Metformin: What It Is, How It Works, and What Alternatives You Should Know

When doctors diagnose Metformin, a first-line oral medication used to lower blood sugar in people with type 2 diabetes. Also known as glucophage, it's been used for over 60 years and remains the most prescribed diabetes drug worldwide. Unlike other diabetes pills that force your body to make more insulin, Metformin works by making your cells more sensitive to the insulin you already have. It also slows down how much sugar your liver releases into your bloodstream—two simple but powerful moves that keep blood sugar steady without causing dangerous drops.

Metformin doesn’t just treat diabetes. Studies show it can help with weight loss, especially in people with insulin resistance, and may even lower the risk of heart disease in diabetics. It’s also used off-label for polycystic ovary syndrome (PCOS), where it helps restore regular periods and improve fertility by balancing insulin and hormone levels. But it’s not magic—it doesn’t work for everyone, and it has side effects. The most common ones? Stomach upset, bloating, and diarrhea. These usually fade after a few weeks, but if they don’t, your doctor might switch you to an extended-release version, which is gentler on the gut.

Metformin isn’t the only option anymore. Newer drugs like GLP-1 agonists, a class of injectable medications that mimic gut hormones to lower blood sugar and promote weight loss—such as Ozempic and Wegovy—are now popular for people who need stronger results or have heart disease. SGLT2 inhibitors, a different class of pills that make your kidneys flush out extra sugar through urine, like dapagliflozin, are also rising in use because they protect the heart and kidneys. But Metformin still leads because it’s cheap, safe for long-term use, and doesn’t cause weight gain or low blood sugar like some other pills do.

What you won’t find in most doctor’s offices is how many people stop taking Metformin because of side effects or because they don’t understand how it works. That’s why so many online searches now ask: Is there a better pill? Can I take it with alcohol? Why does it make me feel sick? And what happens if I skip a dose? The posts below answer those questions with real data—not marketing. You’ll find side-by-side comparisons with other diabetes drugs, tips for managing nausea, what to do if Metformin stops working, and how lifestyle changes can make it more effective. Whether you’re just starting Metformin or have been on it for years, you’ll walk away with clearer answers and real choices.