Not specifically, as it’s actions to keep from gaining weight are pretty mild. It somewhat interrupts gluconeogenesis, so Bg does not rise in response to liver glycogen release.
But for someone who overeats and is obese that’s like trying to put out a forest fire with a garden hose.
thanks doc. 
it is such a sad situation, though, no matter how you see it. now i am curious if she has T2D but just wont talk about it.
my dad is obese as well and refuses to diet, but he is almost 90, so we just ignore his eating habits, figuring he might as well die hearty and happy than putting himself through misery by dieting. he’s been tested so many times for D b/c of his weight. he’s survived multiple cancers, so if he is eating to calm himself, so be it. old dog, new tricks? not with him. and, as we say in yiddish, oy, what a shanda 
Again, I think it depends on whether there is actually insulin resistance in the picture, since untreated insulin resistance can cause weight gain—people often assume the direction is weight gain–>insulin resistance, but it can be either way or a vicious cycle of both. I know for me, I’m overweight anyway, but I have a pretty clear set point my body wants to hover around, and there were a couple of years when it just started creeping steadily up from that, and metformin allowed me to lose all of that extra weight relatively easily. I’m now back to that set point zone; I suspect losing further weight, which I’d like to do, will be substantially more difficult (maybe doable though, we will see), since I think I’ve burned through the part that was caused by IR.
Insulin resistance may cause high Bg, but I don’t quite understand how it could cause weight gain. If the glucose (calories) cannot be transported into the cells to be metabolized, weight gain should not occur.
If I’m wrong about this, please set me straight.
I meant that it was not recommended for people with kidney issues, because of increased risk of lactic acidosis. However, the FDA recommendation for this issue has recently changed, have a look:
research discussion
Metformin in Chronic Kidney Disease: Time for a Rethink - PMC
2016 change in recommendation
FDA: Metformin Safe for Some Patients With Renal Problems
I don’t have time to do a lit search on this now, but I’ve heard numerous medical professionals say this, and it was absolutely consistent with my experience. I think it has to do with greater amounts of insulin being used ultimately fueling fat storage, since it is a growth hormone. For sure in my experience, increased insulin doses seemed to promote weight gain, and taking metformin immediately lowered my TDD insulin and facilitated weight loss.
Ah, that was pretty dense of me to not realize that. If metformin reduces TDD, of course that should cause weight loss.
Thanks!
metformin is also typically used for women who PCOS (polycystic ovary syndrome). If she’s quite overweight, it’s possible that’s what is going on? People with PCOS can also have a lot of trouble losing weight…
Of course, that is more typically used during the reproductive years, so if she’s post-menopausal I’m not sure if it’s still used…
If Sotagliflozin gets approved by the FDA would this be an alternative to the use of Metformin for Type 1 whose doctors are looking to add something in addition to the standard insulin therapy?
Or is the purpose of these two drugs completely different from each other?
she is deffinately NOT post menopausal. and the reason i was thinking that she eats secretly was b/c i never see her eat that much food. she eats like a “normal” woman. so, i can never understand why she is so over weight unless she is eating in secret while no one is around.
hmm, so perhaps she has some other underlying condition such as PCOS, which makes it very hard to lose weight and also leads to insulin resistance – hence the metformin. It can also lead to things like facial hair in women.
i dont know if this counts as facial hair but she has a lot of facial “peach fuzz” which she has threaded. she happens to have beautiful skin with this exception. do you think that that could be a sign?
doesnt insulin resistance require MORE insulin? and b/c insulin is a hormone, doesnt too much insulin cause weight gain? so wouldnt the Metformin cause weight gain? i am lost in the woods here. SOS. i would love to help out my sister. she is an active and vibrant woman who deserves all the best 
It’s the opposite, sort of, or rather you have it half right—insulin resistance results in more insulin needed (whether produced by the body or taken by injection/pump), and the more insulin used, the more people gain weight. Metformin reduces insulin resistance, thereby reducing the amount of insulin needed, thereby assisting with weight loss.
Also your sister def should get PCOS and hypothyroidism ruled out, but if someone is prescribing her metformin, I’m guessing she has probably been evaluated for both.
For what it’s worth, once someone has gained a lot of weight, it can be relatively easy to maintain that weight sometimes—to both lose weight and maintain that weight loss, people often need to engage in much greater degrees of calorie restriction than someone who was that level of thin to begin with.
yes, i think you’re correct about her already having the tests. but its a tricky endeavor to actually ask her. with her autism, anything body related is really off topic. i wish there were some way that i could help her, but i am at a complete loss.
Yes, the purpose is different.
SGLT-1 and-2 inhibitors essentially filter glucose into the urine when blood glucose concentrations reach a threshold. SGLT-1 has a minor role in raising GLP-1 levels as well.
Metformin’s greatest benefit is that it reduces cell wall resistance to glucose. It also inhibits glycogen release from the liver.
I am currently taking both metformin and an SGLT-2 inhibitor.
hey doc, is this combo helping you to lose or control your weight?
I am intrigued by the SGLT-2 inhibitor class of drugs, but I always worry about potentially increasing yeast infections with them—I’ve heard from a few women who have taken them that they discontinued due to that and increased UTIs, from the increased glucose spill over in the urine.
Maybe, but I think my weight control has much more to do with my calorie intake.