‘I’m pre-diabetic. My doctor won’t prescribe Metformin, which I have access to. If the normal starting dosage for a diabetic is 500 mg, could 250 mg help reduce my carb cravings?’

Agreeing, Dr Narander Singla, lead consultant, internal medicine, CK Birla Hospital, Delhi, said that when it comes to dosage, doctors usually start with a lower dose in prediabetes compared to type 2 diabetes. “A common starting point is 500 mg once or twice daily, which can be gradually increased up to 1,000–2,000 mg per day depending on tolerance and blood sugar response. Extended-release formulations are also available and are often easier to tolerate since they are taken once a day,” he told indianexpress.com.

So does metformin help reduce carb cravings?

Dr Singla said that metformin may also help reduce carbohydrate cravings. “By stabilising blood sugar levels and improving insulin sensitivity, it indirectly lowers the urge to consume high-carb foods, which can support better dietary habits,” said Dr Singla.

Should you be concerned? (Photo: Getty Images/Thinkstock)

“It reduces the amount of glucose produced by the liver, improves the body’s sensitivity to insulin so that blood sugar is used more efficiently, and enhances glucose uptake in muscles where it is converted into energy. Together, these effects help prevent spikes in blood sugar and improve overall metabolic health,” said Dr Singla.

However, according to Dr Singla, there is “limited research on how a low dose of 250 mg of metformin specifically may help reduce the chances of side effects.” “If you are considering such a low dose, it is essential to consult with your doctor to determine whether this approach is appropriate for your health profile,” said Dr Singla.

That said, there are important considerations before starting metformin. Metformin is the most studied medication for prediabetes, and we usually begin with a low dose of 500 mg once daily with food to minimise stomach upset, said Dr Kovil.

“After a week or two, most patients can increase to 500 mg twice daily if tolerated, with a goal of 1,500–2,000 mg per day for full effect. In individuals with higher body weight or a strong family history of diabetes, initiating treatment at 500 mg is both safe and evidence-based. Renal function should be checked before and during therapy. Crucially, metformin works best alongside lifestyle measures, balanced diet, regular exercise, and weight loss remain the foundation for preventing progression to diabetes,” said Dr Kovil.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.