Keep patients on metformin, and get more out of it.
TeraHealth coaches away the stomach intolerance that makes patients quit metformin, and runs a diet and exercise protocol shown to lower HbA1c (glycated hemoglobin) and support weight loss beyond what the drug does alone — delivered inside your app, under TeraHealth’s own clinical protocols.
nonadherence reported in some cohorts due to gastrointestinal side effects
reduction in diabetes progression from a structured lifestyle program, versus 31% for metformin itself, in the trial that established the drug’s preventive use
of long-term metformin users have vitamin B12 deficiency, in an analysis of 20 studies
Stomach intolerance is a solved problem that nobody is coaching.
GI (gastrointestinal) side effects hit a large share of new metformin patients and drive early discontinuation before the dose reaches an effective level — most of it manageable with meal-pairing, slower titration, and a formulation switch most patients are never offered. Metformin’s other well-documented effect, vitamin B12 depletion, has no symptom a patient would ever connect to the drug on their own — it just gets found, or it doesn’t.
US adults on metformin
of metformin patients experience a gastrointestinal side effect, in a meta-analysis of randomized controlled trials
higher likelihood of vitamin B12 deficiency in long-term metformin users versus non-users
What the evidence says, outcome by outcome
The same coaching layer that keeps a patient on metformin also runs the diet and exercise protocol shown to move HbA1c, weight, and diabetes risk further than the drug alone.
GI intolerance
Strongest evidence-backed levers
Taking the dose with the largest meal of the day, and splitting it across meals, reduces the local intestinal concentration that drives symptoms; keeping other dietary changes gradual during the first weeks — rather than a big fiber increase or a very different diet all at once — avoids compounding the adjustment. Where symptoms persist, a formulation switch is highly effective (one study cut diarrhea from 18.1% to 8.3%), but that decision belongs to the prescriber
What TeraHealth runs and tracks
Daily meal-pairing and dose-timing, a paced approach to dietary change during titration, and a symptom log that gives her what she needs to raise a formulation switch with her own doctor
Vitamin B12 deficiency
Strongest evidence-backed levers
Metformin reduces B12 absorption in the gut, and diet is the lifestyle lever that helps offset it: B12-rich foods — eggs, dairy, fish, fortified cereals and plant milks — support levels, especially for patients with early or borderline depletion or additional dietary risk factors like reduced meat or dairy intake. An analysis of 20 studies and roughly 292,000 patients found 32% of long-term metformin users have some degree of deficiency
What TeraHealth runs and tracks
A B12-rich nutrition target built into her daily meal plan, with a symptom watch for fatigue or nerve symptoms that’s hers to bring to her own doctor
HbA1c and fasting glucose
Strongest evidence-backed levers
A meta-analysis of 29 randomized trials found soluble fiber lowers HbA1c by 0.63% on its own; in a randomized trial combining exercise with metformin, 90% of patients reached normal blood sugar, versus 80% with exercise alone, 20% with metformin alone, and 10% with neither
What TeraHealth runs and tracks
A fiber and exercise protocol tracked against the same HbA1c the drug is prescribed to move
Weight and diabetes progression risk
Strongest evidence-backed levers
In the trial that established metformin’s preventive use, a structured lifestyle program reduced progression to diabetes by 58%, versus 31% for metformin alone, both against placebo — lifestyle outperformed the drug on its own primary endpoint
What TeraHealth runs and tracks
A weight-management protocol tracked alongside HbA1c and weight at each recheck
How TeraHealth helps
A registered dietitian and a specialized trainer build the plan under TeraHealth’s clinical protocols. The Tera Coaching App carries the plan daily.
Intake
Health history, medications, the metformin dose and titration schedule, and any labs.
Safety check
One health picture, so no plan contradicts a condition.
Plan
A dietitian and a trainer build a pre-set phase plan under TeraHealth’s clinical protocols.
Daily coaching
Meals, sessions, logs, and an AI coach — inside your app, under your brand.
Measure & escalate
Fasting glucose or HbA1c, and vitamin B12, are rechecked at 12 weeks — the point when diet- and exercise-driven changes become visible.
Lifestyle only. The app never recommends a medication or a dose change. Any dose question is hers to bring to her own doctor — the app doesn’t assume it’s already been reviewed by one.
Nonadherence runs as high as 46% in some cohorts of metformin patients — over stomach intolerance a formulation switch and a few meal changes could resolve within weeks — and the generic manufacturer has no budget to fix it. A retail pharmacy can offer this as an upsell the moment a metformin prescription is filled — on the order-confirmation page, by text, or by email — a Medicare Advantage plan can offer it because it’s paid on adherence, and a patient can simply buy it herself.
Part D adherence Star measures include diabetes medications — metformin is among the drugs plans are scored on
Safety and clinical governance
Every plan runs under TeraHealth’s own clinical protocols. The app coaches lifestyle; it never touches the prescription, and it doesn’t assume the prescribing doctor has reviewed it.
Practitioner-signed
A licensed dietitian and trainer build the plan under TeraHealth’s clinical protocols. It is not reviewed by the doctor who prescribed metformin — any finding that needs a doctor’s input is hers to bring to her own physician.
Auditable by design
The Clinical Reasoning Engine works from a curated, cited clinical knowledge base — reasoning is traceable at every step, and the AI only summarizes for the practitioner to decide.
Lifestyle only
The app never recommends a medication or a dose change. Any dose question is hers to bring to her own doctor.