Hi Everyone

[deekh43]

Hi to everyone here.
My name's Derek 43yr old, and diabetic type 1 for 14 yrs.
Having browsed through some of the posts, this place seems like a great place to be. Very informative and helpful.
I'll tell a little about me, and then ask some questions (if that's ok).
As I say, 43 yr old, and extremely overweight (21 stone). Started cutting out my supper and lost 7lbs in past week (well chuffed). Bloods done yesterday, liver and kidneys are fine, hba1c 7.5, cholesterol 4.2.
I am on humalog 3 or 4 times daily (4 if I have a supper) and humulin isophane before bed.
Now some questions,
I take Humulin Isophane before bed 6-10 units, have nothing to eat, yet my BS is always 13-16, why? before my BS is between 4-7.
Metformin, I was told by Consultant at Hospital to take metformin to help me lose weight about 4 or 5 year ago, weighed 13 stone then, I was on 1 morning and 1 night at first. The weight just keeps on rising. 2 years ago the dose was doubled. I have just read about metformin on the main diabetes.co.uk site, where it states, metformin on it's own does not cause hypoglycaemia or weight gain, however when used with insulin, these are likely.
Is this Hospital incompetence?
Cholesterol, I have never had high cholesterol, 4.2 yesterday, 2 months ago 3.5.
However, seeing my GP yesterday, she asked me how I felt about taking simvastatin, saying it was just as a safeguard against cholesterol going high. Asked her about side effects, she mentioned couple, but very casual. I agreed to take them, but last night spoke to my mother, and she strongly advised against taking them, she knows people who take them and the side effects can be horrendous.
Do GP Practices get paid money to encourage patients to take certain drugs?
Sorry if my first post is rather long.
thanks for taking the time to read.
Derek

 

[sugarless sue]

Welcome to the forum,Derek.Track down a thread called 'statins' it will tell you all about simvastatin side effects.Not being an insulin user I'll have to leave the other question to the more knowledgeable who will no doubt be along sometime today.Keep asking questions,that's what we're here for.

 

[Katharine]

Hi Derek,

Because you are a type one and very overweight you can be considered to be one of a growing number of people with what is known as "double diabetes". This means that you are developing insulin resistance /metabolic syndrome as well being insulin deficient.

The metformin is being used to reduce the amount of sugar your liver is making. It is a very good treatment for insulin resistance and it does not cause hypoglycaemia. It is the insulin component that can cause weight gain and hypoglycaemia. It sounds like the DUK site didn't explain it as clearly as it may have.

Doctors are indeed paid to put diabetics on statins. This is via the Quality and Outcomes Framework.

The thinking behind statins for diabetics is that on a population basis type two diabetics have the same raised cardiac mortality of people who have already had a heart attack. Statins can slightly reduce cardiac mortality and this is why type twos are offered it. Type ones over the age of 40 or who already have complications are also being offered it. Perhaps the best thing is to read up about the pros and cons and come to a decision that you are personally happy with.

 

[deekh43]

Hi Sugarless Sue and Katherine,
Thanks for your replies,
To Katherine, I refer you to http://www.diabetes.co.uk/insulin/diabe ... ormin.html which is where I read adout Metformin. I can't find anything about metformin for type 1 diabetics, everything I have read upto now points to type 2 diabetics. Also a bit confused about insulin resistance, I wasn't aware I was insulin resistant. I was prescribed Metformin to help with weight loss, however the article I refer you to contradicts this. When taken alone, Metformin is unlikely to cause hypoglycaemia or weight gain, but when taken in conjunction with insulin or a sulfonylurea both of these side effects are more likely. Obviously I haven't been very well educated in diabetes.
Thanks again

Derek

 

[Geoff]

Hi Derek, it is very unlikely you will find any info for type 1 diabetics and metformin usage, as it it the first line drug to control type 2 diabetes. Below I have inserted a quote from a medical book called "A Case-Based Guide to Clinical Endocrinology" which outline the advantages of metformin for type 2 diabetics. One interesting point in the quote is that metformin has demonstrated cardiovascular protective effects, (protects against heart attack) I do not know if this is true for type 1 diabetics, but if so, why would your GP want to prescribe statins for you, which do the same job? Some of the wording in the quote is medical jargon, but I hope it is of some help to you.

Compared to other oral agents, metformin has several advantages. The United
Kingdom Prospective Diabetes Study (UKPDS) demonstrated cardiovascular protective
effects. Patients treated with metformin had reductions of 32% for any
diabetes-related end point (microvascular and macrovascular), 42% for diabetesrelated
deaths, and 39% for myocardial infarction compared to those treated
with conventional less-aggressive therapy. Patients receiving metformin had more
impressive risk reductions in any diabetes-related end point and all-cause mortality
than those receiving sulfonylurea or insulin with similar A1c improvement [3].
Additionally, metformin may cause modest weight loss, it is relatively unlikely to
cause hypoglycemia, and it has salutary effects on plasma lipid levels. With longterm
therapy, metformin produces a 10% to 20% reduction in plasma triglyceride
levels due to decreased hepatic synthesis of very-low-density lipoprotein, a 5% to
10% decrease in plasma total cholesterol, and small increases in plasma high-density
lipoprotein cholesterol (HDL) [2]. Its side effects are generally limited and mild,
and it is inexpensive. For all of these reasons, metformin is generally considered
the first-line oral agent for the treatment of type 2 diabetes [1]. Metformin can be
started at 500 mg once or twice daily and increased to 1000mg twice daily after
1 week if tolerated. If side effects are persistent, the dose can be increased more
slowly. The maximum dose is 2550mg daily.

 

[totsy]

hya derek,
i asked a similar thing recently about metformin,
my dr put me on metformin about 2 and a half yrs ago ,i was already on insulin and type 1, saying that another dr has just taken me off it and says he believes it causes too many hypo,s with insulin,
so thats two drs with different beliefs,your guess is as good as mine :wink:

 

[deekh43]

Hi
sorry took so long to reply, thanks a lot to all who replied.
Think I was kidding myself on, looking for something to blame for weight gain, so blame the metformin, rather than just blame overeating. Time to grow up I think.

 

[deb1]

insulin and victoza

hi i am an IDD who has been on victoza now for about 2 months i had the usual nausea cramps but this quickly settled . At present i have been suffering with bad sinus problems and can not breathe well through my nose some time i am completely blocked causing dull hearing problems i am wondering if this is just a persistant allergy (i have had a chest infection which is difficult to shift) or is it related to the victoza can anyone help . thanks x

 

[graham64]

Re: insulin and victoza

Hi deb and welcome, I think you need to discuss this with your doc according to this link Victoza is not recommended for T1s.

Victoza is not insulin. It is not known if Victoza is safe and effective when used with insulin. Victoza is not for people with type 1 diabetes or people with diabetic ketoacidosis.

http://m.victoza.com/press-release/

Regards
Graham