Metformin for Type 2 Diabetes and Insulin Resistance

What Metformin Is and How It Works

Metformin is a biguanide medicine for type 2 diabetes. It helps lower blood sugar and improves insulin sensitivity. Many patients start with metformin 500 mg tablets and adjust the dose as needed. It is also used off-label for polycystic ovary syndrome (PCOS) and insulin resistance. Metformin hydrochloride (metformin HCL) is available as immediate‑release and extended‑release tablets.

Metformin reduces glucose made by the liver. It also decreases intestinal absorption of glucose and improves peripheral uptake. The result is better fasting and post‑meal glucose with a low risk of hypoglycemia when used alone. Dosing is once or twice daily for immediate‑release. Extended‑release (metformin ER) is taken once daily with the evening meal in many cases.

YouDrugstore is a licensed Canadian pharmacy in Manitoba. Canadian pharmacists review each prescription before dispensing. You can order online, and our team supports you with caring service. We offer brand and generic medicines at Canadian prices and also carry OTC health products. We work with licensed, vetted partner pharmacies abroad to broaden supply, keep prices affordable, and ensure authentic products.

Dosage and Usage

Always follow your prescriber’s directions. Doses below are general information for context only.

• Immediate‑release: many start at 500 mg once daily with food, or 500 mg twice daily.
• Titrate by 500 mg weekly as tolerated to improve control and limit stomach upset.
• Typical effective dose is 1,500–2,000 mg per day. Some regimens reach 2,550 mg daily.
• Extended‑release (metformin ER): often 500 mg once daily with the evening meal.
• Increase ER by 500 mg weekly as tolerated. Usual maximum is 2,000 mg once daily.
• Swallow ER tablets whole. Do not crush, split, or chew extended‑release tablets.
• Take doses with meals to reduce gastrointestinal side effects.
• Missed dose: take the next dose at the usual time. Do not double up.
• Metformin may be held before iodinated contrast or certain surgeries per clinical guidance.

Storage and travel tips:

• Store metformin at room temperature in a dry place.
• Keep tablets in the original bottle until use.
• When traveling, carry your medicine in your hand luggage.
• Bring enough tablets for your trip, plus a few extra days.
• Use a pill organizer only if you can keep it dry and labeled.

Benefits and Savings

Metformin lowers A1C by about 1% to 1.5% on average. It can reduce fasting glucose and post‑meal spikes. It is weight‑neutral and may support modest weight loss in some patients. It has a long safety record and a low risk of hypoglycemia when used alone. It can improve insulin sensitivity and may help lipids and liver enzymes in insulin resistance.

Convenience matters. Generic metformin is widely available as immediate‑release and extended‑release tablets. Many patients appreciate once‑daily ER dosing. YouDrugstore offers pharmacist review, easy online ordering, and friendly customer‑service chat during posted office hours. Savings vs typical US prices often reach 60–80%, which helps lower metformin cost for long‑term therapy.

Side Effects and Safety

Many effects are mild and improve as the dose increases slowly.

• Common: nausea, diarrhea, gas, stomach discomfort, metallic taste, and reduced appetite.
• Less common: headache, dizziness, and fatigue.
• Vitamin B12 levels may decline with long‑term use. Monitoring can be considered.
• Serious but rare: lactic acidosis. Risk increases with severe kidney disease, hypoxia, dehydration, heavy alcohol use, or severe infection.
• Do not use in severe kidney impairment. Dosing changes may be needed in moderate impairment.
• Use caution with liver disease or conditions that reduce oxygen delivery.
• Alcohol can increase risks. Limit or avoid heavy drinking.
• Discuss contrast imaging and surgery plans with the care team in advance.

This information is not a substitute for advice from your prescriber or pharmacist.

Onset Time

Blood sugar may start to improve within several days. Gastrointestinal side effects often settle after one to two weeks as the body adjusts. The full A1C effect is seen in 8–12 weeks. Dose titration and adherence support steady outcomes over time.

Compare With Alternatives

Other diabetes medicines may be used if metformin alone is not enough, or if it is not tolerated.

GLP‑1 receptor agonists help reduce A1C and weight. Oral semaglutide is an example; see Rybelsus® for more details. These agents can support weight management and cardiovascular risk reduction in selected patients.

SGLT2 inhibitors increase urinary glucose excretion and can support heart and kidney outcomes. Invokana® is an example. These are often combined with metformin when appropriate.

Other options include DPP‑4 inhibitors, sulfonylureas, thiazolidinediones, and basal insulin. Choice depends on glucose targets, tolerability, kidney function, weight goals, and cardiovascular or renal disease.

Combination Therapy

Metformin is often the foundation of type 2 diabetes care. It can be combined with GLP‑1 receptor agonists, SGLT2 inhibitors, DPP‑4 inhibitors, sulfonylureas, thiazolidinediones, or basal insulin. Combination therapy targets fasting and post‑meal glucose and may reduce the dose of other agents. Many patients use metformin 1000 mg twice daily or metformin ER once daily as part of a multi‑drug plan. For PCOS, metformin may be used with other treatments to support ovulation plans.

Patient Suitability and Cost-Saving Tips

Metformin is intended for adults with type 2 diabetes and insulin resistance. It can be considered in overweight patients, in prediabetes under certain protocols, and for PCOS management. It is not for type 1 diabetes or diabetic ketoacidosis. Do not use it in severe renal impairment, and use caution in moderate kidney disease.

Support cost control with smart choices. Generic metformin medicine usually offers the best value. A 90‑day supply can lower per‑month costs compared with 30‑day fills. You can set reorder reminders in your account to avoid gaps. YouDrugstore offers Canadian pricing and helpful service so your metformin price stays predictable across refills.

Learn more about diabetes in our Diabetes category. For PCOS, explore Polycystic Ovary Syndrome. For deeper reading, see Metformin And Its Role In Type 2 Diabetes Care and Does Metformin Cause Diarrhea.

Authoritative Sources

Review official prescribing and regulatory information using these resources:

• Health Canada Drug Product Database: Metformin
• DailyMed: FDA‑approved labeling for metformin products
• FDA Drug Label Search

YouDrugstore makes it simple to get the metformin medication you need. Order online with confidence and get pharmacist‑reviewed care, Canadian pricing, and prompt, express shipping. Temperature‑sensitive items ship with cold‑chain methods when required.

This content is for general information only. It does not replace advice from your healthcare professional. Always follow your prescriber’s directions and the patient leaflet that comes with your medicine.