Metformin: What It Is, How It Works, and What You Need to Know

When you hear metformin, a first-line oral medication used to manage type 2 diabetes by reducing liver glucose production and improving insulin sensitivity. Also known as Glucophage, it’s the most prescribed diabetes drug in India — and for good reason. It’s not a miracle cure, but for millions, it’s the difference between feeling tired all day and being able to walk to the market without getting winded.

Metformin doesn’t force your body to make more insulin. Instead, it helps your cells use what you already have more efficiently. That’s why it’s often the first choice for people with insulin resistance, a condition where the body’s cells don’t respond well to insulin, leading to high blood sugar. It’s also used off-label for weight management in people with PCOS, and some doctors prescribe it to prediabetic patients to delay full-blown diabetes. Unlike other diabetes pills, metformin rarely causes low blood sugar — a big plus if you’re juggling work, kids, or both.

It’s not perfect. Some people get stomach upset — nausea, bloating, loose stools — especially when they start. Most get used to it within a few weeks. Taking it with food helps. There’s also a rare but serious risk of lactic acidosis, mostly in people with kidney problems, so your doctor will check your kidney function before and during treatment. You won’t find metformin on pharmacy shelves without a prescription, but it’s cheap — often under ₹50 a month in government hospitals and most private clinics.

What you won’t see in ads is how many people stop taking it because they think it’s "not working." But metformin doesn’t make you feel different. It works quietly — lowering your fasting sugar from 180 to 120, keeping your HbA1c under 7%, reducing your long-term risk of heart attacks and kidney damage. If you’re on it, you’re not just managing sugar — you’re protecting your future.

There are newer drugs like Ozempic and Wegovy that get all the attention, but metformin is still the backbone of diabetes care in India. It’s not flashy, but it’s proven. And for many, it’s the only thing standing between them and complications that could change their lives forever.

Below, you’ll find real stories and practical advice from people who’ve been on metformin for years — how they handle side effects, what they eat, how they track progress, and when they decided to switch or add another medication. Whether you’re just starting out or have been on it for a decade, there’s something here that applies to you.