Berberine vs. Metformin: Which Drug Is Better For Diabetes

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More than 34 million Americans—10.5% of our population—have diabetes. Another 88 million—one in three adults—have prediabetes, meaning that if they continue down the road they’re on, they may well end up with full-blown type 2 diabetes.

If you fall in either camp, you know what you need to do. You know that excess weight, especially in the abdominal area, is a leading contributor. You know inactivity and a lousy diet rich in sugars, starches, and excess calories increases blood sugar. And you know that regular exercise and a healthy diet are your ticket to weight loss, blood sugar control, and prevention or even reversal of diabetes.

But you may not know about berberine—a safe natural compound that can lower blood sugar as effectively as oral diabetes drugs.

Berberine’s Effects on Blood Sugar

I speak from experience. More than 15,000 patients have come to my clinic looking for natural alternatives for controlling their blood sugar and treating diabetic complications of the nerves, blood vessels, eyes, and kidneys. Most of them did quite well on our therapeutic diet, exercise and weight loss programs, and targeted nutritional supplements.

Berberine, however, upped our game. Little more than a decade ago, berberine was virtually unknown in the US. Although plant sources of this natural alkaloid are mainstays of Ayurveda and traditional Chinese medicine—and have been used to treat diabetes for thousands of years—even integrative doctors who use natural therapies were not aware that berberine can lower blood sugar.

A Breakthrough Study

That changed in 2008, when an American medical journal published a small clinical trial by Chinese researchers comparing the effects of berberine versus metformin, the world’s most popular oral diabetes drug. After three months on these treatments, fasting and postprandial (after-meals) blood sugar improved dramatically, and hemoglobin A1C went from an average of 9.5% to 7.5%.

Here’s what really caught my attention—berberine’s effects were identical to metformin’s! Plus, berberine was much better than metformin at lowering cholesterol and triglycerides. Equally important, it had no serious side effects.

At that time, berberine supplements were extremely rare, so I found a company to source and encapsulate it for me and began using it with my patients. They responded beautifully, with remarkable drops in blood sugar. They also began reporting other improvements such as lower blood pressure, weight loss, and reductions in cholesterol and triglycerides.

Research Intensified, Popularity Soared

As more and more integrative physicians and individuals with blood sugar issues learned about berberine and experienced its benefits, the word slowly got out. It took a few years, but today, this safe, inexpensive supplement is recognized as the most effective natural therapy for blood sugar control.

Additional studies followed as well. A 2019 meta-analysis of clinic trials involving 2,313 participants tested berberine against metformin or other drugs, placebos, and/or lifestyle changes. This study confirmed that berberine has a significant blood sugar-lowering effect, similar to that of oral diabetes drugs but with fewer side effects. It also noted that when berberine is used along with metformin or other drugs, it enhances their effectiveness.

Berberine research is not limited to blood sugar control. Other studies have demonstrated benefits for high cholesterol and triglycerides, obesity, fatty liver disease, cardiovascular conditions, digestive disorders, neurodegenerative diseases, and some types of cancer. In short, berberine is one of our most valuable and versatile nutritional supplements.

How Does Berberine Work to Lower Blood Sugar?

To fully appreciate why berberine is so good for type 2 diabetes, you need a basic understanding of how it works. The primary mechanism is an increase in AMP-activated protein kinase (AMPK), an enzyme that is a basic regulator of metabolism present in every cell.

Increasing AMPK activity has positive effects in tissues throughout the body—many of them directly involved in glucose metabolism:

  • Inhibits the production of glucose in the liver: Gluconeogenesis, as this is called, is elevated in diabetes, and suppressing it lowers blood sugar.
  • Improves insulin sensitivity: By enhancing the uptake of glucose in muscle cells and increasing the number and activity of insulin receptors, it reduces insulin resistance—the hallmark of type 2 diabetes.
  • Reduces inflammation and oxidative stress: Berberine’s versatility is due in part to AMPK’s anti-inflammatory and antioxidant properties. This includes protection of insulin-producing beta cells in the pancreas.
  • Supports the gut microbiota: Positive effects on gut bacteria also play a role in berberine’s ability to lower blood sugar. Another gut-related benefit is slowing the breakdown of carbohydrates into simple sugars and their transport into the bloodstream.

Who Should Take Berberine?

Berberine is my top recommended supplement for type 2 diabetes. I also recommend it for anyone with prediabetes—blood sugar above normal but not in the diabetic range.

Its positive effects on blood pressure, lipids, weight, and insulin resistance make berberine an excellent therapy for metabolic syndrome as well. This cluster of risk factors, which include hypertension, cholesterol and triglyceride abnormalities, abdominal obesity, and/or modestly elevated blood sugar, increase the likelihood of developing both diabetes and heart disease.

When combined with diet changes, exercise, and weight loss, berberine not only enhances blood sugar control. It can also help put the brakes on prediabetes and metabolic syndrome and prevent them from progressing into far more serious health problems.

How much should you take? The recommended berberine dosage for diabetes is 500 mg three times a day. Taking 500 mg twice a day may be sufficient for prediabetes and metabolic syndrome. The best time to take berberine is about 30 minutes before meals.

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Dr. Julian Whitaker

Meet Dr. Julian Whitaker

For more than 30 years, Dr. Julian Whitaker has helped people regain their health with a combination of therapeutic lifestyle changes, targeted nutritional support, and other cutting-edge natural therapies. He is widely known for treating diabetes, but also routinely treats heart disease and other degenerative diseases.

More About Dr. Julian Whitaker