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Diabetic type 2
My wife has had Type 2 diabetes since the age of about 19–20 and she is now 29. For many years she was taking Glycomet SR 500 mg twice daily and her blood sugar used to remain around 105–110 mg/dL. Recently this dose was not controlling her sugar well and her HbA1c increased to 8.7%.
After consulting an endocrinologist, her dose was increased to Glycomet SR 1000 mg twice daily and she was also given a diet plan (oats/vegetables in the morning, small portion of rice with vegetables, dal and fish/meat/paneer at lunch, boiled chickpeas in the evening, and 2 rotis with vegetables at night).
Her sugar is now around 108–110 mg/dL and HbA1c has improved to 7% in one month. However, since increasing the dose she has been experiencing loose stools. She passes stool normally in the morning but does not feel completely relieved and has to go 2–3 more times during the day. The stool is somewhat loose, similar to mild dysentery. Loosing weights also.. help
Answers (23)
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You should follow up with your consultant.
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This looks like metformin-related GI intolerance after increasing the dose to 2 g/day, which is dose dependent and fairly common. The loose stools and increased frequency fit well, though the associated weight loss should not be ignored and needs a quick assessment to rule out other causes.
Next Steps
I would consider reducing the dose to around 1500 mg or switching to an extended-release formulation taken strictly after meals. Instead of pushing metformin further, it’s more practical to add a second agent such as a DPP-4 inhibitor or SGLT2 inhibitor. If symptoms persist, basic workup like CBC, TSH, and stool examination can be done.
Health Tips
Supportive measures like probiotics, ispaghula husk, and dietary adjustment (avoiding sudden high fiber or irritants) usually help. If symptoms don’t settle within a couple of weeks despite these changes, switching to an alternative drug class is reasonable.
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This is a known side effect of metformin.
Next Steps
if it is more troublesome, the tablet can be changed to some other group
Health Tips
Consult a physician
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After effects of metformin maintain hydration if not settled in a week then consult your endocrinologist
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Could be due to metformin or due to diabetic autonomic neuropathy.
Get stool tested for ova and cyst. Consult your endocrinologist, dose of meformin can be reduced and glimepiride be added with it.
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Loose stools are most likely a side effect of Metformin (Glycomet SR), especially after dose increase. It causes intestinal irritation and faster gut movement. Weight loss + loose stools can occur but usually improve with time or dose adjustment.
Next Steps
-Continue Tab Glycomet SR 1000 mg – twice daily with meals
-Add Tab Probiotic (e.g. Vizylac/Enterogermina) – once daily for 5–7 days
-Add Tab Racecadotril 100 mg – twice daily for 3–5 days (if loose stools persist)
If symptoms persist: reduce dose or switch formulation after consulting endocrinologist
Health Tips
-Always take metformin after food
-Avoid oily/high-fiber foods temporarily
-Stay hydrated
-Symptoms usually settle in 1–2 weeks
Contact me anytime on practo for further consultation
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This most likely a reaction to the metformin commonly seen when dosage is around 2g/day. Ideally it should be made sure that she is taking the tablet after food and not on empty stomach and to avoid spicy oily food. However despite lifestyle changes if symptoms persist then metformin dosage will have to be reduced and if sugars become uncontrolled then a second anti diabetic tablet should be added. Please consult for the same.
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Need few more details for proper understanding of your issue.
You can consult with me online on Practo or whatsapp on eight three one eight four six nine eight eight six for proper diagnosis, conclusion and management
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Loose stools are a common side effect after increasing Glycomet (metformin), especially at higher doses. It usually settles in few weeks, but if persistent, dose adjustment or change of form (like XR) may be needed.
Ensure hydration and light diet; if weight loss or diarrhea continues, she should be reviewed by doctor.
Please consult me for proper evaluation and treatment.
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Consult superspecialist treating doctor
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Do consult
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Plz consult me for better advice
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This is a classic side effect of Metformin (Glycomet SR)—especially after dose escalation to 1000 mg twice daily.
Key points in her case:
• Good glycemic response (HbA1c 8.7% → 7%) = treatment effective
• Loose stools, incomplete evacuation, frequency = dose-related GI intolerance
• Weight loss = partly expected with metformin + diet, but needs monitoring
Next Steps
• Do not stop abruptly, but adjust strategy:
– Try dose splitting (e.g., 500 mg morning + 1000 mg night)
– Ensure strictly after meals intake
– Consider switching to better-tolerated extended-release formulation (if not already optimized)
• If symptoms persist:
– Reduce dose slightly and add second agent (instead of high-dose metformin alone)
– Options (doctor decision): DPP-4 inhibitor / SGLT2 inhibitor
• Rule out red flags:
– Blood/mucus in stool, fever → then evaluate for infection
Health Tips
• Avoid taking metformin on empty stomach
• Temporarily reduce high-fiber foods (oats, chickpeas)—they can worsen loose stools
• Add probiotics/curd to improve gut tolerance
• Hydration is important to prevent weakness
• Weight loss is okay only if gradual and not excessive
⸻
Her sugars are improving well, so this is more about optimizing tolerance without compromising control—if you want, I can help you adjust her medication plan to balance sugar control and gut comfort, book a consultation for a tailored regimen.
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Diabetic drug induced diarrhea .its common in diabetic patients.please consult here or tell your physician about this to add antidiarrhoeal drug also .
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Yes it is seen very commonly. There are lots of better options. Please consult.
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Diabetes Mellitus
Brisk walk 30 minutes per day
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Dr. Pawan Kumar Tiwari
General Physician
5 yrs exp
Varanasi
The loose stools (incomplete relief after morning motion + 2–3 more loose episodes daily, feeling like mild dysentery) and weight loss that started after the dose increase are very common side effects of metformin, especially when jumping to a higher dose like 2000 mg/day. Metformin works partly in the gut and can alter microbiome, increase water in the intestines, or cause bile acid changes, leading to softer/looser stools and incomplete evacuation; this affects up to 30–50% of people, is more noticeable with dose hikes, and is usually worse in the first few weeks but often improves or settles within 2–4 weeks as the body adjusts.
The weight loss is also typical and often a positive side effect here—metformin itself promotes modest loss (1–3 kg average), the GI upset can reduce appetite temporarily, and her new diet (oats/veggies, controlled rice/rotis, protein-focused) plus better sugar control naturally helps shed a bit without harm, especially since she was previously on lower
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Dr. Sachin Madan
General Physician
8 yrs exp
Rajgarh
Your wife’s blood sugar control has improved significantly, which indicates that the current treatment is effective. The loose stools are most likely a side effect of the increased dose of metformin (Glycomet SR), as gastrointestinal symptoms like loose motions and a feeling of incomplete evacuation are common after dose escalation. These symptoms are usually temporary and tend to settle within 3 to 5 days. Taking the medication after meals and maintaining adequate hydration can help reduce these effects. If symptoms persist, dose adjustment or change of formulation may be required.
Next Steps
-Continue current medication for a few more days and observe
-Take Glycomet strictly after meals
-Maintain hydration and light, balanced diet
-If loose stools persist beyond 1 week or worsen, consult the treating doctor for dose adjustment or alternative therapy
Health Tips
- Avoid oily and spicy foods temporarily
- Monitor for excessive weakness, dehydration, or significant weight loss
- Do not stop medication abruptly without medical advice
- Regular follow-up and HbA1c monitoring is important
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Dr. Pooja Ghosh
General Physician
11 yrs exp
Bangalore
Hi
CGM installation Benefits Main aim is to reduce the glucose spikes so that medication dose can be altered High fibre diet
It sounds like you’re looking at using a Continuous Glucose Monitor (CGM) to better manage blood sugar and guide diet/medication changes. Here’s a clear, practical breakdown:
🩺 What is CGM & how it’s installed
A CGM is a small wearable device that continuously tracks glucose levels in real time.
Installation (simple & quick)
A tiny sensor is inserted just under the skin (usually abdomen or upper arm)
Done using an applicator—feels like a quick pinch
No stitches or surgery needed
Takes ~5 minutes
Sensor lasts:
7–14 days depending on the device (e.g., Freestyle Libre or Dexcom G6)
📊 Benefits of CGM
1. Real-time glucose tracking
See glucose levels anytime on phone/reader
Understand how food, stress, sleep, and exercise affect sugar
2. Detect glucose spikes
Identifies post-meal spikes (even if fasting sugar is normal)
Helps fine-tune diet
3. Reduce hypoglycemia risk
Alerts for low glucose levels (important if on insulin or certain meds)
4. Better medication adjustment
Doctors can:
Adjust timing/dose
Reduce unnecessary medication
Personalize treatment
5. Improve long-term control
Helps improve HbA1c
Increases “Time in Range” (a key CGM metric)
🎯 Your Main Aim: Reduce Glucose Spikes
You’re absolutely on the right track. CGM helps you:
Identify which foods spike your sugar
Track how quickly glucose rises and falls
Optimize:
Meal timing
Portion size
Food combinations
🥗 Role of High-Fibre Diet
A high-fibre diet is one of the most effective ways to reduce spikes.
Why fibre helps
Slows glucose absorption
Reduces post-meal spikes
Improves insulin sensitivity
Keeps you full longer
Best high-fibre foods (Indian context)
Whole grains: oats, brown rice, millets (ragi, jowar, bajra)
Legumes: dal, chickpeas, rajma
Vegetables: spinach, broccoli, beans, gourds
Fruits (low GI): guava, apple, pear
Seeds: chia, flaxseed
Practical tip
👉 Combine:
Carbs + fibre + protein + fat
Example: roti + dal + sabzi + curd
This reduces spikes significantly
📈 How CGM + Diet + Medication Work Together
Use CGM data
Identify high-spike meals
Modify diet
Increase fibre
Reduce refined carbs
Add protein/fat
Adjust medication (with doctor)
Reduce dose if spikes improve
Change timing if needed
Next Steps
If you want a further consultation that can be arranged to explain better
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.