January 31st, 2022

Metformin is the first-choice medicine for type 2 diabetics. This medicine reduces the levels of blood glucose. It is both effective and well-tolerated. This medication is the first-line treatment as per the ADA. Contrasting to other drugs, it doesn’t prevention of any specific food products. The medicine is also not related to weight gain like other diabetes drugs. Metformin does interact with alcohol. Hence, it’s best to contact a doctor before drinking while on this drug. Read this article to know about foods to avoid while taking metformin.

What is Metformin?

Metformin is a drug recommended for treating Type 2 diabetes, prediabetes as well as insulin resistance. Of the above 30 million diabetics, 90 to 95% of them have Type 2 diabetes, according to the CDC. Metformin belongs to the class of medications called biguanides, which are drugs that prevent the liver from forming sugar. Metformin also reduces the amount of sugar the body absorbs from the food a person consumes and improves the body’s response to insulin.

Also Read: Normal Sugar Level For Women

Foods to Avoid While Taking Metformin

Below are 6 food products one must avoid while consuming Metformin:

Fats

Healthy fats are excellent. They form a great healthy diet if a person is on Metformin. Also, avoid food products rich in trans and saturated fats while on Metformin.

Simple and refined carbohydrates:

Simple and refined carbs raise a person’s blood glucose levels.  Carbs such as candy, soda, and desserts must be avoided. Avoid refined carbs including pasta, white bread, or white rice.

High fiber foods

Fiber is thought to absorb certain medicines and reduce their concentration in the bloodstream. If a person consumes huge quantities of fiber, the levels of Metformin might reduce. Keep the consumption of fibers below 30 grams per day.

Sodium

A person must avoid consuming an excess of sodium while a person is on Metformin. Keep the intake of sodium below 2300 milligrams per day.

Alcohol

A person must avoid huge amounts of alcohol since it enhances the risk of developing low blood glucose as well as lactic acidosis. Alcohol is found to prevent the liver from storing and liberating sugar. Since diabetics already struggle to manage blood sugar levels, reducing the risk factor of alcohol intake is worth consideration. Drinking alcohol on an empty stomach may result in low blood glucose.

This is true for individuals using insulin or other anti-diabetes medicines that enhance the levels of insulin. Metformin is found to amplify the quantity of lactate. Lactate is the underlying compound of lactic acid. Research confirms that an excess of alcohol in combination with a thiamine deficiency may give rise to lactate accumulation. Alcohol and Metformin together might cause excessive lactic acid in the blood.

This may result in a severe condition, lactic acidosis. Overall, drinking in moderation is safe. Safe levels are one drink per day for females as well as 2 drinks per day for males.

Grapefruit

One study explored at the grapefruit effects on Metformin. Researchers found that the participants who had both Metformin and grapefruit juice had a higher quantity of production of lactic acid as compared to the participants who had just Metformin. They might also have more weight gain.

It was also established that grapefruit juice enhanced the build-up of metformin in the liver. This then brought up an increase in lactic acid production. It was also concluded from the studies that drinking grapefruit juice may result in a greater risk of lactic acidosis in patients consuming Metformin.

How does grapefruit have an effect on Metformin?

Metformin does not get broken down by the same enzyme as the medicines listed above. It remains unprocessed by a person’s body and removed in the form of urine.

A study discussed the effects of grapefruit with Metformin in non-diabetic people. Few people were exposed to grapefruit juice as well as Metformin. Others were exposed to only Metformin.

It was found that there was an increase in the amount of production of lactic acid in the people who were exposed to Metformin as well as grapefruit juice.

It was guessed that grapefruit juice increased the build-up of Metformin in the liver. This, sequentially, brought about an increase in lactic acid production. It is suggested that drinking grapefruit juice may cause an enhanced risk of lactic acidosis in people having Metformin.

Also Read: Side Effects of Metformin

Metformin and Alcohol

Generally, diabetics must moderate their alcohol consumption as alcohol impairs the liver’s ability to store and liberate sugar. This is a problem for diabetics as their bodies already fight to manage blood sugar. Furthermore, drinking alcohol on an empty stomach might bring about low blood sugar (hypoglycemia).

This alcohol-associated complication is more common in individuals using insulin or diabetes medicines that enhance insulin levels. Metformin does not enhance insulin levels, hence alcohol-induced hypoglycemia is less expected to take place in individuals who take it.

Metformin-Related Lactic Acidosis

When the body utilizes sugar as energy, lactic acid gets released. Metformin enhances the amount of lactate, the basic compound present in lactic acid in the bloodstream. This is classically a benign effect, however, as per a research study, an excessive intake of alcohol in addition to a thiamine (vitamin B1) deficiency might lead to the accumulation of lactate. This combination of Metformin and alcohol might bring about an excess of lactic acid in the blood, a deadly condition that might give rise to lactic acidosis, in individuals having acute or chronic alcohol abuse.

Metformin-related lactic acidosis (MALA) occurs rarely however, is possibly dangerous. While the risk of lactic acidosis for diabetic people is low, his or her risk is greater if a person has congestive heart failure or impaired liver or kidney function.

If a person is using Metformin, he or she must drink alcohol in moderation. “Moderation” signifies:

1. one drink per day for females
2. males above 65 years of age
3. two drinks per day for males below the age of 65 years.

But discussing the intake of alcohol with a healthcare provider as a no-alcohol lifestyle can be healthiest for him or her.

Foods to Include in a Metformin Diet

Below are 5 foods a person can add in his or her Metformin diet.

• Complex carbs: These carbohydrates are derived from fruits, veggies, whole grains like brown rice as well as whole-grain bread. They have more amount of fiber and this increases their difficulty in getting metabolized. This then slows the liberation of sugar into the bloodstream. If a person is having complex carbohydrates, it is a must to keep a track on his or her overall carb consumption. This is significant as carbs directly affect blood glucose levels.
• Lean protein: Encourage the consumption of lean proteins such as turkey, fish, and tofu.
• Healthy fats: Healthy fats can be obtained from sources such as fish, nuts, and olive oil.
• Non-starchy veggies: They might assist in slowing down the carb metabolism. Examples of such veggies may include broccoli and leafy greens.
• Moderate fiber consumption: Even though it is suggested not to have lots of fiber, moderate fiber consumption might actually be useful. This is due to the reason that fiber helps in regulating the levels of blood sugar. The average consumption of fiber is between 25 and 30 grams per day.

Other Things to Avoid While on Metformin

Consumption of few medicines while using Metformin might enhance the risk of developing lactic acidosis. Thus, it is important to discuss with the concerned doctor if a person is taking any of the following medicines:

• Diuretics like acetazolamide
• antipsychotic medications including chlorpromazine
• anticonvulsants like topiramate, zonisamide
• oral contraceptives
• corticosteroids like prednisone
• antihypertensives such as amlodipine

A person must also avoid having high-fibre foods after consuming this drug. This is because fibre can bind to medicines and reduce their concentration. Metformin levels reduce when consumed with huge quantities of fibre (more than 30 grams per day).

Also Read: Diabetes and Yeast Infections

Few Diet Guidelines for Diabetics are as Follows:

• Add carbs derived from veggies, fruits, and whole grains. Make sure to monitor carb intake, as this would directly influence blood sugar.
• Avoid food rich in saturated and trans fats. In its place, have fats from fish, nuts, and olive oil.
• Consuming 25 to 30 grams of fiber every day might aid in regulating blood glucose levels.
• Avoid sodium. Try to have less than 2,300 milligrams each day.

Look at the Overall Diet

Metformin reduces the levels of blood glucose.  It is much less efficacious when it’s not followed by a balanced, healthy diet. Try avoiding or limiting foods causing high sugar:

• to derive the most profit from any diabetes medicine
• to improve a person’s overall health.

Major culprits when it comes to high blood sugar:

• foods consisting of simple carbs (sodas, candies, desserts)
• refined carbs (white bread, white rice, pasta)

As an alternative, choose complex carbs such as brown rice and whole-grain bread. These carbs have a large amount of dietary fiber. Thus, they are harder for the body to metabolize. This slows the liberation of sugar into the bloodstream. In addition:

• ensure to add lean proteins (such as turkey, fish, and tofu)
• fill half of plate with non-starchy veggies at each meal. These can be broccoli and leafy greens.

This would help in slowing down the carb metabolization.

Also Read: Symptoms of Type 2 Diabetes

FAQs:

References:

1. https://www.livestrong.com/article/30849-foods-eat-taking-metformin/
2. https://diatribe.org/everything-you-always-wanted-know-about-metformin-were-afraid-ask

 Last Updated on January 31, 2022 by Dr. Damanjit Duggal