Taking Metformin pills separately yields better results

Hi all, this is my first post here but I’ve been reading since I was diagnosed with Type II about a year-and-a-half ago at age 40. I’ve been taking Metformin extended release (2 750 mg pills per day) plus a weekly Trulicity shot since I was diagnosed (my A1C was 11.2, I’d been ignoring symptoms for awhile). They also prescribed glyburide at first but discontinued it as unnecessary when my A1c went down to 5.7. My last A1c was 6.4 which could be better of course, but is in the range my doctor wants to see.

At first I was taking one Metformin pill in the morning and one at night, but the nurse practitioner suggested I might have less digestive issues if I took them both together in the evening. So I’ve been doing that for the past few months but have seen my BG numbers increase quite a bit. I didn’t link it to taking the pills together at first, but I’ve been quite frustrated. Before, my BG might range from 110-140 in the morning but now it was regularly 140-160…not where I want to start the day! My numbers later in the day were worse too, even though I tried not to eat any carbs for several hours after waking up.

I was on the verge of contacting the nurse practitioner again to ask for a change in medication, when I decided first to try staggering the Metformin doses again, morning and evening. Amazingly, my BG is again much better, both morning and evening. Has anyone else experienced this or had big changes from playing with the timing of medication? The nurse practitioner had even predicted that my morning numbers–the ones I can least control–might even go down from taking two pills at night, but instead they went up!


Interesting. I’m down to 2 500mg Metformin ER due to CKD. I had been on 4 for quite a while. I switched to nighttime because that’s when I take all my other meds and my morning routine is not stable and I would often forget those 2 tablets. Your experience suggests that maybe the extended release wasn’t giving you 24-hour coverage. I may try to split my doses again - 12-hours apart - and see what happens.

If you try it, please let me know if it makes a difference. I agree that the Metformin ER was probably not lasting 24 hours, but what I really can’t figure out is why my morning numbers were higher when taking two pills at night–often just before I went to sleep. There must be some mechanism at work here that I don’t understand.

It is recommended that metformin be taken with meals. It wasn’t clear if you where. It is fat that used to distress my gut. On ER and eat low fat. No more issues. A small snack before bed can help prevent an increase in am. Blood sugars . Nancy50

Well the Nurse Practitioner did recommend that I take it with dinner, but I would usually forget until bedtime anyway. I do eat before I go to bed but my morning numbers are always high regardless. I’ve been working very hard to limit carbs–not full-on keto diet but still fairly limited–so limiting fat too would not be very practical. Thankfully the stomach upset seems to have decreased over time anyway.

That makes sense because they don’t necessarily last the whole day. You get better coverage if you take them 2x a day—I’ve heard that from other people on Met ER as well, and it’s my experience with it. Personally, I don’t understand why it would be prescribed 1x a day except in order to slowly step up to a twice a day as your body gets used to side effects. But perhaps it is like Lantus, with considerable individual differences in metabolism, where for most folks it does not provide 24 hour coverage despite often being prescribed as a 1x a day shot, but for some it does work ok.

Also it’s not about taking the pills separately, it’s about dosing 2x a day. I believe most people on metformin ER, like myself, take the max dose of 1000mg (2 500mg pills) 2x a day.

Remembering pills is important, I use a pill box by my place setting at the table. And occasionally I may forget but not very often. Nancy50

I have an iron clad gut lol. I take 1000 mgs of Metformin every morning with my Lisinopril and no food at all. No problems. It’s like taking a sugar pill for me. At night I take the other 1000 mgs with my once a day evening meal. Some people have a lot of issues with Met though.

I’ve never taken Metformin with food oops . Until last summer, I had been taking 2000mg of ER at bedtime. Now I’m down to half that dose since I now have moderate CKD. The last 2 days I’ve split the dose at bedtime and when I get up (8ish), seems like my BG has been a little more stable, but admittedly I’m not controlling for too many other variables. I switched from Libre to Dexcom 10 days ago and I’ve been on OmniPods for about 2 weeks

Well, you check your blood sugars and you know if it’s working for you! Did the Trulicity cause any problems for you getting started?? I’d like to go on that class of medicine to lose weight but I have a very sensitive stomach. I used to take 1,000 mgs of extended relief metformin and had to take it as 500 mgs. twice a day because of stomach issues. It worked fine for me that way.

Bravo for this personal initiative and experimentation! Clinicians don’t know everything and reasonable personal experiments like this can often reward you with great results.

Now I know some people don’t like cutting corners on doctor’s orders but I don’t see much harm provided if it is limited in nature. You’ve now discovered a tactic that works for you. I hope you also found that relying on your own initiative can sometimes provide better health and quality of life.

Thank you Terry, I’m just annoyed at myself that it took me so long to try switching back. It’s been over a week now and my numbers continue to be MUCH better.

Hi Jean,
My doctor started me on a lower dose of Trulicity at first just to make sure it didn’t cause issues, and as far as I could tell it didn’t, although I also started Metformin at the same time which caused some nausea and stomach upset. After a month she increased the Trulicity dose to 1.5 (not sure if that’s ml or what unit) and it still doesn’t seem to cause me any problems thankfully. It did help bring my numbers down quite a bit.