I havent noticed any diff when taking metaformin with GH v.s. just metaformin alone. I usually take 500mg with around 80carbs or 1000mg with a higher 150-200g carb meal. never had any hypo issues from it. Ive taken 500mg with only 50g carbs and no hypo either. I do notice a few hours later I feel more hungry than normal and kinda feel a little sick. Not hypo but kinda sluggish and weak, well maybe that is hypo lol but not typical hypo feelng where your dizzy,etc.. after eating I feel much better. I stopped taking GH with metaformin after hearing it lowers IGF levels so now I time my GH around metaformin use since metaformin lowers IGF levels as long as its active which I believe is 4hrs.