Metformin is a drug that has been used to help control blood glucose levels in people with Type 2 Diabetes. Although Glucophage has been used in Europe for over 25 years, it was not available in the US until 1995. The FDA has approved metformin only for the treatment of Type 2 Diabetes. Consequently, some physicians don't have much clinical experience with Glucophage, or are reluctant to use it unless the patient has diabetes.(1)
Metformin appears to work in three ways. First, it decreases the absorption of dietary carbohydrates through the intestines.
Second, it reduces the production of glucose by the liver.(2) The liver uses the raw material in your food to create a reserve supply of blood sugar. When your body experiences stress, the liver releases the reserve glucose to supply your brain and muscles with an immediate source of energy to cope with the stress. Glucophage suppresses the production of this reserve fuel.
Third, and perhaps most importantly, metformin increases the sensitivity of muscle cells to insulin.(2) Insulin is the hormone that delivers glucose into your cells to be burned as fuel, or stored. Women with PCOS frequently have "insulin resistance", a condition where excessive amounts of insulin are required in order to get blood glucose moved into cells, where it belongs. Glucophage helps your body to ransport glucose with relatively less insulin, thus lowering your insulin levels. Chronically high levels of either glucose or insulin in your blood contributes to obesity, heart disease, infertility, and certain cancers, as well as the development of diabetes.
Metformin is available in three different forms:
1. Generic Metformin Hcl
2. Glucophage (brand name)
3. Glucophage XR (brand name)
Glucophage is available in 500 mg, 850 mg, or 1,000 mg tablets. The usual dose is 850-1,000 mg twice daily. The maximum safe dose is thought to be 850 mg three times daily. To minimize GI upset or diarrhea, it's recommended that you start with a low dosage and work your way up to the recommended dose.
Glucophage XR, an extended-release version of Glucophage, allows you to take only one dose a day. The slower release of long-acting Glucophage XR may help to reduce stomach upset that may occur with the regular Glucophage or metformin.
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