The A1C level that metformin should be started is when your A1C level is 7% or higher.
And for people with prediabetes, specifically with A1C levels between 5.7% and 6.4%, metformin is not the standard first line treatment and should only be considered for people at the highest risk.
And in cases of severe hyperglycemia, (A1C>9-10%) with symptoms, insulin is usually the recommended treatment instead.
An A1C level of 7% is the typical starting point for beginning metformin therapy for type 2 diabetes.
The drug metformin is better than empagliflozin and is also considered safe and metformin is often the first line medication for type 2 diabetes.
The drug empagliflozin also known as Jardiance is an SGLT2 inhibitor that is used to manage type 2 diabetes by helping your kidneys remove sugar from your body and it also significantly reduces your risks of heart failure and chronic kidney disease progression, even for people that are not diabetic, by preventing reabsorption of glucose.
The drug empagliflozin is taken once a day, and works with diet and exercise, but can also cause urinary tract infections, yeast infections, dizziness and a rare but serious condition called ketoacidosis.
Metformin is also considered safer than empagliflozin also known as Jardiance, even though Jardiance has less reported side effects than metformin.
Jardiance also has the potential to cause dangerously low blood pressure and kidney problems as well as dehydration, yeast infections and urinary tract infections.
Metformin is widely considered to be a first line medication and is also a generally pretty safe medication for type 2 diabetes, with common side effects including digestive issues.
Common side effects of metformin include digestive issues like stomach cramping, nausea and diarrhea.
Metformin is considered a first choice medication due to extensive safety data it's low risk of hypoglycemia and it's weight neutral and can improve certain conditions like PCOS.
Metformin is best for people with type 2 diabetes, who are also looking for a generally safe and well tolerated , first line medication.
Jardiance lowers your A1C by an average of 0.7 to 0.9 percent when used alone and when Jardiance is used with other diabetes medications like metformin Jardiance can lower your A1C by an additional 0.6 percentage points.
Although the exact reduction of your A1C varies, but most people taking Jardiance seen an A1C decrease of around 0.7 percent to 0.8 percent after 24 weeks when Jardiance is taken alone.
For people that have very high starting A1C levels, such as 8.5 percent the reduction in A1C with Jardiance can be higher and sometimes even exceed 1.4 percent reduction.
Jardiance can affect your bowels, mainly by potentially causing dehydration, which can lead to constipation, and it's also associated with a rare but also serious necrotizing infection in your genital/anal area or perineum, which affects tissue, that requires immediate medical care, although diarrhea is not a common direct side effect of Jardiance.
Jardiance increases urination, which can also lead to fluid loss and this dehydration can also result in constipation, which is a known issue for people with diabetes and potentially can also be worsened by Jardiance.
Jardiance does not slow gastric emptying as Jardiance works by causing your kidneys to excrete more glucose, and GLP-1 drugs work by mimicking the hormone GLP-1 to slow gastric emptying, suppress glucagon and increase insulin secretion.
Slowing gastric emptying is a side effect of GLP-1 receptor agonists like Victoza and Ozempic but not Jardiance.
Jardiance can also cause yeast infections, because Jardiance makes the kidneys excrete more sugar also known as glucose into your urine, which makes a sugar environment in your genital area that also feeds the yeast and the bacteria that leads to fungal growth, especially in women, although yeast infections can also occur in men as well when taking Jardiance.
The increased sugar content is what promotes the microbial growth, which causes common side effects like genital yeast infections, although they are often mild, but can also be managed with antifungal treatments.
Jardiance is an SGLT-2 inhibitor which blocks proteins in your kidneys from reabsorbing sugar back into your bloodstream.
This then causes excess glucose to be flushed out of the body through your urine and the extra sugar in your urinary tract and your genital area provides food for yeast, "fungi" and bacteria, which allows them to grow.
People with a history of yeast infections are at a higher risk of getting yeast infections when taking Jardiance.
The symptoms of the yeast infection are redness, itching, soreness and a thick white discharge.
If you suspect a yeast infection or know you have a yeast infection you should see your doctor, who can prescribe prescription antifungal creams or even suggest over the counter antifungal creams.
Jardiance is a high risk medication as Jardiance comes with significant risks which include severe urinary tract infections, increased risk of lower limb amputations and dehydration as well as potential for fatal ketoacidosis.
These conditions require careful monitoring and immediate medical attention, especially for severe symptoms like genital pain, trouble breathing and nausea.
Ketoacidosis is an emergency and you should seek immediate medical attention in the case of ketoacidosis.
Jardiance is considered a safe medication as well, even though there's some serious risks associated with it.
Jardiance is beneficial for blood sugar and heart health, but you must be aware of the serious possible side effects that can occur like the genital infections, ketoacidosis, dehydration and potential amputation risk, especially when Jardiance is combined with other diabetic medications like sulfonylureas and insulin.
Diabetic ketoacidosis is a serious and life threatening condition with high ketones, which can lead to hospitalization or death, and requires immediate medical attention for treating.
The symptoms of diabetic ketoacidosis are stomach pain, trouble breathing and fatigue and some people may not be aware of the diabetic ketoacidosis until it's too late.
Dehydration from Jardiance can cause dizziness as well as kidney problems, especially with vomiting, diarrhea or intense heat.
And serious infections like severe urinary tract infections and necrotizing fasciitis which is a flesh eating infection in the genital area can also occur with Jardiance.
And when taking Jardiance you can be at an increased risk of lower limb amputation like the toes, feet or legs, especially if you have existing foot issues or poor circulation.
Low blood sugar which is also known as hypoglycemia is also a potential risk when combining Jardiance with sulfonylureas or insulin.
If you notice any signs of diabetic ketoacidosis such as nausea, vomiting, abdominal pain, fatigue or trouble breathing or you notice any signs of serious infection like redness, fever, swelling, pain in your genital area or urinary tract you should contact a doctor or get to the ER immediately.