Metformin Alternatives: Different Diabetes Medications to Consider Instead of Metformin

Last updated on March 13th, 2023

People with diabetes are very familiar with the name “Metformin. Metformin is the safest and affordable medicine to treat type 2 diabetes. But sometimes, it can cause side effects for some people. In that case, such individuals have to look for the best alternative to metformin. In this blog, we will read about some good alternatives to metformin.  

Overview

Type 2 diabetes is a metabolic disorder that causes sugar spikes in the blood. In spite of the fact that the pancreas produces insulin in this situation, the body cannot effectively use it or the produced amount is insufficient. A bad lifestyle is the main contributor to type 2 diabetes.

Type 2 diabetes is influenced by several variables, including age, gender, ethnicity, family history, high blood pressure, obesity, and others.

In recent years, type 2 diabetes has become more prevalent among young people and children. The good news is that it can be reversed by adopting a disciplined and healthy lifestyle.

Apart from a disciplined lifestyle, medicines play an important role in controlling high blood sugar levels. For this, doctors suggest metformin as the most prescribed and trusted medicine.

However, this medicine is safe but some people show side effects of metformin. 

Also Read: Foods to Avoid While Taking Metformin

Why do some people need metformin alternatives?

1. Many diabetic individuals show side effects of metformin like nausea, vomiting, stomach cramps, diarrhea, B12 deficiency, weight loss, nerve damage, etc. In some cases, it shows some other side effects like hypoglycemia, the risk of lactic acidosis, and kidney damage. 
2. Metformin shows some drug-to-drug interactions so if someone is taking certain medications for any ailment, it can be harmful to use metformin from the start.
3. Metformin is not magic for all. It is not effective in some cases and doesn’t control blood glucose levels, or reduce HbA1C and weight.  

For such individuals, there are many metformin alternatives available in the market. So let’s read about the usage, dosage, and side effects of these alternatives:

Also Read: Metformin 1000 mg Tablet Uses, Side Effects, Dosage & Interactions

Metformin Alternatives 

SGLT – 2 Inhibitors ( Invokana, Farxiga, Jardiance, and Steglatro)

Usage: This can be a good metformin alternative for people who show side effects of metformin. This medicine helps to control blood sugar levels by releasing extra glucose through urine.

The medicine also protects the heart and reduces the risks of heart disease and stroke. It also promotes weight loss and reduction of HbA1C. 

However, this particular medicine is not safe for people with existing kidney diseases. As it affects the kidney to a great extent. 

Dosage: SGLT-2 Inhibitors are prescribed from 5-10mg once a day. Although consult your doctor for better results as per your requirements. 

Side-effects: This medicine can also have some side-effects like: 

• Risk of kidney damage
• Frequent urination
• Prone to frequent Urinary Tract Infections (UTI)
• Low Blood Pressure
• Increases thirst and dehydration
• Risk of diabetes ketoacidosis 
• Increased risk of amputation especially because of Invokana 

Also Read: Metformin Side Effects

GLP – 1 Receptor Agonists (Bydureon, Byetta, Ozempic, Adlyxin, Rybelsus, Trulicity, and Victoza)

Usage: This is another alternative to metformin. This comes in both oral and injection forms. GLP-1 receptor agonists are safe for kidney patients as it reduces risks of kidney damage and also support heart health.

It is an effective option to reduce HbA1C and blood sugar levels. Additionally, it also helps in weight loss which eventually leads to better sugar control. 

Dosage: It starts with 0.6mg daily for a week then it increases from 1.2 – 1.8mg once a day. For better results, consult your doctor.

Side-effects: The common side-effects of GLP-1 receptor agonists are:

• Hypoglycemia (if taken with insulin)
• Nausea
• Weight Loss
• Diarrhea 

Also Read: Vildagliptin and Metformin – Uses, Side Effects, Dosage & Interactions

Sulfonylureas or SFUs [DiaBeta, Glynase, or Micronase (glyburide or glibenclamide) Amaryl (glimepiride) Diabinese (chlorpropamide) Glucotrol (glipizide)]

Usage: This is a good alternative to metformin and works well to lower blood sugar levels. These oral medications are effective in lowering HbA1C levels for type 2 diabetic patients.

However, it may cause hypoglycemia or weight gain. This medicine helps your body to become more insulin sensitive and stimulates insulin secretion and use. 

Dosage: This medicine dosage starts from 5 mg daily for a week and progresses to 10 and 20. Its maintenance dosage can vary between 100-250 mg/day. However, for severe cases, its dosage goes up to 500-750 mg/daily.

Diabetes medicine dosage depends on an individual’s need and sugar levels so ask your doctor for the right dosage. 

Side-effects: Like every medicine, there are some common side-effects of sulfonylureas drugs:

• Increased appetite
• Weight gain 
• Low blood sugar levels or hypoglycemia
• Upset stomach 

Also Read: Glimepiride and Metformin Tablet Uses, Side Effects, Dosage & Interaction

Dipeptidyl Peptidase – 4 Inhibitors or DPP – 4 Inhibitors (Tradjenta, Onglyza, Nesina, and Januvia)

Usage: It is also one of the prescribed alternatives for metformin. These medicines induce insulin production from the pancreas and also stop glucagon production in the liver. This helps in reducing sugar levels and HbA1C. However, these medicines do not help in protecting against heart disease or kidney damage. 

Dosage: Its dosage varies from 5mg once daily to 100mg as per requirement. To adjust its dosage according to blood sugar levels, consult a healthcare provider or doctor. 

Side-effects: Possible side effects of DPP-4 inhibitors are: 

• Body ache
• Fever
• Upset stomach 
• Hypoglycemia or low blood sugar 
• Risk of pancreatitis 
• Flu

Also Read: Gliclazide + Metformin Tablets to Control Your Blood Sugar Levels

Thiazolidinediones or TZDs ( Rosiglitazone, and Pioglitazone)

Usage: It is also known as glitazones which are used to treat type 2 diabetes. Insulin resistance is the root cause of type 2 diabetes and TZDs medicines reduce insulin resistance of the cells. This way body cells use insulin properly which leads to controlled sugar levels. It helps in increasing insulin sensitivity which helps to manage type 2 diabetes. However this medicine does not give protection against heart diseases or help in weight reduction, but it helps in better control of sugar levels. 

Dosage: As an initial prescription, it starts with 15 mg PO with a meal once a day. As per requirement, it increases by 15 mg to 45 mg once a day. For your prescription, consult a doctor based on your sugar levels and HbA1C. 

Side-effects: Common side effects of Thiazolidinediones are: 

• Risk of heart diseases
• Prone to bone fracture
• Weight gain
• Edema of legs, arms, feet, hands

Also Read: Know aboutMetformin 500 MG Tablet

How to Switch to Metformin?

Metformin is the first-line medicine prescribed by any physician or diabetologist for type 2 diabetes. Its effectiveness is the major reason why doctors trust this medicine. Metformin is a safe medicine to treat high sugar levels as a result of type 2 diabetes. However this medicine is safe and effective, still, some individuals show allergies or side effects to metformin. In such cases, the doctor has to go on the alternative medicines of metformin. 

Remember, never stop taking metformin on your own or start taking alternative medicines available over the counter. This can lead to hazardous effects on your health and hyperglycemia. 

Switching from metformin to other medicine should be a well-supervised process by your doctor. If you are allergic to metformin or show some side effects then notify your doctor. 

Other alternatives of metformin have increased side effects of kidney damage or gastrointestinal problems. 

To switch to metformin, the doctor will need to run various tests, especially kidney function. It will provide detailed information on the patient’s current health readings. Based on these, a doctor can choose any of the alternatives that are best suited for them. 

Apart from your physical findings, side effects of new medicines are also a concerning factor that will be supervised by your doctor.

Its dosage is decided by your blood sugar level control or glycemic control. Also, switching from metformin also required constant monitoring through dosage adjustment of a new medication. 

For a safe metformin switch, stay connected to your doctor and switch it under physician monitoring. 

Also Read: Do Antibiotics Raise Blood Sugar Levels in Diabetics?

Natural Alternatives for Metformin

Metformin is used to control high sugar levels in the body and to increase insulin sensitivity. These results can be attained through some natural ways. Modifying lifestyles is one such natural way to reduce sensitivity.

Apart from that, you can also use some home remedies to control sugar levels. These traditional remedies help reduce insulin resistance and maintain normal blood sugar levels. Let’s read natural ways to substitute metformin. 

1. Plan a diabetic-friendly diet that controls your sugar levels. A good diabetic diet should include low-carb, high-fiber, low-fat, high-protein, and low-calorie food. Fiber slows down the digestion that releases glucose slowly into the bloodstream. Also, try to add low-glycemic food to your diet. 
2. Include exercises and physical activities in your lifestyle. Exercise increases insulin sensitivity and enables muscles to use glucose properly. Do not live a sedentary lifestyle and move a lot. It will help to control your sugar levels. 
3. Try to lose weight. Obesity is one of the major reasons for type 2 diabetes so focus on weight loss. Losing 5-10% of body weight can bring significant positive changes in your blood glucose levels. 
4. There are many herbal alternatives that have been used in traditional medicinal practices that improve insulin sensitivity and help control spiking sugar levels. You can use such herbs for better results. These herbs are fenugreek, neem, bitter gourd, jamun, gurmar etc. 
5. Also, add nuts and seeds to your diet. Seeds like pumpkin, chia, flaxseeds, and nuts like peanuts, almonds, cashews, etc are helpful to manage glucose levels. 

Also Read: How to Reduce Daily Carb Consumption?

Conclusion

Metformin is a trusted drug to treat type 2 diabetes and is prescribed by all doctors. This is one invincible medicine for type 2 diabetes but some people need its alternative for various reasons. People with allergies or side effects of metformin need to switch to alternatives.

There are many alternatives available for metformin with different health benefits. These alternatives are SGLT – 2 inhibitors, GLP – 1 receptor agonists, sulfonylureas SFUs, DPP – 4 inhibitors, and thiazolidinediones TZDs.

Apart from these medicines, you can also modify your lifestyle with diet, exercise, and traditional medicines. These alternative medicines can also cause some side effects so it is important to consult a doctor for the monitored switch from metformin.    

FAQ’s

Reference

https://diabetesstrong.com/alternatives-to-metformin/

https://diatribe.org/what-are-my-choices-metformin-alternativesLast Updated on March 13, 2023 by Dr. Damanjit Duggal