Metformin hydrochloride (C4H11N5 · HCl), belonging to the biguanides class of drugs, is one of the commonly prescribed medications for managing type 2 diabetes and polycystic ovary syndrome (PCOS). It helps control blood sugar by improving insulin sensitivity and reducing the amount of sugar produced by the liver. Thus, it remains a first-line treatment for managing type 2 diabetes. However, to maximise its effectiveness and avoid potential side effects, it is essential to follow metformin dietary guidelines. Here we have compiled a list of foods to avoid while taking metformin. This blog also includes metformin’s mechanism and how dietary adjustments can help manage blood sugar levels.

Understanding the Primary Mechanism of Metformin:

To answer people asking ‘how metformin works?’, it decreases the amount of glucose (sugar) in your blood and increases your insulin sensitivity. Hence, helping people with reduced insulin sensitivity (type 2 diabetics):

• Reducing glucose production in the liver: It decreases the amount of glucose released by the liver, ensuring your blood sugar levels don’t spike after meals.
• Increasing insulin sensitivity: Metformin helps your body respond better to insulin, improving your ability to use glucose.
• Slowing down glucose absorption: It may slow the absorption of sugar in the intestines, preventing rapid rises in blood sugar after eating.

Given these actions, it’s important to avoid certain foods that may interfere with how Metformin functions or could cause unwanted side effects.

Foods to Avoid While Taking Metformin

Some metformin food interactions can interfere with the effectiveness of Metformin or aggravate side effects like gastrointestinal discomfort (nausea, bloating, etc.). A table of foods to avoid with Metformin and why:

Food Type	Reason to Avoid
High-sugar foods (sweets, sodas, sugary snacks)	High in glycemic index, causing rapid spikes in blood sugar that Metformin can’t prevent on its own.
Refined Carbs (white bread, pasta)	These quickly break down into sugar, potentially overwhelming your blood sugar levels, making Metformin less effective.
Alcohol	Alcohol consumption increases Metformin lactic acidosis, a rare but serious side effect.
High-fat foods (fried foods, fast food)	These foods slow down digestion and can make it harder for Metformin to work efficiently, e.g., bacon, sausages, beef ribs, and pork ribs.
Caffeinated beverages	According to WebMD, Metformin may slow down caffeine digestion, hence increased effects/side effects of caffeine may be experienced.
Dairy (cheese, full-fat milk)	No need to stop dairy, only limit it, as it can increase gastrointestinal side effects, such as bloating and diarrhea.
Artificial Sweeteners	These can potentially disrupt your body’s insulin response, leading to imbalances in blood sugar.

In type 2 diabetes, your body produces less insulin or becomes insulin resistant. As a result, when you consume carbohydrates, most of them are not broken down into energy, and the carbs (sugar) stay in your bloodstream. This sugar in your bloodstream further results in several complications. Low-carb meals for diabetes have thus been famous since old times, as they simply minimize the cause of blood sugar spikes.

Still Unaware of a CGM System?

CGM systems typically consist of CGM sensors, usually inserted on the back of your upper arm or on the abdomen, and a handheld monitor (not mandatory). Latest CGMs, such as Freestyle Libre 2 Plus Sensors, can be fully controlled through your compatible smartphone and can even be integrated with an automatic insulin delivery (AID) system, such as OmniPod 5.

Metformin Dietary Guidelines

To optimise the effect of Metformin on blood sugar control, here are some dietary tips:

1. Focus on Low-Glycemic Index Foods: Foods that have a low glycemic index (GI) are absorbed slowly, preventing rapid blood sugar spikes. Examples include whole grains (restricted), legumes, and non-starchy vegetables.
2. Include Fiber-Rich Foods: High-fiber foods, such as fruits, vegetables, and whole grains, can help regulate blood sugar levels and support digestive health.
3. Healthy Fats: Incorporating sources of healthy fats like avocado, olive oil, and nuts can help balance blood sugar and improve heart health.
4. Regular Meals: Eating small, balanced meals throughout the day can help prevent blood sugar fluctuations.
5. Limit Simple Carbohydrates: Avoid highly processed carbs like pastries, sugary snacks, and white bread.
6. Stay Hydrated: Drinking plenty of water is important for supporting kidney function and reducing the risk of dehydration, especially when on Metformin. If you experience frequent urination, consume in sips.

Managing Blood Sugar with Metformin

Metformin alone cannot be considered a miracle drug. Instead, to manage diabetes effectively, it should be combined with a healthy lifestyle, including:

• Dietary Modifications: Avoiding high-carb, sugary, and fatty foods, as discussed, while focusing on low glycemic foods for diabetes. You may consume whole foods, vegetables, and lean proteins in a balanced manner.
• Physical Activity: Regular exercise helps improve insulin sensitivity, which enhances Metformin’s effects. Aim to walk at least 30 minutes per day.
• Monitoring Blood Sugar: Regular checks can help you understand how your diet, medication, and exercise routine are working together. You may move towards finger prick free glucose monitoring by opting for a continuous glucose monitoring system (CGM system).

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Conclusion

Managing diabetes or PCOS with Metformin involves more than just taking the medication. A balanced diet, avoiding foods that interfere with Metformin, and maintaining a healthy lifestyle are essential for effective blood glucose control. Restricting high-sugar, refined carbs, and alcohol can help you minimize metformin’s side effects and maximize its benefits.

Frequently Asked Questions