Drinking with Metformin

Thread starter #1
How would you guys handle this situation??

About 3 months ago i started Metfromin at 1g daily.

In about a month I'll be getting together with a group of buddies for our annual 4 days of shenanigans. We will be drinking alcohol in excess for most of each day, probably starting Bloody Marry's at breakfast. I''m not going to pretend that i'm going to take it easy on the alcohol, Because that'd be a lie.

I know Metformin and Alcohol do not mix well. Should i just stop the metformin a few days before the event and then resume after returning?
 

dnfuss

Active Member
#3
Alcohol, in and of itself, does not typically raise serum glucose, even in diabetics. It is generally prioritized in hepatic metabolism and therefore merely delays, but neither increases nor decreases, blood sugar changes resulting from dietary intake.

Of course, if the alcohol ingested involves a carbohydrate medium (e.g., beer, sweet wine, mixed drinks including sugar in the form of sugary sodas, fruit juices, or added sugar or syrup such as gin and tonic, screwdriver, cosmopolitan, rum and coke, margarita, pina colada, LI Iced Tea, etc.), blood sugar may rise dramatically in response thereto once the alcohol has been metabolized.

This is why when I choose to have a cocktail I will have a Martini or a Scotch and soda, which have essentially no residual sugar. One (or two) generally has no significant effect on my blood sugar.

But my blood sugar issues are very mild and controlled with just diet and metformin. Those with moderate-to-severe diabetes, especially Type 1s and those on insulin or sufonylureas, must be very vigilant when drinking alcohol (obviously a challenge) to avoid a potential episode of acute hypoglycemia (which could result in coma or even death).

Metformin doesn't per se involve such a risk of hypoglycemia, but the literature still generally warns against drinking alcohol when on metformin in an abundance of caution, as metformin has been associated with increased risk of lactic acidosis and alcohol reduces the capacity to metabolize lactic acid. This is especially important for those with impaired kidney function, which itself carries an increased risk of lactic acidosis.

So, bottom line, many of those on metformin can and do enjoy a drink, but please do so after considering carefully all of the above.
 
Thread starter #4
I guess I actually wasn't really being concerned with Glucose levels when i made this post. I was concerned with lactic acidosis and it killing me.

I don't have diabetes but my A1C was just shy of pre-diabetes on a couple tests.

And i'm not going to be having 1 or 2 cocktails. I'll pretty much be drinking in some capacity usually starting about noon and well into the wee hours of the morning. 12-15hr of drinking per day.
 

Vince

Moderator
#5
I guess I actually wasn't really being concerned with Glucose levels when i made this post. I was concerned with lactic acidosis and it killing me.

I don't have diabetes but my A1C was just shy of pre-diabetes on a couple tests.

And i'm not going to be having 1 or 2 cocktails. I'll pretty much be drinking in some capacity usually starting about noon and well into the wee hours of the morning. 12-15hr of drinking per day.
I understand what you're saying. Metformin causes an increase of lactic acidosis and heavy drinking can prevent your body from getting rid of it. The best decision would be, don't drink any alcohol LOL.
 

dnfuss

Active Member
#6
I guess I actually wasn't really being concerned with Glucose levels when i made this post. I was concerned with lactic acidosis and it killing me.

I don't have diabetes but my A1C was just shy of pre-diabetes on a couple tests.

And i'm not going to be having 1 or 2 cocktails. I'll pretty much be drinking in some capacity usually starting about noon and well into the wee hours of the morning. 12-15hr of drinking per day.
I understand what you're saying. Metformin causes an increase of lactic acidosis and heavy drinking can prevent your body from getting rid of it. The best decision would be, don't drink any alcohol LOL.
In your situation, the other option if you are concerned would be to stop metformin before your get-together. Three days prior is probably fine (especially if you're on the immediate-release version). A maximum of two weeks prior if you are the worrying type and want to be absolutely certain.
 
Thread starter #7
It's the extended release version, I think i'll just stop the weekend before and go have fun. Then resume my regular protocol after returning.
 
Thread starter #8
I understand what you're saying. Metformin causes an increase of lactic acidosis and heavy drinking can prevent your body from getting rid of it. The best decision would be, don't drink any alcohol LOL.
Yeah i know that would be the BEST decision, But that just not gunna happen;)
 
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