While a point of metformin’s side effects can’t be helped, Marcey Robinson, MS, RD, CSSD, CDE, BC-ADM, co-founder of Achieve Health & Performance, says there are literally several things doctors can do when prescribing metformin to make sure patient adherence. However, she says, many physicians simply don’t. The first issue, Robinson told Healthline, is that there are two sorts of metformin to settle on from: regular and extended-release. Most people do better on the extended-release version because the drug’s potency affects the body over the course of several hours, instead of hitting you all directly. “Sometimes, it’s just a doctor’s standard of practice and that they don’t even believe it. They’ve always prescribed it a method, so that’s what they still do,” said Robinson. “For some patients, the doctor may additionally think that having a much bigger boost of the medication all directly goes to assist a patient who is battling high blood sugars after a meal. But that’s really not how metformin is predicted to figure within the body,” she added.
Educating patients
Although there are many diabetes drugs on the market today, doctors will likely push metforminfirst.
“There have never been as many diabetes treatment options available as there are now,” explained Robinson. “But doctors check out cost, and metformin is that the cheapest. Insurance companies tend to try to that, too: ‘How can we pigeonhole everybody on this one drug?’ If you’re looking just from a price perspective, you’re forcing people onto a drug regimen that simply doesn’t work for everybody .”
But there’s another pertinent reason Robinson believes numerous people stop taking their diabetes medication: lack of education.
“If you check out the [American Diabetes Association] guidelines, the primary line of defense is metformin, but there’s no education that’s presented when the doctor prescribes it,” she said.
Robinson is that the diabetes educator for Dr. David Borchers’ patients in Colorado.
“If the doctor didn’t have me to teach his patients, we’d have an equivalent problem during this office with patients stopping their medication,” Robinson said. “Educators help make sure the patients understand why they’re taking that medication, which results in a way higher adherence rate.”
Teaching patients why they’re taking a particular medication, the way to take it, and the way it’s getting to improve their health are vital, insists Robinson. And it’s often overlooked.
For example, metformin should be crazy food. The dose should be titrated initially, gradually increasing the dose over the course of several weeks, to stop severe gastric distress.
This is an important detail that’s easily miscommunicated or misprescribed when patients don’t meet with a diabetes educator.
“I started taking metformin four years ago,” Tony Song, president, and CEO of Diabetes Care Partners told Healthline.
Song received a diagnosis of prediabetes in 2008.
“The first week was tough with diarrhea and a touch of dizziness. I started on a coffee dose, and that I knew about this side effect, but I used to be surprised that my doctor didn’t mention any of this once I received the prescription,” he said.
Song contacted his doctor after the primary week and was switched to the extended-release version. While it still caused diarrhea, it mostly resolved itself within two days.