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Dan Molson

Managing Pre-Diabetes with Fasting and Metformin

Question:
I’m doing fasting. I’m at pre-diabetic level. I have metformin, but you have to take it with food.

Answer:
For managing pre-diabetes, your fasting approach can help control blood sugar, but you’re correct that metformin usually requires food to prevent stomach discomfort or other side effects. Here are a few strategies that might work around this, helping you stay on track with fasting while using metformin effectively:

  1. Take Metformin with Your OMAD Meal: Since you’re on a one-meal-a-day (OMAD) plan, you could time your metformin with this meal so it’s well absorbed and gentler on your stomach.
  2. Split Doses (if Prescribed Twice Daily): If metformin is recommended twice a day, consider talking to your doctor about taking it once daily or as a split dose around your eating window if that’s manageable. Some formulations (like extended-release metformin) may allow for flexibility in timing.
  3. Consider Extended-Release Metformin: If you’re on regular metformin, you might ask your doctor about switching to the extended-release (ER) version, which is often gentler on the stomach and may not require as much food with it.
  4. Hydration and Electrolytes: Staying well-hydrated and balancing electrolytes during fasting can help maintain energy and balance blood sugar, especially on days when your fast is longer.

Your fasting approach is already helping by giving your pancreas time to rest, lowering blood sugar, and helping increase insulin sensitivity. Balancing it with metformin as needed should enhance those effects and keep you feeling well throughout your fasting journey.

Scientific Citations

  • American Diabetes Association. (2023). “Diabetes Care & Treatment.” Retrieved from https://www.diabetes.org/
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2023). “Metformin and Diabetes Management.” Retrieved from https://www.niddk.nih.gov/
  • Rena, G., Hardie, D. G., & Pearson, E. R. (2017). “The mechanisms of action of metformin.” Diabetologia, 60(9), 1577-1585.
  • Maruthur, N. M., Tseng, E., Hutfless, S., et al. (2016). “Diabetes medications as monotherapy or metformin-based combination therapy for type 2 diabetes.” Annals of Internal Medicine, 164(11), 740-751.