Overview
Metformin is first-line for type 2 diabetes and has a long safety record. GI side effects are common but often improve with time or extended-release formulation.
Symptoms to watch for
- Nausea
- Diarrhea
- Metallic taste
- Reduced appetite
- Long-term: B12 deficiency
Treatment
Start low (500 mg with dinner), titrate slowly. Extended-release reduces GI side effects. Check B12 annually.