Treatment of Diabetes Mellitus: Tablets – Treatment of type 2 diabetes begins with diet control. If diet alone is unable to control blood sugar levels, then tablets have to be taken. If both diet and tablets fail to control the blood sugar levels, insulin injections may be needed. Oral anti-diabetes tablets are used for treating type 2 diabetes.
| Type of Tablet | Action | Comment |
| Sulphonylureas e.g. – Chlorpropamide (Diabinese®) – Glibenclamide (Daonil®) – Gliclazide (Diamicron®) – Tolbutamide (Rastinon®) – Glimepiride (Amaryl®) | Help the pancreas to release more insulin and the body to use glucose more effectively. | Take the tablet(s) daily immediately after meals (except Gliclazide which is consumed half an hour before meals). Do not miss or delay meals. Otherwise, your blood sugar level may fall too low. Sometimes other tablets (e.g. those for blood pressure) can react with anti-diabetes tablets. If in doubt, talk to your doctor or pharmacist. Alcohol interferes with some of these tablets: consult your pharmacist if you are planning to drink alcohol. For example, having alcohol with Chlorpropamide causes side effects like redness and vomiting. |
| Biguanides e.g. Metformin (Glucophage®) | Help the body to use glucose more effectively. | Take the tablet(s) with meals or after meals. |
| a-glucosidase inhibitors eg. Acarbose (Glucobay®) | Help to stop the quick rise of blood glucose after a meal. | Take the tablet(s) with the first mouthful or immediately before each of the three main daily meals. |
| Meglitinides e.g. Repaglinide (Novonorm®) | Help the pancreas to release more insulin. | Take the tablet before meals. |
| Thiazolidinediones e.g. Rosiglitazone (Avandia®) | Enhance insulin action and help the body to use glucose more effectively. | Take the tablet with or without food. |
When should I take my diabetes medicine before or after meals?
To help the body process the meal – Medicines for diabetes that are taken by mouth should usually be taken around meal times. This is to reduce blood sugar levels after eating and to avoid a very low blood sugar (hypoglycaemia). Enzyme supplements, which can be used to help people with chronic pancreatitis, should also be taken with food to help the body process the meal.
What is best time to take metformin?
How to take it – It’s best to take metformin tablets with, or just after, your evening meal to reduce the chance of getting side effects. Swallow your metformin tablets whole with a drink of water. Do not chew them. If you’re taking metformin sachets, pour the powder into a glass and add water (about 150ml).
At what blood sugar level do I need metformin?
The oral biguanide metformin (Glucophage, and others) is generally the drug of choice for initial treatment of type 2 diabetes. It has also been used to prevent or at least delay the onset of diabetes in patients considered to be at high risk for the disease.
What is a good blood sugar level for a diabetic on medication?
What are blood sugar targets? – A blood sugar target is the range you try to reach as much as possible. These are typical targets:
Before a meal: 80 to 130 mg/dL. Two hours after the start of a meal: Less than 180 mg/dL.
Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.
Is it OK to take diabetes medicine at night?
When should you take insulin? – The answer to this question depends on a few things. Most importantly, though, is the type of insulin that you take. For example, fast- or rapid-acting insulins, such as lispro (Humalog), glulisine (Apidra), and aspart (Novolog, Fiasp), are meant to be taken 10 to 15 minutes before eating.
- The new fast-acting insulin Fiasp is taken right at the start of a meal or within 20 minutes of starting a meal.
- Fiasp starts to work a couple of minutes after you inject it.
- What about other insulins? Here’s the rundown: • Regular insulin, which is a short-acting insulin, is generally taken 15 to 30 minutes before your meal.
• NPH, an intermediate-acting insulin, is typically given 30 to 60 minutes before a meal or at bedtime. • Long-acting insulins, such as glargine (Lantus, Basaglar, Toujeo) and detemir (Levemir), are often taken at bedtime, but also in the morning. Because these insulins are considered to be “peakless” and are types of basal insulin, taking them is not dependent on your meal times.
Can I take metformin 1 hour after eating?
Metformin is currently the first line of drug for managing diabetes. Metformin is a very safe medicine for diabetics. The time of taking metformin depends on your blood sugar readings, your weight and other factors like diet, exercise and lifestyle. Metformin works in the following ways: -It makes your body more sensitive towards the action of insulin.
-It acts on liver and it restricts liver in producing glucose. -It acts on intestines and reduces the absorption of sugar. Because of this, metformin has several side effects like reduction of appetite and weight loss. Some other bothersome side effects are nausea and stomach ache, giddiness, light headedness, muscle pain, body aches, constipation and flatulence To overcome these side-effects, it is better to take it with meals or just after finishing meals.
This helps to reduce some of these side-effects. Thus, it is advisable to take metformin with meals or just after finishing meals.
What is the benefit of taking metformin at night?
Abstract – The administration of metformin, as glucophage retard, at bedtime instead of supper time may improve diabetes control by reducing morning hyperglycemia. This modification of glucophage treatment was tried in 3 groups of diabetic patients: I.
Those with secondary failure of routine treatment with sulfonylurea (SU) and glucophage; II. those with combined SU and bedtime insulin; III. Type 1 patients with early morning hypoglycemia. The first 3 months of observation in 258 patients showed that 136 (52.7%) reacted very well to the change. In Group I the addition of insulin to SU could be postponed.
In Group II, night insulin could be reduced or eliminated. In Group III, evening or night insulin could be reduced by up to 70%. There was no early morning hypoglycemia nor morning hyperglycemia. The success rate in the 2 Type 2 groups was better (72% and 60%) than in the Type 1 group (34%).30 patients (11.6%) had to stop the treatment because of side effects of the glucophage (mainly diarrhea or nausea).
What are the signs that metformin is working?
You’ll have more energy as your body uses insulin more efficiently. Common diabetes-related symptoms, such as blurry vision, being thirsty all of the time, or having to pee a lot, improve or disappear.
How quickly does metformin lower blood sugar?
Luckily, metformin may start to work within the first week of treatment. In one study of over 700 people, metformin ER lowered blood glucose within the first week of treatment. But it took about 2 months for it to have its full glucose-lowering effect.
Can your blood sugar go too low on metformin?
Metformin does not usually cause low blood sugar. But you may get low blood sugar when you take metformin and you exercise hard, drink alcohol, or do not eat enough food. Sometimes metformin is combined with other diabetes medicine. Some of these can cause low blood sugar.
Is 15 sugar level high?
If you regularly have high blood sugar levels – Having high blood sugar levels regularly is not something you should live with. This is because in the long-term it can increase your risk of developing diabetes complications, such as neuropathy and retinopathy,
If you notice that your blood sugar levels are often high, (above 10mmol) you should contact your diabetes healthcare team. They will review your treatment and provide you with advice on how to get your blood sugar levels back within your target range. This advice may include increasing your medication.
In the video below, Lynsey talks to Khalida about feeling anxious after getting a high blood sugar level reading. If you’re finding it hard to deal with similar feelings, we’ve got information on emotional health that you may find helpful.
What should diabetics do before bedtime?
If you take insulin or other diabetes medications, you may sometimes need to snack before bedtime to treat or prevent low blood sugar (hypoglycemia) during the night. If this happens frequently, talk to your doctor.
What should blood sugar be at bedtime for diabetic?
Check your blood sugar level Bedtime is another good time to test. It’s a good idea to keep our blood sugar goal at bedtime in the range of 80 to 180 milligrams per deciliter (mg/dL).
Should I take metformin at bedtime?
Be sure to take it with meals to reduce the stomach and bowel side effects that can occur – most people take metformin with breakfast and dinner. Extended-release metformin is taken once a day and should be taken at night, with dinner. This can help to treat high glucose levels overnight.
Can diabetes medicine be stopped once started?
Coming off medication in diabetes remission – Some people are able to stop taking diabetes medication like metformin, by putting their diabetes into remission, This means that blood sugar levels are in the non-diabetes range without needing any medication.
- There are many ways people with diabetes have done this, but they mostly involve making changes to your diet and losing weight,
- It’s important to remember that this isn’t an option for everyone and isn’t an easy thing to do.
- If you’re thinking of making changes to your diet, it’s a good idea to speak to your healthcare team first.
We’ve got lots of information about diabetes remission so you can get all the facts. Jon was diagnosed with type 2 in 2013 and was given metformin. But after learning more about his condition, Jon started to address his weight. After a couple of months, he was able to gradually stop taking medication. 
“Realising I had to address my weight, I started swimming every day and walking as much as possible Within two months, I’d lost nearly 4 stone, my sugars had gone back to pre-diabetes levels and I was able to gradually stop taking metformin.” Jon was diagnosed with type 2 diabetes in 2013
How do you feel after starting diabetes medication?
Know Your Medicines – Different types of diabetes drugs have their own side effects and ways they interact with other medicines. Biguanides: Metformin ( Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet ). Metformin is usually the first drug that doctors suggest you try to treat type 2 diabetes,
- It cuts blood sugar by improving the way your body uses insulin,
- It also lowers the amount of sugar that the liver makes.
- What are the side effects? You may have nausea, gas, bloating, diarrhea, b12 deficiency, and an upset stomach.
- These problems usually go away in a few weeks, as your body gets used to the medicine.
It may also help to take the drug with food. In rare cases, metformin may cause a serious condition called lactic acidosis, That’s when too much lactic acid builds up. Call your doctor right away if you get any of these symptoms:
Unusual weakness, tiredness, or sleepiness Trouble breathing Muscle pain that’s not normalSudden stomach problems, such as vomiting
Do they clash with other drugs ? Some drugs may interfere with some of the enzymes that metformin uses to work. Your doctor may need to monitor your blood sugar or adjust your metformin dose if you take any of these:
Amiloride ( Midamor ) Cephalexin ( Daxbia, Keflex ) Cimetidine ( Tagemet ) Digoxin ( Lanoxicaps, Lanoxin ) Procainamide Pyrimethamine ( Daraprim ) Quinidine ( Quinidex ) Quinine Trimethoprim ( Primsol ) Vancomycin ( Vancocin )
Anticholinergic drugs, such as dicyclomine ( Bentyl ) and oxybutynin ( Ditropan, Ditropan XL, Oxytrol ), may raise the amount of metformin your body absorbs. This may lead to low blood sugar, Sulfonylureas: Glipizide ( Glucotrol, G lucotrol XL ), glimepride ( Amaryl ), glyburide ( DiaBeta, Glynase PresTab).
These drugs lower your blood sugar by helping your pancreas make more insulin, What are the side effects? The most common one is low blood sugar, This can make you feel shaky, sweaty, dizzy, and confused. Severe low blood sugar can be life-threatening. To prevent it, eat regularly and don’t skip meals.
Other side effects that you might get are weight gain, dark urine, and an upset stomach. Sulfonylureas can also cause skin rashes and reactions to the sun. Do they clash with other drugs? About 100 drugs can change the way sulfonylureas work. Some can make them work too well, which may lead to dangerously low blood sugar.
Azole antifungals, including fluconazole and ketoconazole Some antibiotics, such as chloramphenicol, ciprofloxacin, clarithromycin ( Biaxin ), isoniazid ( Nydrazid ), rifampin, and sulfasalazine ( Azulfidine, Azulfidine Entabs, Gantrisin Pediatric, Sulfazine, Sulfazine EC, co-trimoxazole, Zonegran ) Cholesterol -lowering drugs, such as clofibrate and gemfibrozil Tricyclic antidepressants H2 blockers Gout medications, such as probenecid Some high blood pressure medicines, including ACE inhibitors and bosentan Beta-blockersCorticosteroidsCalcium channel blockersOral contraceptives Thiazide diuretics Thyroid medicines
Meglitinides: nateglinide ( Starlix ), repaglinide ( Prandin ). They help your pancreas make more insulin. Although these drugs work faster, they don’t last as long in the body. What are the side effects? These medications can lead to low blood sugar and weight gain.
Azole antifungalsCertain antibiotics, including rifampin and isoniazidSome high blood pressure medicines, such as calcium channel blockers, beta-blockers, and thiazide diureticsCorticosteroids Estrogen Nicotinic acid Oral contraceptives PhenothiazinesPhenytoin ( Dilantin, Phenytek ) Thyroid supplementsMonoamine oxidase inhibitors NSAIDs Probenecid Salicylic acid Sulfonamides
Thiazolidinediones (TZDs): Pioglitazone ( Actos ), rosiglitazone ( Avandia ). These drugs boost the way insulin works in the body. What are the side effects? It may cause you to hang on to fluids in your body, which can lead to swelling. TZDs can also make you gain weight and raise your levels of LDL “bad” cholesterol,
Fluoxetine ( Prozac ) Gemfibrozil ( Lopid ) Ketoconazole ( Nizora l ) Rifampin ( Rifadin ) Trimethoprim ( Primsol )
Other medicines, when combined with a TZD, may raise your chance of having heart problems:
NSAIDsSulfonylureasNitrates
Alpha-glucosidase inhibitors: Acarbose ( Precose,) miglitol ( Glyset ). You take alpha-glucosidase inhibitors with the first bite of each meal. They slow the breakdown of carbohydrates. What are the side effects? Because these medicines affect your digestion, you may have gas, diarrhea, and stomach pain,
They also may cause an increase in blood markers of a stressed liver. Do they clash with other drugs? Alpha-glucosidase inhibitors may not work as well if you also take digestive enzymes and activated charcoal supplements, Alpha-glucosidase inhibitors can also make it harder for the body to absorb digoxin,
They may also change the way warfarin works. Talk to your doctor if you take either of these drugs. DPP-4 inhibitors: alogliptin ( Nesina ), linagliptin ( Tradjenta ), saxagliptin ( Onglyza ), Sitagliptin ( Januvia ). These medicines help your pancreas release more insulin after meals.
- They also lower the amount of sugar you make.
- What are the side effects? You could get a sore throat, stuffy nose, upset stomach, and diarrhea.
- You may also run the risk of acute pancreatitis, liver failure, possible worsening heart failure and joint pain Do they clash with other drugs? Some drugs may affect how much DPP-4 inhibitors are absorbed in the body.
Your doctor will want to track your blood sugar levels carefully and watch for potential side effects if you take these medicines:
Atazanavir ( Reyataz ) and ritonavir ( Norvir ) Clarithromycin ( Biaxin ) and rifampin ( Rifadin, Rimactane ) Diltiazem ( Cardizem ) Ketoconazole ( Nizoral, Xolegel )
ACE inhibitors combined with DPP-4 may raise your chance of swelling. SGLT2 inhibitors: Canagliflozin ( Invokana ), dapagliflozin ( Farxiga ), empagliflozin ( Jardiance ), ertugliflozin ( Steglatro ). They work in the kidneys and remove extra sugar from your blood through urine.
What are the side effects? These drugs raise your chances of having urinary tract and yeast infections, They may also cause low blood sugar. On the positive side, they may reduce the risk of kidney disease for those with diabetes and can reduce the risk of being hospitalized or dying from heart failure.
Do they clash with other drugs? SGLT2 inhibitors don’t interact with many drugs. Rifampin may make the drug less effective. SGLT2 inhibitors may also raise the amount of digoxin in the body. Insulin therapy: insulin aspart ( Novolog ), insulin detemir ( Levemir ), insulin glargine ( Lantus ), Insulin glulisine ( Apidra ), insulin isophane ( Humulin, Novolin N ), insulin lispro ( Humalog ),.
- If other medicines aren’t doing enough, you may need insulin therapy.
- You’ll need to inject insulin using a needle and syringe or a pen injector.
- What are the side effects? The most common side effect is low blood sugar.
- You may also have a wide variety of symptoms, such as headaches, rashes, dizziness, anxiety, cough, and dry mouth,
Talk to your doctor. Some may go away as your body gets used to the medicine. Do they clash with other drugs? Some drugs affect the way that insulin works in the body. This may cause your blood sugar to become too low or high. Your doctor may need to monitor your blood sugar level, adjust your dose, or change your medicine if you take some of these:
Diabetes medicinesSalicylic acidCertain antidepressants, such as fluoxetine and monoamine oxidase inhibitorsSome antibiotics, including isoniazid and sulfonamideFibratesSome high blood pressure medicines, such as ACE inhibitors and angiotensin II receptor blocking agentsCertain cholesterol -lowering drugs, including fibrates and niacin Propoxyphene, pentoxifylline and somatostatin analogsCorticosteroidsOral contraceptives EstrogensDiureticsPhenothiazines Danazol ( Danocrine )Protease inhibitors Glucagon ( GlucaGen ) Thyroid medicine
Should metformin be taken on a full stomach or before a meal?
Proper Use – Drug information provided by: IBM Micromedex This medicine usually comes with a patient information insert. Read the information carefully and make sure you understand it before taking this medicine. If you have any questions, ask your doctor.
- Carefully follow the special meal plan your doctor gave you.
- This is a very important part of controlling your condition, and is necessary if the medicine is to work properly.
- Also, exercise regularly and test for sugar in your blood or urine as directed.
- Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment.
Swallow the tablet or extended-release tablet whole with a full glass of water. Do not crush, break, or chew it. While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about.
Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Use the supplied dosing cup to measure the mixed extended-release oral suspension. Ask your pharmacist for a dosing cup if you do not have one. Use only the brand of this medicine that your doctor prescribed.
Different brands may not work the same way. You may notice improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this.
Should metformin be take 30 minutes before meal?
How should I use this medication? – Take this medicine by mouth. Swallow it with a drink of water. Follow the directions on the prescription label. Take this medicine before meals. It should be taken no earlier than 30 minutes before meals. If a meal is skipped, skip the dose for that meal.
Do not take more often than directed. Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed. Elderly patients over 65 years old may have a stronger reaction and need a smaller dose. Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
What is the difference between taking medicine before and after food?
Some medicines need to be taken “before food” or “on an empty stomach”. This is because food and some drinks can affect the way these medicines work. For example, taking some medicines at the same time as eating may prevent your stomach and intestines absorbing the medicine, making it less effective.
grapefruit juicecranberry juicefoods high in vitamin K, such as leafy green vegetablessalt substitutes or food supplements high in potassium, such as bananas
You should follow the instructions you receive with your medicine. If you’re unsure how to take your specific medicine or whether you can have anything to eat or drink before taking it, speak to your GP or pharmacist (chemist) or phone NHS 111 for advice.
Can you take metformin an hour after eating?
Metformin is currently the first line of drug for managing diabetes. Metformin is a very safe medicine for diabetics. The time of taking metformin depends on your blood sugar readings, your weight and other factors like diet, exercise and lifestyle. Metformin works in the following ways: -It makes your body more sensitive towards the action of insulin.
It acts on liver and it restricts liver in producing glucose. -It acts on intestines and reduces the absorption of sugar. Because of this, metformin has several side effects like reduction of appetite and weight loss. Some other bothersome side effects are nausea and stomach ache, giddiness, light headedness, muscle pain, body aches, constipation and flatulence To overcome these side-effects, it is better to take it with meals or just after finishing meals.
This helps to reduce some of these side-effects. Thus, it is advisable to take metformin with meals or just after finishing meals.