Doctor won't prescribe metformin for me

fenlady

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Having to be on a weight loss diet all the time
Help - I am really struggling to control my Type 2 with diet alone, and am in a wheelchair so can't exercise much. My last Hba1c was 36 (5.4). I know this is a good reading, but my weight keeps going up even so. And I'm only eating 1350 calories a day. I really think metformin would help me to control my weight as well as my blood sugars, but the doctor won't prescribe it and won't say why! Can anyone explain this - what does my Hba1c have to be before I can be offered metformin? Thanks.
 

ally1

Expert
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5,402
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liver
I do think it depends on your blood test results
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
My surgery has to follow the rules set them by the local NHS governing body (are they still called primary care trusts, or have they changed name yet again?) - and their rule is that metformin is only prescribed to diagnosed diabetics with an hba1c above 48

Some people have posted that their surgeries refuse to prescribe met until the hba1c hits 53
 
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Lamont D

Oracle
Messages
15,936
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Help - I am really struggling to control my Type 2 with diet alone, and am in a wheelchair so can't exercise much. My last Hba1c was 36 (5.4). I know this is a good reading, but my weight keeps going up even so. And I'm only eating 1350 calories a day. I really think metformin would help me to control my weight as well as my blood sugars, but the doctor won't prescribe it and won't say why! Can anyone explain this - what does my Hba1c have to be before I can be offered metformin? Thanks.
There must be a medical reason why your doctor has not prescribed you metformin.
Perhaps he thinks it's unnecessary!
Your hba1c is a good reading and well within normal levels.
Do you low carb?
Are you still eating a lot of carbs with your meals?
If you could give us an idea of what you are having to eat, we can advise you on what to do.

Meanwhile I've tagged @daisy1 to give you the newcomers welcome information.
 
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Bluetit1802

Legend
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25,216
Type of diabetes
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The others are right. It would be most unusual to be prescribed Metformin with an HbA1c as good as yours (well done by the way). Basically, you don't need it. My HbA1c was 53 at diagnosis and Metformin was never mentioned, and hasn't been since.

Perhaps try to lower your calories a bit? I was on 1200 a day when I was in the game of losing weight, and that worked. I know everyone is different, but it could be that 1350 is a tad too high for you.
 
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zand

Master
Messages
10,789
Type of diabetes
Type 2
Treatment type
Diet only
I feel for you. I'm not allowed metformin anymore either and I found it really helped with the weight loss. You would think that needing to lose weight was enough reason to prescribe it.
 

fenlady

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Having to be on a weight loss diet all the time
The others are right. It would be most unusual to be prescribed Metformin with an HbA1c as good as yours (well done by the way). Basically, you don't need it. My HbA1c was 53 at diagnosis and Metformin was never mentioned, and hasn't been since.

Perhaps try to lower your calories a bit? I was on 1200 a day when I was in the game of losing weight, and that worked. I know everyone is different, but it could be that 1350 is a tad too high for you.

Thank you so much, everyone. I guess I must just be controlling my BS too well! My diabetes specialist nurse told me to eat 1450 calories per day, but this meant I put on weight again, so I dropped it to 1350. But now I will try 1250 and see how I go ...
My diet is nothing special - just low GI, only three servings of whole grain per day (muesli or porridge and fruit for breakfast, then 1 slice wholegrain bread with lunch). No potatoes, rice, pasta or corn. Lots of veggies and fruit, low fat dairy, lean meat, fish and chicken. Also plain yogurt before bedtime.
My postprandial readings have gone as high as 8.5 when I've had a cold, but normally below 7.5, and sometimes as low as 5.5. I buy my own testing strips and meter, because the surgery is too mean to prescribe them for me, and this is the only way I can see what's happening and which foods to avoid.
I can already see this forum is going to be a great tool!
 
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Lamont D

Oracle
Messages
15,936
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
That looks fine!
I would reduce your calories a bit more and see how you go!
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
Type 2
Treatment type
Diet only
You could look into using berberine.

There have been studies that show it works in a similar way to metformin, but can be bought in health food stores.

But please be very careful. It hasn't been researched nearly as well as metformin - the studies are much less rigorous. And you need to source a good quality supply, from a reputable source. There are a lot of iffy suppliers out there, and heaven knows what they put in the capsules! There are also capsules that claim to contain berberine, but actually contain different herbs... It is a minefield, and i gave up the battle.

If you do find a source, then it will act very similarly to met, so yo may find it lowers your bg too far - yet another thing to take into account! It can also produce digestive issues - just like met.

I am no expert on weight loss while totally sedentary, but I agree with the others that your food intake may simply be too high. Which is not something that anyone ever wants to hear.

Have you calculated your basal metabolic rate? It gives a rough idea (very approx!) of the no of calories a person needs based on height, weight and activity levels. It would give you a very rough starting point, and is more accurate for people eating carbs as you are, than for very low carbers.

Good luck
 

Dark Horse

Well-Known Member
Messages
1,840
You could try fitness routines suitable for wheelchair users, there are a number available on youtube, they might be more pleasant than further food restriction. Using free weights helps burn more calories.
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
@fenlady

Hello Fenlady and welcome to the forum :) Here is the information, mentioned above, which we give to new members and I hope you will find it useful in addition to all the replies you have received so far. Ask any questions you need to and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 

SunnyExpat

Well-Known Member
Messages
2,230
Type of diabetes
Prefer not to say
Treatment type
Tablets (oral)
Help - I am really struggling to control my Type 2 with diet alone, and am in a wheelchair so can't exercise much. My last Hba1c was 36 (5.4). I know this is a good reading, but my weight keeps going up even so. And I'm only eating 1350 calories a day. I really think metformin would help me to control my weight as well as my blood sugars, but the doctor won't prescribe it and won't say why! Can anyone explain this - what does my Hba1c have to be before I can be offered metformin? Thanks.

It did absolutely nothing at all for my weight, or appetite, so don't worry too much about it being any use as an appetite suppressant.
 
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Sirmione

Well-Known Member
Messages
477
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Donald Trump
Metformin. makes me hungry ! The side effects vary from person to person, with hba1c that low I would avoid Metformin.
Looking at your diet there is quite a lot of grain foods and fruit in it and it seems relatively low on fats and oils.
Fatty food satisfys hunger better for longer than carbohydrates, and contrary to accepted dogma many of us on a low carb higher fat diet have found it lowers cholesterol.
 

Pinkorchid

Well-Known Member
Messages
2,927
Type of diabetes
Type 2
Treatment type
Diet only
My surgery has to follow the rules set them by the local NHS governing body (are they still called primary care trusts, or have they changed name yet again?) - and their rule is that metformin is only prescribed to diagnosed diabetics with an hba1c above 48

Some people have posted that their surgeries refuse to prescribe met until the hba1c hits 53

The nurse I saw said they are now advised to prescribe Metformin to all diabetics unless it is really not suitable for whatever reason. My HbA1c was 46 when diagnosed and I will start on it this week
 
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zand

Master
Messages
10,789
Type of diabetes
Type 2
Treatment type
Diet only
The DN nurse I saw yesterday


The nurse I saw said they are now advised to prescribe Metformin to all diabetics unless it is really not suitable for whatever reason. My HbA1c was 46 when diagnosed and I will start on it this week
Thank you! I will mention this to my doctor at my next review.
 
Messages
6,107
Type of diabetes
Type 2
Treatment type
Diet only
For some people Metformin is a quite effective laxative. It may be that the doctor took this into consideration when he refused to prescribe it. To be honest it didn't do much (nothing) for my sugar levels and no-one ever suggested it would help me to lose weight.
 

eminydax

Member
Messages
6
Type of diabetes
Type 2
Help - I am really struggling to control my Type 2 with diet alone, and am in a wheelchair so can't exercise much. My last Hba1c was 36 (5.4). I know this is a good reading, but my weight keeps going up even so. And I'm only eating 1350 calories a day. I really think metformin would help me to control my weight as well as my blood sugars, but the doctor won't prescribe it and won't say why! Can anyone explain this - what does my Hba1c have to be before I can be offered metformin? Thanks.
Hi there, I was diagnosed 2 months ago and the biggest help has been this website. As for the Metformin, my GP said she would not normally prescribe it straight away but as my HBA1c was so high (it was 69) it was necessary, so you're just managing yours too well, well done, I am still trying to get to grips with the new diet and lose weight.
 

Tim55

Well-Known Member
Messages
1,052
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Rap and hip - hop
Hi there

with an HBb1c at that level, with no meds, I'd be happy to carry on as you are.

After 15 months of metformin, LCHF and a few supplements to my diet, I have got down to similar levels, halved my netformin and am thinking about reducing it still further.

I would not get stressed about the refusal to prescribe - I'm prescribed it, and am becoming more convinced I don't need it, if I watch myself