When diagnosed with type 2 diabetes, you’re likely to be prescribed with metformin, the first-line treatment for the disease.

It’s often extremely effective in controlling blood sugar, can be used safely with many other medicines, and is getting a reputation as a wonder drug.

Studies have found that metformin lowers the risk of breast, colon and prostate cancers in people with type 2 diabetes.

It also lower risks for dementia and stroke.

Some studies have noted less cognitive decline and a lower rate of dementia, as well as a lower rate of stroke, among people with diabetes taking metformin compared with those who were not taking it.

It’s also known as the immortality drug, because it appears to slow ageing, prevents age-related disease, and increases lifespan.

So what’s not to love?

Not everyone can take metformin. Some people suffer gastrointestinal side effects. These aren’t usually serious, but they can be wearing or embarrassing. Farting is a problem.

More importantly, for many people metformin’s efficacy wanes over time. This mean patients will require a bigger dose or try a different treatment.

Bottom line: Metformin is terrific, but it might pay to delay taking it, if possible.

How to delay taking this drug?

The 5:2 diet, pioneered by the late, great Dr Michael Mosley, has proved useful for people with type 2 diabetes.

Weight loss is the key to putting type 2 diabetes in remission. It’s not easy, but worth trying for.

Also, losing weight and improving your blood sugars through diet means you may not need medication. At least not in the short term.

And, as a 2018 study from the University of South Australia found, a 5:2 diet can be a less challenging way of losing weight than daily calorie counting. Read more here.

The findings were based on a year-long clinical trial of 137 people with type 2 diabetes, half of whom followed a 5:2 diet and the others an ongoing restricted diet, consuming between 1200 and 1500 calories a day.

The study found that “fasting on two non-consecutive days, consuming between 500 and 600 calories, and then eating normally for five other days each week led to weight loss and improved blood glucose control”.

Can diet work better than drugs?

New research from China found that a change in diet can do a better job than medication in controlling blood sugars and losing weight. At least in the short term.

The study involved 405 adults in China who had obesity or were overweight. The participants had been diagnosed with type 2 diabetes within the previous year.

According to a report from Medical News Today: The participants were randomly allocated to either receive metformin, empagliflozin (another diabetes drug) or a 5:2 meal replacement eating plan for a 16-week period.

All of the participants were also given guidance on exercise, diet and diabetes education every four weeks.

Those in the 5:2 meal replacement group had two non-consecutive days each week in which they used meal replacements. These are products commonly used in dieting plans, along similar lines to a protein shake.

On the meal replacement days, the participants had one meal replacement instead of eating three regular meals. This amounted to an intake of 500 calories for women and 600 calories for men.

On the other five days, the participants in the 5:2 group were encouraged to monitor their calorie intake but eat whatever they wanted for breakfast and lunch. At dinner they then had a meal replacement.

Researchers reported that participants on the eating plan had better glycemic control and weight loss at 16 weeks compared to those on diabetes medications.

The researchers reported that “those in the 5:2 meal replacement group showed the greatest reduction in average HbA1C blood glucose levels over three months”.

Those in this group “also had greater weight loss than the other two groups with a significant reduction in both waist and hip circumference”.

These are promising results, but the approach won’t suit everybody.