Diabetes Treatment “Need To Know” – Metformin

In our second edition of our Diabetes Treatment “Need To Know” series, Roma, our expert pharmacist talks us through a very common diabetes medication  – metformin.

Why may a person with diabetes be prescribed metformin?

If you are diagnosed with Type 2 diabetes, your doctor will initially advise you to make diet and lifestyle changes. This is to help lower your blood sugar levels; in other words, eating a healthy, balanced diet and increasing the amount of exercise you do.

Your blood sugar levels will then be monitored again after a few months and if they are still higher than the recommended levels, then you may need medication to help decrease your blood sugar levels. So, metformin is usually the first choice of medication that is prescribed for Type 2 diabetes if diet and lifestyle changes have been insufficient.

What should people expect to happen when they first start taking metformin?

To understand this, it would be helpful to look at how metformin actually works. Metformin helps to reduce the amount of sugar that your liver releases into the body and it also helps the body’s insulin work better. Both mechanisms result in a drop in blood sugar levels to a healthy level.

This means that if you have been experiencing any symptoms of diabetes, such as increased thirst and urination, feeling tired, or blurred vision, then these symptoms will resolve as you take metformin and your blood sugar levels are controlled. You may possibly experience some side effects – indigestion being the most common.

Is metformin known by any other name, and are there different types?

There are two types of metformin: standard-release and slow-release. Standard-release tablets will release metformin into your body straight away and it will work quickly. However, this means it will get used up quickly too, so you may have to take it several times a day. Slow-release tablets release metformin gradually into your body throughout the day so taking it once a day is usually sufficient.

A liquid form of metformin is also available for those who may not be able to swallow tablets.

Metformin can come as a standard generic medication, or it can be known by the following brands: Bolamyn, Diagment, Glucient, Glucophage, Metabet and Sukkarto.

What are your 3 top tips for people to ensure they take their metformin effectively?

Firstly, take your metformin with or after a meal. While this will help reduce any side effects, it is also a good way to remember to take medication. If you take it everyday with breakfast, then you will automatically reach out for your metformin every morning with your food.

Secondly, speak to your doctor if you experience any side effects, especially indigestion. They will be able to provide you with options to overcome this.

And thirdly, metformin can very rarely cause more serious side effects. Watch out for shortness of breath, muscle cramps or feeling extremely cold.

I’ve heard metformin can give you a bad stomach. Should I be worried?

Taking metformin with or after a meal greatly reduces the chances of a bad stomach, so try this first. Your doctor will also recommend slowly increasing your dose of metformin within the first few weeks depending on your blood sugar levels.

If you still get indigestion, speak to your doctor and they can consider switching you to a slow-release metformin. This formulation is known to have a significantly lower occurrence of indigestion.

If that doesn’t help, then your doctor may consider prescribing you an alternative diabetic medication to suit your needs. There are several solutions available, so don’t worry.

Thanks for lending us your expertise, Roma. Look out for our next edition, our “need to know” series covers diabetes treatments and medications.

At Spirit Pharmacy we’re here to help people live well with diabetes. We offer free NHS prescription delivery, expert support, plus a free Live Well With Diabetes welcome pack with your first delivery. 

Please note, this article is not intended to be individual healthcare advice. Always follow specific advice relating to your condition given to you by your doctor, pharmacist, diabetic nurse, or dietician.

Diabetes friendly recipes

We know that cooking can be time consuming and the temptation to treat yourself to a takeaway on the weekend is strong. Try our amazing ‘fake-away’ recipes instead of a takeaway, from a warming curry to a spicy chilli or finger licking chicken to fragrant Chinese. Our recipes will ensure that you will be able to enjoy amazing food, whilst choosing a healthier option.

Ultimate Curry Night

This ultimate curry night recipe uses high-protein chicken dhansak curry with lentils, cauliflower rice, and a mushroom bhaji accompaniment which makes this the perfect weekend alternative to an Indian takeaway and guaranteed to warm you up.

This meal is high-protein, low GI and provides 426 kcal per portion.

Ingredients (serves 4):

For the Cauliflower Rice1 large head cauliflower

For the Mushroom Bhaji400g white mushrooms, 1 medium onion, 1 tsp tomato paste, 2 cloves garlic, 1 tsp turmeric, 1 tsp cumin, handful of coriander

For the Chicken & Lentil Curry4 chicken breasts cut into chunks, 1 medium onion, 100g red lentils, 2 cloves of garlic, 1 thumb sized piece of ginger, chilli to taste, 1 tsp turmeric, 1 tsp garam masala, handful of coriander, 400g tin of tomatoes, 500ml chicken or vegetable stock

Nutritional Information (per serving)

Calories 426, Fat 6.1g, Carbs 38.4g (9g of which sugars), Fibre 14.6g, Protein 59.3g

For the Cauliflower Rice

  • Wash and thoroughly dry cauliflower, then remove all greens.
  • Cut the cauliflower into chunks and use the medium-sized holes on a cheese-grater – to grate into “rice.” This process can also be done using a food processor.
  • Transfer “rice” to a paper towel and press and squeeze to remove any excess moisture and leave to one side.
  • Fry in a large frying pan over medium heat in a little oil. Cover with a lid so the cauliflower steams and becomes more tender. Cook for a total of 5-8 minutes, then season as desired (leave this step until the curry is almost ready).

For the Chicken & Lentil Curry

  • In a large pan or saucepan, on a medium heat, warm some oil or low calorie-cooking spray.
  • Add the onions and cook for 5-minutes, until soft and lightly browned.
  • Add the chicken and cook for a couple of minutes until seared.
  • Stir in the garlic, ginger and spices and allow them to release their fragrance.
  • Add the tomatoes, stock and bay leaves and simmer for 35-minutes until the chicken is tender and the lentils have broken down.
  • Remove the lid for the last 10-minutes and at this point start with the mushroom bhaji and cook the cauliflower rice.

For the Mushroom Bhaji

  • In a separate pan, warm a little oil or low-calorie cooking spray. Add the onions and cook until soft.
  • Add the mushrooms, ginger and garlic and cook until the moisture has evaporated.
  • Add the spices and cook for 1-minute so that they release their fragrance.
  • Add the tomatoes and about 50ml of water to loosen the mixture. Cook until the tomatoes have broken down.
  • Serve with some plain yogurt and coriander.

Smokey Chipotle Chilli Tacos

This incredible taco recipe uses high-protein beans with low calorie lettuce tacos which makes this an amazing alternative to a chilli con carne and nachos.

This meal is high-protein, low fat and provides under 440kcal per portion.

Ingredients (serves 4):

For the Chilli – 1 stick celery, 1 large onion, 1 red pepper, 2 cloves garlic, 2 red chilli’s, 3 tsp chipotle paste, 400g canned kidney beans, 400g canned black beans, 400g canned pinto beans, 400g chopped tomatoes, 500ml vegetable broth, 1 bay leaf, 1sp ground cumin

To Garnish – 4 spring onions, 4 tbsp greek yoghurt, 1 lime, 1 handful chopped coriander

To Serve – gem lettuce, used as tacos

Nutritional Information (per serving)

Calories 436, Fat 6.3g, Carbs 72.9g (11.7g of which sugars), Fibre 23.3g, Protein 26g

For the Chilli

  • In a large pan or saucepan, on a medium heat, warm some oil or low calorie-cooking spray. Add sliced onions, pepper and celery and cook for 5-minutes, until soft and lightly browned.
  • Add sliced chilli and crushed garlic and cook for a further 3 minutes.
  • Add the cumin and cook for 1 minute until it releases its aroma. Then add the chipotle paste and mix in.
  • Drain and wash all the beans and add to the mix. Allow the beans to cook for a few minutes – it’s ok if they start to break up as this will thicken the chilli later.
  • Add the tomatoes, stock and bay leaves, cover with a lid and simmer for 35-minutes until the chilli is thick and aromatic.
  • Top up with a little water now, if the chilli is looking too thick.
  • Garnish with some plain yogurt, sliced spring onions, coriander and lime.
  • Dig in with some individual lettuce ‘tacos’.

Southern Fried Chicken & Sticky Cauliflower Wings

This indulgent recipe uses high-protein chicken with an array of spices for a real taste of the south, accompanied by moreish cauliflower ‘wings’ makes this a finger-licking dish that any colonel would be envious of.

This meal is high-protein, low GI and provides 187 kcal per portion and only 14.2g carbohydrates.

Ingredients (serves 4):

For the Spiced Chicken – 1 tsp paprika, 1 tsp cajun spice mix, 1 tsp dried thyme, 1 tsp dried oregano, 1 tsp garlic powder, 400g chicken breast

For the Cauliflower ‘Wings’1 head cauliflower broken into florets, 2 tsp chipotle paste, 2 tsp tomato puree

Nutritional Information (per serving)

Calories 187, Fat 3.4, Carbs 14.2g (6.2g of which sugars), Fibre 6.3g, Protein 26.1g

For the Spiced Chicken

  • In a small bowl mix all the spices together until well combined.
  • Spread some tin foil on the counter – enough to wrap the chicken a couple of times.
  • Place the chicken on the foil and cover top and bottom with the spice mix.
  • Wrap the chicken in the foil to create a little parcel.
  • Take a rolling pin and bash the chicken in the foil all over until flattened. You might burst the foil in places.
  • Unwrap the chicken, it should be about 1-2cm thick throughout.
  • In a large pan or saucepan, on a medium heat, warm some oil or low calorie-cooking spray. Add the chicken and cook until it is white throughout.

For the Cauliflower Wings

  • Break the cauliflower into individual florets.
  • In a bowl, coat the cauliflower in chipotle paste and tomato puree.
  • Roast in the oven on 200c for 20 minutes, or until tender with a little bite.

Chinese Sweet & Sour Turkey & Stir Fried Vegetables

This incredible Chinese style stir fry uses delicious turkey with a rainbow of vegetables which makes this an great alternative to a Chinese takeaway.

This meal is high-protein, low GI and provides 378 kcal per portion.

Ingredients (serves 4):

1 tbsp soft brown sugar, 1 tbsp vinegar, 150ml chicken stock, 1 tsp tomato puree, 1 tsp Chinese five-spice, 1 tsp flour, 400g turkey escalope sliced, 2 cloves garlic, 2 peppers (any colour), 2 spring onions, 1 tsp ginger, 200g broccoli florets, 200g carrots, tin water chestnuts or bamboo shoots, handful cashews

Nutritional Information (per serving)

Calories 378, Fat 19.2g, Carbs 33.5g (7.7g of which sugars), Fibre 4g, Protein 18.1g

To make the sweet and sour turkey & stir fry vegetables

  • In a large pan or saucepan, on a medium heat, warm some oil or low calorie-cooking spray. Add sliced turkey and lightly brown.
  • Add broccoli and sliced carrots and cook lightly until slightly softened.
  • Add garlic, peppers, spring onion and ginger and cook until aromatic.
  • Drain and wash the water chestnuts (or bamboo shoots) add to the stir fry.
  • In a separate pan, mix all the ingredients together except for the flour.
  • Once mixed together, add the flour and stir quickly to combine allow to simmer gently and the mixture should thicken.
  • Once at desired consistency, add to the turkey and vegetables.
  • Garnish with cashews for some extra crunch.

At Spirit Pharmacy we’re here to help people live well with diabetes. We offer a free NHS prescription delivery, expert support, plus we have an online shop with healthy eating and diabetes products.