‘Why do doctors prefer prescribing Metformin for type 2 diabetes instead of just recommending keto diets or intermittent fasting?’

Experts urge that medical science depends on what consistently works for different groups of people. “That’s where Metformin comes in,” said Dr Vijay Negalur, HOD, diabetology, KIMS Hospitals, Thane.

Metformin is often the first medication prescribed worldwide because it has decades of evidence showing that it safely lowers blood sugar, improves the body’s use of insulin, and even provides added benefits like supporting heart health and modest weight loss, said Dr. Negalur. “Unlike many drugs, it is affordable, well-tolerated by most patients, and does not typically cause dangerous drops in blood sugar,” added Dr Negalur.

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In contrast, while dietary strategies like the ketogenic diet or intermittent fasting can be helpful, they are not suitable for everyone. “These approaches require strict discipline, may not fit patients with other health problems, and often become difficult to maintain over time. For instance, a keto diet can raise cholesterol levels in some people, while fasting may not be safe for those with unstable blood sugar, kidney issues, or those taking certain medications,” said Dr Negalur.

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Doctors stress that one should not ignore lifestyle changes, as these are the foundation of managing diabetes. “We promote balanced diets, regular exercise, stress management, and good sleep, along with medication. However, when someone’s sugar levels are already high, waiting months to see if a strict diet works could lead to complications that affect the eyes, kidneys, heart, or nerves. Metformin offers a reliable safety net while these lifestyle changes are being made,” said Dr Negalur.

In short, the goal is not “medicine versus diet” but “medicine and lifestyle”. Metformin provides stability, while sustainable lifestyle changes create long-term control. Together, they give patients the best chance at living healthier, complication-free lives.

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.