Eat metformin on time every day, why is blood sugar still high?

As we all know, diabetes is a chronic disease
.
Once diagnosed, most patients with type 2 diabetes require lifelong antidiabetic drugs to control stable blood sugar levels [1].

Some bad habits of taking medicine, such as taking less, missing doses, and stopping drugs without authorization, may cause blood sugar fluctuations
.
And this common sense, even the "layman" of diabetes, has some understanding
.

But there is such a group of people, obviously "excellent students" who take hypoglycemic drugs - they pinch time to eat metformin every day, never stop or reduce drugs at will, but blood sugar still can't be lowered!

And there are not a few sugar friends who have such troubles, and a casual search on the Internet has as many as 42 million related results▽

Then again, is it that metformin has a poor hypoglycemic effect?

Metformin, is the hypoglycemic effect good?

Friends of "guan" who are so worried, please put your heart in
your stomach.

As a classic old drug, metformin has a history of 100 years since its first synthesis and 65 years of clinical application, which can be said to be a very thoroughly studied and understood hypoglycemic drug, and its efficacy and safety can be called tested [2].

No matter how the guidelines are updated and changed, metformin has always been the preferred drug recommended by authoritative diabetes guidelines at home and abroad:

The Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2020 Edition) recommend metformin treatment as the first-line treatment for patients with type 2 diabetes mellitus and should remain in the drug treatment regimen for diabetes mellitus unless contraindicated [1].

The 2020 American Diabetes Association (ADA) guidelines recommend metformin as the first-line drug throughout the treatment of diabetes [3].

Therefore, "guanidine" friends do not have to worry about entering the wrong group, in terms of reducing sugar, metformin is very "hit"!

Eat metformin every day, blood sugar is still high? Probably these 4 reasons!

1.
The dosage is wrong

To achieve the desired hypoglycemic effect, first see if the dose of metformin you are taking has been increased to the optimal dose
.

The principle of dose adjustment of metformin is "start with a small dose and gradually increase the dose", and in the range of the smallest initial dose (500mg/day) to the optimal effective dose (2000mg/day), its hypoglycemic effect is positively correlated with the size of the dose [2].

Therefore, when the initial dose of metformin does not effectively control blood sugar, the dose can be gradually adjusted under the guidance of a doctor until the best effective dose or the maximum tolerated dose
.

By the way, if you are worried about gastrointestinal reactions after increasing the dose, you can choose a dosage form
that stimulates the gastrointestinal tract relatively little.
For example, metformin original drug sustained-release tablets, after taking the drug, the drug is released slowly, reducing gastrointestinal adverse reactions [2].

Metformin original research drug, namely metformin patented drug, is an original hypoglycemic drug approved for marketing through strict clinical trials, with the advantages of preparation technology and strict supervision before and after marketing, so it has a more stable absorption rate and fewer adverse reactions
.

2.
The medication time is not right

At present, there are three commonly used dosage forms of metformin on the market: metformin ordinary tablets, sustained-release tablets and enteric-coated tablets
.

The dosage time is different for different dosage forms
.
To reduce gastrointestinal adverse reactions, ordinary tablets should be taken with or after meals; Extended-release tablets are slowly released in the gastrointestinal tract and can be taken before, during, or after meals; And in order to make the drug better absorbed, enteric-coated tablets should be taken half an hour before meals [2].

Therefore, when taking metformin, you should master the timing of different dosage forms in order to achieve the desired effect
.

Compared with the other two dosage forms, metformin original drug sustained-release tablets have a long action time, generally only need to take 1 time a day, can achieve a stable hypoglycemic effect, busy work or often forget to take the drug sugar friends can choose this type of dosage form
.

3.
The daily diet is unreasonable

For patients with diabetes, diet management is the cornerstone of disease treatment [4].

If you take the medicine on time and your blood sugar is still high, you should consider whether there are some unreasonable eating habits
.
For example, diet management is simply understood as "no sugar" and neglects to control total calories
.

Therefore, sugar friends should pay attention to "controlling total calories and reasonable nutritional matching" in their diet in order to better manage
their diet.

4.
Poor weight management

Obesity, especially central obesity, is the main cause of insulin resistance, which impairs islet function and progresses to type 2 diabetes
.
Therefore, weight loss is the key to
alleviating insulin resistance and treating obese patients with type 2 diabetes.
Studies have shown that a weight loss of about 10 kg can reduce mortality in diabetics by approximately 25% [5-6].

Among diabetic patients in China, the proportion of abdominal obesity patients is close to 50% [5].

Therefore, sugar friends should manage their weight
while using medicine rationally.

Overweight and obese patients with type 2 diabetes should consider the impact
of drugs on weight when choosing antidiabetic drugs in addition to strict lifestyle interventions.
For example, metformin, there are currently a number of clinical trials that have proved that metformin has a certain weight control effect for obese and overweight patients with type 2 diabetes [2].

Editor: Qin Lianxiu

Illustration: Liaoqin

Producer: "Chinese Family Doctor" magazine