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Disclaimer: This article is for informational purposes only and is not intended for diagnostic use. LifeDNA does not provide diagnostic reports on any traits discussed. Genetics is just one piece of the puzzle; please consult a healthcare professional for comprehensive guidance on any health condition.
Metformin is one of the most commonly prescribed medications for type 2 diabetes. It helps control blood sugar, is generally well-tolerated, and it is studied for its potential benefits as an anti-aging and cancer prevention agent. But here’s a little catch you need to know; not everyone responds to metformin the same way.
While metformin works well for some people, others may get more side effects or see little improvement. The answer lies in our genes. In recent years, researchers have begun uncovering how genetic differences affect our response to this medication. If you’re planning on taking Metformin, understanding how your DNA may influence its effectiveness to personalize your treatment plan and improve outcomes is important.
You may want to read: Are You Always Craving Sugary Drinks? Your Genetics May Be the Cause
Metformin is a medication commonly used to help people with type 2 diabetes manage their blood sugar levels. It is often the first treatment doctors recommend because it works well and doesn’t usually cause weight gain or dangerously low blood sugar levels like some other diabetes medicines.
Metformin is approved by the FDA and is most effective when combined with healthy habits like eating well and exercising regularly. By keeping blood sugar levels in a healthy range, metformin can help prevent serious long-term problems such as kidney damage, nerve pain, vision loss, foot or leg amputations, and even heart attacks or strokes.
In addition to diabetes, metformin is also being studied for other health conditions, including polycystic ovary syndrome (PCOS), obesity, and aging.
Metformin helps lower blood sugar in three important ways:
While metformin works well for many, about 1 in 3 people either don’t get optimal results or experience side effects like nausea, diarrhea, or abdominal pain. For some, this leads to stopping the medication altogether. One major factor is our genetic variation. Your DNA may influence how your body absorbs metformin or your liver and kidneys process it and how sensitive your cells are to insulin.
A seminal genome-wide association study (GWAS) discovered that genetic differences help explain why people respond differently to metformin, the most widely used drug for type 2 diabetes (T2D). Researchers studied over 13,000 individuals from diverse ethnic backgrounds and discovered that a variant in the SLC2A2 gene, which affects the glucose transporter GLUT2, is linked to a significantly stronger response to metformin. People with this variant have reduced GLUT2 activity, limiting glucose processing in the liver—an effect that metformin helps reverse. The variant was also associated with higher body weight, potentially explaining why metformin often works best in overweight patients. These findings support a move toward precision medicine in diabetes care, suggesting that some patients may benefit from higher doses or earlier intervention based on their genetic profile.
Several recent pharmacogenetic studies have demonstrated that variations in genes encoding various cellular transporters are associated with metformin pharmacokinetics, pharmacodynamics and metformin response.
While genetics provide valuable insight, they represent only one aspect of the overall picture. Several other factors can significantly influence an individual’s response to metformin. However, these factors may also be affected by your genetic make-up.:
Metformin is a commonly used medication, especially for type 2 diabetes and sometimes PCOS. While it works well for many people, some experience uncomfortable side effects—and your genes could be part of the reason why. Let’s look at some of these symptoms and how your body’s natural makeup might influence them.
Unusual Muscle Pain: Muscle pain while taking metformin can be a sign of a rare but serious problem called lactic acidosis. Some people’s bodies process metformin more slowly, which can cause it to build up and lead to this condition. If you’re more sensitive to metformin, your muscles might ache even with normal doses.
Feeling Cold: Feeling cold can also be linked to how your body handles metformin. If metformin builds up in your system or affects your energy levels, you might feel chilly or have trouble staying warm. This is more likely if your body naturally clears the medicine more slowly.
Trouble Breathing: Difficulty breathing is another serious sign that metformin might not be agreeing with you. Some people are more prone to having low energy production in their cells when taking metformin, which can lead to breathing problems—especially if too much of the medicine stays in the body.
Feeling Dizzy, Light-Headed, Tired, or Very Weak: If you feel faint, tired, or unusually weak, your body might be reacting strongly to the effects of metformin. Some people experience drops in blood sugar or shifts in energy levels more easily, depending on how their body processes the medication.
Stomach Pain, Vomiting: Stomach issues like cramps, pain, or vomiting are some of the most common side effects. But some people feel these more intensely. Your genes may make your stomach more sensitive to metformin, leading to stronger reactions even if you’re taking the standard dose.
Slow or Irregular Heart Rate: A very slow or uneven heartbeat can happen if metformin affects the balance of fluids or energy in your body. If your system doesn’t handle the drug efficiently, this kind of side effect can be more noticeable.
Some health and wellness companies offer genetic tests that look at your DNA to see how you might respond to metformin. These tests check for specific genetic differences that can affect how well metformin works for you or whether you might experience side effects.
Although these genetic tests are not yet used by doctors to officially prescribe or adjust metformin, they can still be helpful. Knowing your genetic information can make it easier to talk with your doctor and may help you:
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