Key takeaways
Metformin (Glucophage) and Actos (pioglitazone) are both medications used to manage type 2 diabetes, but they work differently and have distinct characteristics. Metformin lowers the amount of sugar your body makes or absorbs and helps you use your body's natural insulin better. It is often a first-choice medication and is also available in long-acting forms (Glucophage XR). Actos improves your body's ability to use insulin to lower blood sugar and is typically taken once daily. Metformin doesn’t typically cause weight gain and rarely causes low blood sugar. Actos rarely causes low blood sugar, but can cause weight gain and fluid build-up, which may lead to heart failure. Additionally, there is a small chance that Actos can cause bladder cancer or liver damage. Bone fractures are also possible, especially in women. Long-term use of metformin can also cause low levels of vitamin B12, which can lead to anemia. Both medications have their own side effects and risks, so it's important to discuss with a healthcare professional to determine which one is best for you.
