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Jul 19, 2023


Differences Between Metformin and Ozempic for Type 2 Diabetes

Managing type 2 diabetes requires an individualized approach that may involve different medications. Two commonly prescribed options are metformin and Ozempic. Metformin, a well-established oral medication, and Ozempic, an injectable medication, both are effective at controlling blood sugar levels.

While they share the goal of managing diabetes, these medications have distinct mechanisms of action, administration methods, and potential side effects. Understanding the characteristics and differences between metformin and Ozempic can help individuals make informed decisions in consultation with their healthcare providers regarding the most suitable treatment approach for their specific needs.

Overview of Type 2 Diabetes Mellitus

Type 2 diabetes is a chronic metabolic disorder characterized by high blood sugar levels, (hyperglycemia) resulting from the body's inability to effectively use insulin or produce enough of it. Insulin is a hormone produced by the pancreas that regulates the uptake and utilization of glucose (sugar) in the body's cells for energy.

In type 2 diabetes, the body becomes resistant to insulin, or the pancreas doesn't produce enough insulin to maintain normal blood sugar levels. This leads to an accumulation of glucose in the bloodstream, causing various health complications over time.

Symptoms of type 2 diabetes may include increased thirst and hunger, frequent urination, fatigue, blurred vision, slow healing of wounds, and recurring infections.

Monitoring parameters for type 2 diabetes include blood sugar (a current view of how much sugar is in your blood) and A1C (a parameter that measures how well controlled your blood sugar has been for the past 3 months).

Read more about Medication for Type 2 Diabetes

How They Work


Metformin works primarily by reducing the production of glucose (sugar) in the liver, decreasing absorption of sugars in your gut, and by making body tissues more sensitive to insulin. Unlike medications that increase insulin sensitivity, metformin is not known to cause low blood sugar, (which can be dangerous) as the actual amount of insulin remains the same.

Unlike certain medications that can cause low blood sugar levels, metformin does not typically lead to dangerously low levels of blood sugar because it does not directly increase insulin levels in the body. Instead, metformin works by making the existing insulin more effective. While metformin is effective in controlling blood sugar, it does not have proven benefits specifically for heart or kidney health, unlike some other medications used for type 2 diabetes.

What is metformin used for?

Ozempic belongs to a group of medications called GLP-1 receptor agonists. It works by mimicking a hormone called GLP-1 that is naturally produced in our bodies. GLP-1 helps regulate blood sugar levels after we eat by stimulating insulin release from the pancreas and reducing the amount of another hormone called glucagon, which raises blood sugar levels.

Additionally, Ozempic slows down the emptying of the stomach, which means that sugar from the food we eat is released into the bloodstream more gradually. This helps prevent spikes in blood sugar after meals. By stimulating insulin release, reducing glucagon, and slowing down stomach emptying, Ozempic helps lower blood sugar levels in individuals with type 2 diabetes.

So, while metformin primarily focuses on reducing the production of glucose in the liver and improving insulin sensitivity, Ozempic works by mimicking a hormone that helps stimulate insulin release, reduce glucagon, and slow down stomach emptying. Both medications aim to lower blood sugar levels, but they do so through different mechanisms. The choice of medication depends on various factors, and it's important to discuss with your healthcare provider which option is best for you.

7 most frequently asked questions about Ozempic


  • Metformin: It is available in oral tablet form and is usually taken once or twice daily with meals.
  • Ozempic: It is administered once a week as a subcutaneous injection.


  • Metformin: It is considered a first-line treatment for type 2 diabetes and has been widely used for many years. It effectively lowers blood glucose levels and helps improve insulin resistance.
  • Ozempic: Clinical studies have shown that Ozempic is effective in reducing A1C levels (a measure of long-term blood glucose control) and can lead to weight loss in individuals with type 2 diabetes.

Weight Effects

  • Metformin: It is considered weight-neutral or may result in mild weight loss.
  • Ozempic: One of the advantages of Ozempic is that it can lead to weight loss in individuals with type 2 diabetes, which can be beneficial for those who are overweight or obese.

Side Effects

Both medications come with the risk of possible side effects. Many of these side effects are similar, though there are some that are unique.


Side effects of metformin are relatively common but can be relieved by taking the medication with food. Common side effects from metformin include:

  • Flatulence
  • Lack of energy
  • Indigestion
  • Diarrhea
  • Nausea
  • Vomiting

Side effects of Ozempic are relatively common but can be relieved by taking the medication with food. Common side effects from Ozempic include:

  • Abdominal pain
  • Decreased appetite
  • Injection site pain
  • Weight loss
  • Low blood sugar

    Risk of low blood sugar is increased if used alongside other insulin-increasing medications, such as sulfonylureas and insulin.

  • Nausea
  • Vomiting
  • Diarrhea


As metformin comes in a number of different doses, the prices can vary slightly. However, at the typical dose of 500 or 1000 mg twice daily, metformin would cost you only $6 per month.

In major contrast, at the typical dose of Ozempic, a one-month supply would cost you at least $800-900. Since Ozempic pens come in set-volumes, if you use an increased dose (greater than 0.5 mg per week) you may pay double this price for a monthly supply.

Prices mentioned in this article are based on average retail price at major box chain pharmacy in the U.S. as of July 13, 2023.


  1. GLUCOPHAGE® (metformin hydrochloride) Tablets. Food and Drug Administration. (Revised 04/2017). Retrieved July 13, 2023, from
  2. Ozempic (semaglutide) injection, for subcutaneous use. Food and Drug Administration. (12/2017). Retrieved July 12, 2023, from
  3. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes. 2018;42(Suppl 1): S1-S325. Retrieved July 13, 2023, from
  4. Metformin (generic Glucophage and Riomet). GoodRx. (n.d.). Retrieved July 13, 2023, from
  5. Ozempic. GoodRx. (n.d.). Retrieved July 13, 2023, from

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