I had really bad side effects when I first started metformin and I didn't want to try another drug if I could help it. So my doc gave me 3months of diet and exercise and if there was an improvement I could skip meds for now.
I didn't really change my diet aside from less simple carbs and more fiber and protein. I think what made the difference was increased exercise. I worked up to 1-2 hours a day, typically a 3mile run in the morning and a brisk walk with my dogs at night. Now I only have to take meds when I'm on prednisone for my arthritis and asthma and the much lower dose of metformin is mostly tolerable especially for just a few weeks
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