P
paltry
Guest
Has anyone here been put on metformin straightaway at diagnosis? My reseach shows it to be recommended by many studies and diabetologists, especially for those of us who are overweight(!)
T
T
Yes I was pu on Meformin straight away but was also strictly warned no o lose any weight as I was underweight.paltry said:Has anyone here been put on metformin straightaway at diagnosis? My reseach shows it to be recommended by many studies and diabetologists, especially for those of us who are overweight(!)
T
Blood glucose lowering therapy
Initial therapy guided by body mass index (BMI) [6]:
* if patient with BMI above 25kg/m2 - start metformin
* if patient with BMI 25kg/m2 or less - consider starting metformin or prescribe an insulin secretagogue (sulphonylurea)
Consider the following when starting metformin [6,7]:
* step up metformin over several weeks to minimise risk of gastrointestinal (GI) side effects
* consider trial of extended-absorption metformin if GI tolerability prevents the person continuing with metformin
* review metformin dose if serum creatinine is greater than 130micromol/L or estimated glomerular filtration rate (eGFR) is less than 45mL/minute/1.73m2
* stop metformin if serum creatinine is more than 150micromol/L or the eGFR is less than 30mL/minute/1.73m2
* prescribe metformin with caution for those at risk of a sudden deterioration in kidney function, and those at risk of eGFR falling to less than 45mL/minute/1.73m2
* if the patient has mild to moderate liver dysfunction or cardiac impairment, discuss benefits of metformin so due consideration can be given to its cardiovascular-protective effects before any decision is made to reduce the dose
Consider sulphonylurea if [6,7]:
* patient is not overweight (tailor the assessment of body-weight-associated risk according to ethnic group); or
* metformin is not tolerated or is contraindicated; or
* a rapid therapeutic response is required due to hyperglycaemic symptoms
References:
[6] National Institute for Health and Clinical Excellence (NICE). Type 2 diabetes: newer agents. Clinical Guideline 87. London: NICE; 2009.
[7] Srinivasan B, Lawrence I, Davies M. Diabetes: glycaemic control in type 2. Clin Evid 2008; 07: 607.
those Metformin are still in their box, untouched!
bowell said:those Metformin are still in their box, untouched!
Your body your choice
Metformin has other benefits eg with Cholesterol
Have good read up on Metformin
You can lead a horse to water: but you cant make him drink
bowell said:Just for interest have you tested 2hr+from a meal ?
uote][/quote]bowell said:Depends on your glucose levels at diagnosis and or BMI
If your only just in range your more than likely be on diet only to start with
Refer to the T2 map of medicine for info see below
http://healthguides.mapofmedicine.com/choices/map/diabetes2.html
From above:
Blood glucose lowering therapy
Initial therapy guided by body mass index (BMI) [6]:
* if patient with BMI above 25kg/m2 - start metformin
* if patient with BMI 25kg/m2 or less - consider starting metformin or prescribe an insulin secretagogue (sulphonylurea)
Consider the following when starting metformin [6,7]:
* step up metformin over several weeks to minimise risk of gastrointestinal (GI) side effects
* consider trial of extended-absorption metformin if GI tolerability prevents the person continuing with metformin
* review metformin dose if serum creatinine is greater than 130micromol/L or estimated glomerular filtration rate (eGFR) is less than 45mL/minute/1.73m2
* stop metformin if serum creatinine is more than 150micromol/L or the eGFR is less than 30mL/minute/1.73m2
* prescribe metformin with caution for those at risk of a sudden deterioration in kidney function, and those at risk of eGFR falling to less than 45mL/minute/1.73m2
* if the patient has mild to moderate liver dysfunction or cardiac impairment, discuss benefits of metformin so due consideration can be given to its cardiovascular-protective effects before any decision is made to reduce the dose
Consider sulphonylurea if [6,7]:
* patient is not overweight (tailor the assessment of body-weight-associated risk according to ethnic group); or
* metformin is not tolerated or is contraindicated; or
* a rapid therapeutic response is required due to hyperglycaemic symptoms
References:
[6] National Institute for Health and Clinical Excellence (NICE). Type 2 diabetes: newer agents. Clinical Guideline 87. London: NICE; 2009.
[7] Srinivasan B, Lawrence I, Davies M. Diabetes: glycaemic control in type 2. Clin Evid 2008; 07: 607.
http://care.diabetesjournals.org/content/29/8/1963.fullManagement of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy
A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes
1. David M. Nathan, MD1,
2. John B. Buse, MD, PHD2,
3. Mayer B. Davidson, MD3,
4. Robert J. Heine, MD4,
5. Rury R. Holman, FRCP5,
6. Robert Sherwin, MD6 and
7. Bernard Zinman, MD7