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I also have PCOS, and was prescribed Metformin for a long time, to manage it, as it helps treat the hormone imbalances associated with the syndrome, although I'm not clear how exactly. I was told I had diabetes insipidus which has nothing to do with sugar levels at all, but affects how your body uses salts? It was causing a lot of thirst and nighttime urination frequency. And I had stopped having monthly cycles. I was on 500mg Metformin and also was on Spirinolactone to help with the testosterone levels. I react badly to birth-control so they couldn't put me on any pill to help with the estrogen/progesterone balances. At the time, I had no issues with high blood sugars, and was not diabetic. However I did frequently get episodes of low-sugars, so I had to make sure I tested regularly. After being on the Metformin for a long time, I started having weight gain, although my diet and activity levels had not changed. I was checked frequently for any signs of pre-diabetes, as I had gestational diabetes during one pregnancy as well. 4 years later, I still showed no signs of pre-diabetes, but although I still maintain a low-carb diet, my weight had continued to increase despite my efforts. By 6 years later, still on the Metformin, I suddenly developed full-blown diabetes, which was not discovered until I got sick and went into the ER and had a BG of 500+. The Metformin was upped to 1000mg with no effect, glimepride was added with barely any effect, and so I was taken off of the Metformin, and started on insulin instead, with the long-acting Levemir and the fast-acting Novolog, and 5mcg Byetta. The Levemir and Novolog together do a pretty good job of keeping me in the normal range most of the time.

anyhow, the Metformin is designed to lower sugar levels and react to increases in sugar, as one website I found says: "The medicine reduces the amount of sugar made by the liver, limits the amount of sugar absorbed into the body from the diet, and makes insulin receptors more sensitive (helping the body respond better to its own insulin). All of these effects cause a decrease in blood sugar levels."

and the reason it's used in PCOS is: "Metformin is a miracle drug for women with PCOS. It helps them lose weight, increase fertility, and prevent or delay the onset of diabetes, among other benefits." and: "women with PCOS commonly have insulin resistance, a condition wherein extra insulin is needed in order to transport glucose into the blood stream where it belongs. High levels of glucose or insulin in the blood stream can cause obesity, infertility, heart disease and diabetes.

The main goal of Metformin is to lower blood sugar levels to normal. It does this by decreasing the amount of sugar made by your liver, decreasing the amount of sugar absorbed by your intestines and by helping your body better process the insulin it makes.

Metformin does not cause your body to make more insulin."

What my doc told me was that the metformin was supposed to do several things: lose weight, restore monthly cycles, and prevent diabetes due to the insulin resistance caused by the PCOS. For me, it did NONE of those things.

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