We have received a reader question "Are there two types of metformin?" Yes, there is a more expensive form of the drug, Glucophage XR, that is formulated to release the drug into the bloodstream slowly to keep blood sugars down overnight. If you are using metformin for dawn phenomenon (blood sugar levels that soar just before you get up in the morning), then you probably should ask your doctor for a prescription for Glucophage XR.
Another reader question we received is "Does metformin cause panic attacks?" Actually, in our experience, it's the other way around. Especially in women who are taking metformin for PCOS (polycystic ovarian syndrome), better blood sugar control leads to slower heart rates and less of a startle response. Of course, it's possible to lower blood sugar levels without using metformin, but the medication is very commonly prescribed to women who have PCOS.
Another reader asks, "Has anyone lost weight using metformin?" The huge advantage of metformin over pioglitazone and rosiglitazone (Actos and Avandia) is that it does not stimulate the activity or creation of fat cells. You won't lose weight just because you take metformin. You still need to burn more calories than you take in. Metformin, however, at least doesn't cause the additional problem of creating billions of new baby fat cells the way Actos and Avandia do.
We are also asked, "Is there an herbal substitute for metformin?" Well, yes, there is, but the herb actually costs more than the medication. Goat's rue was the original source of the active chemical that became known as metformin. While we have nothing against herbs, in this case, the medication is actually better. And you don't want to be dependent on either an herb or a drug.