Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

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What is the most effective way to reduce gastrointestinal side effects from metformin?

  1. Take the medication with food or milk

  2. Take the entire day’s dose at bedtime

  3. Take the medication on an empty stomach

  4. Take with water only and stay upright

The correct answer is: Take the medication with food or milk

Taking metformin with food or milk is the most effective way to reduce gastrointestinal side effects associated with this medication. Metformin is known for causing gastrointestinal issues such as nausea, diarrhea, and abdominal discomfort, particularly when a person first starts taking it or if there is an increase in the dosage. Consuming metformin alongside food helps to buffer the stomach, leading to a gradual release of the medication into the system, which can ameliorate these unwanted side effects. Taking the medication on an empty stomach may lead to an increased risk of gastrointestinal upset as there is less food to minimize the irritation that metformin can cause to the gastrointestinal lining. Taking the whole day’s dose at bedtime would not be beneficial, as it could lead to a higher concentration of the drug in the system without the protective buffer that food provides, potentially exacerbating side effects. Moreover, simply taking it with water and remaining upright does not provide the same protective effect against gastrointestinal disturbances that food or milk would offer. Therefore, the method of taking metformin with food or milk is not only effective in reducing side effects but also promotes better adherence to the medication regimen.