Type 1 Lifer being put on Metformin

[Ladybirdy75]

Hi there, it's been a long time since I've visited the forum but i have a question that I'm hoping somebody may be able to help me with.

I've been a Type 1 diabetic for 40 years now (I'm 45) and recently suffered a heart attack (mid March) which required a stent. Ironically I'd already been working with my wonderful DSN for the previous year to lower my high HbA1c, lose weight with an LCHF diet and exercise but unbeknown to me I already had coronary heart disease.

After my heart attack I've been very motivated to bring my levels down and stabilise them (I'm on a pump) and be as healthy as i can. I went to see my consultant on 17th May and although my levels are stabilising, my HbA1c has reduced greatly and I've had no c-peptide tests he has decided that I've developed Type 2 on top of my Type 1 and has prescribed Metformin to be started 3 months on from the heart attack (so mid June). I feel really worried about this as I've never heard of a T1 having to go on this drug and i can find only limited info on it and it seems to be all doom and gloom (people dying of lactic acidosis, horrid side effects, etc). There's plenty of info on T2's on Metformin having to go on insulin but not the other way around and i can't seem to get an appointment to discuss it.

I'm really thinking of not taking it. My May HbA1c was 67 which I've got down from 83 and I'm still working on getting it in range and although I'm around 20lbs overweight it is slowly coming off! I can't understand the need????

Is there anybody out there with a similar experience?

 

[Engineer88]

I'm interested as I've been wondering if it might be able to help me too. I think there are a few on Metformin but cant remember who!

 

[CarbsRok]

I used it for about a year due to being very inactive as have ME. I found it caused no problems but then on the other hand can't see it did any good anyway.
As I understand it the Met is very good for insulin resistance and helps with weight loss. So if you have insulin resistance then give it a try and see how you get on. Bottom line though is it's your choice as to whether you use it or not.

Well done on your weight loss and lowered A1c

 

[tim2000s]

@Ladybirdy75 The principle behind putting you on Metformin is that you have developed Insulin resistance and that they need to bring this down to reduce the amount of insulin you require. Exercise will also help with this. @Spiker has persuaded his Consultant to give him metformin to manage his insulin levels. I've tagged him so he can give his opinion.

 

[yingtong]

I'm a Type1 of over 52 years and I have been taking Metformin for over 10 years,it certainly helped me reduce my insulin requirement by over 20% and I have had no problems with taking these tablets.

 

[Postitnote]

I'm Type 1 on MDI (Novorapid and Levemir) and also take one 500mg Metformin twice a day. I love it. My BS is predictable (generally speaking - when it is not, it is my own fault because of poor food/exercise choices!), my insulin needs are down and I am reassured that it is beneficial for CVD. Not that I have shown any risk of that (so far!) but, every little helps I'm sure.

I was put on Metformin as an "experiment" ... told to stop insulin, take Metformin and see what happened. It was a scary week with BS all over the place. Now, back on insulin and am still taking the Metformin.

HOW do you lose weight as a Type 1 on LCHF? I've been doing LCHF for a year.... no impact on my weight whatsoever and was as low as less than 20g carb a day. Although my BS stabilized and I didn't gain any weight... I have recently loosened up though, up t 200g carb a day and the change has had no real impact either way.

 

[Ladybirdy75]

Thank you so much guys. I'm still thinking about it. I think the problem is that i haven't actually been tested for insulin resistance and i already exercise daily and eat an LCHF diet plus my A1c is falling. It just seemed weird that he was basing his decision on a wonky two weeks. Then again maybe i am as the weight loss is very slow despite effort and i guess i am the dreaded apple shape with my weight being around my middle. Maybe i should just give it a go for a while.

 

[Ladybirdy75]

Postitnote:- yes i admit weight loss is very slow, sometimes just half a pound a fortnight!! Thinking about it for the months following my heart attack (almost 3 now) I've only lost 3lbs and that's with a great diet and exercise effort!

I guess I've been mostly worrying about the side effects, especially on my heart. At my appointment he said to take 1 x 500mg at night only but when i collected the prescription it's says take 2 x daily?!! Maybe I'll just start with the night one and see how i go. Hope there's not too many hypos :-D

 

[CarbsRok]

Postitnote:- yes i admit weight loss is very slow, sometimes just half a pound a fortnight!! Thinking about it for the months following my heart attack (almost 3 now) I've only lost 3lbs and that's with a great diet and exercise effort!

I guess I've been mostly worrying about the side effects, especially on my heart. At my appointment he said to take 1 x 500mg at night only but when i collected the prescription it's says take 2 x daily?!! Maybe I'll just start with the night one and see how i go. Hope there's not too many hypos :-D

Hi Ladybird,
you need to take the Met with food. and yes it's best to start with 1 tablet a day as the runny bum side effects could kick in

 

[Engineer88]

Please help educate me a bit, what are the pros and cons of met? I looked at it previously (when under my previous hospital who wouldnt change my insulin) but that was ages ago

 

[LucySW]

I did masses of reading about it and really think it's a good safe drug. Insulin sensitivity is what we all want. It just stops your liver dumping glucose. Dr Bernstein recommends it. I found it fine - the only things were 1) up the dosage gradually as everyone says - there's a reason they say it ! And 2) you cant drink much alcohol while you're on it, so go easy on that.

 

[Postitnote]

I did masses of reading about it and really think it's a good safe drug. Insulin sensitivity is what we all want. It just stops your liver dumping glucose. Dr Bernstein recommends it. I found it fine - the only things were 1) up the dosage gradually as everyone says - there's a reason they say it ! And 2) you cant drink much alcohol while you're on it, so go easy on that.

Hi Lucy - I am curious about your alcohol comment as I've found conflicting advice. Although "advice" is what I have gleaned from the internet and is apocryphal in nature. I would love to see if there is actually a medical study backing this up/disproving this!

 

[tim2000s]

HOW do you lose weight as a Type 1 on LCHF?

You really need to look at what you're actually eating. I only lost weight by controlling calorie intake as well as carbs. It's worth calculating what you are eating per day to see whether you can cope with a 10% cut in calories and see what the impact that is. I saw very quick weight loss once I restricted myself to 2000 calories per day.

 

[Postitnote]

You really need to look at what you're actually eating. I only lost weight by controlling calorie intake as well as carbs. It's worth calculating what you are eating per day to see whether you can cope with a 10% cut in calories and see what the impact that is. I saw very quick weight loss once I restricted myself to 2000 calories per day.

Sorry, just a quick response as I am aware that we are moving off thread topic....

.... I would be very glad to show you my food diary (for a week, fortnight, a month?!) but I really, truly tried - I was so miserable when I started on Insulin and gained 10kg (?!??!!!) I went low carb (i.e. less than 20g) and low calorie at the same time (restricting myself to 1,200 calories) took up resistance training and .... nothing worked. I then took some advice from this forum, changed my proportions so I was eating more fat (nuts, oils, avocado) and less protein, still restricting my carbs (although this meant that my calorie count went up to about 1,500).... nothing. I am still a blob. On the plus side, all those squats and lunges have given me a perkier bottom

 

[tim2000s]

@Postitnote I've pm'd you.

 

[BaliRob]

@Ladybird75 says "...........consultant.............has decided I've developed Type 2 on top of my Type 1"

Please can someone explain this for me - never seen this discussed on the Forum. It provokes the question. "How can someone who has been Type 1 for 40 years suddenly have a pancreas producing some insulin (if that is what is happening)?

 

[Ladybirdy75]

Thank you all for your comments. I don't know how to reply individually so I'll just have to try here :-S


@BaliRob. I honestly believe that i DO NOT have a pancreas that's suddenly producing insulin after 40 years. My readings since March were generally in the 5 & 6's then i had a few readings that went up into the 12 to 15's, although scattered over a 2 week period and mostly early morning/late night - i was going to basal test and make the necessary base rate adjustments on my pump. The Endo looked at the higher readings and based his decision (seemingly) on that snap shot of readings and the fact I'm finding it difficult to shift the pounds. Up until then there had been no mention of this at my 6 weekly DSN appointments and as i said before, my A1c's is falling, some weight has come off and my BG's were stable-ish. I'm baffled as to how he's come to that conclusion. I should add here that i also tested borderline for under active thyroid which he didn't want to treat yet as the drugs higher my heart rate and with my heart problems that's not a good idea (reason for slow weight loss??). I'm testing for that again in mid-August to see where the levels are.

The only thing i have found whilst scouring the web is that somehow i have become resistant to the insulin being self administered. I can't remember on what site I've seen these as some were from scholarly articles and one other was a guy talking about his experience of it with a few comments (asweetlife? I googled type 1 diabetic on Metformin and found him). The scholarly articles are where all the worrying doom and gloom came from lol.

Postitnote: your weight loss problems sound so like mine lol. I've been sticking to 1200 -1400 cals a day, nuts, lots of raw veggies, fish, tiny bit of fruit in the form of raspberries and blueberries, fat free yoghurt, poached eggs, rarely wholemeal bread or pasta, tons of water, all in the right proportion and accounted for, daily 45 minute exercise (walking and cross trainer at moment as heart restricting me until stress echocardiogram confirms i can push more) blah blah and 3lbs off in 3 months!! I even had the dietician sit in on one appt who said my diet was exemplary (gold star for me lol).

I'm happy to have read that some folks on here are type 1 and on Metformin without problems. After June 19th I'll try one a day to start with at dinner and see what happens. I can then update you and possibly get a lot more info to share.

 

[Dillinger]

I asked to be put on Metformin as I have high bolus ratio for insulin to carbs (1 unit : 1 gram of carbs at some points during the day).

The initial period on it was great; dropped a lot of weight and has pretty good impact on my blood sugars (though not huge). I've never suffered any side effects. After a year or 2 its impact is less noticeable though.

Metformin is a generally well tolerated drug (some dodgy tummies aside).

Here is a study about it and Type 1's

http://www.ncbi.nlm.nih.gov/pubmed/17199734

Best

Dillinger

 

[Ladybirdy75]

Here's a link i looked at :

http://asweetlife.org/catherine/blo...rmin-and-type-1-diabetes-an-experiment/36143/

 

[Ladybirdy75]

I asked to be put on Metformin as I have high bolus ratio for insulin to carbs (1 unit : 1 gram of carbs at some points during the day).

The initial period on it was great; dropped a lot of weight and has pretty good impact on my blood sugars (though not huge). I've never suffered any side effects. After a year or 2 its impact is less noticeable though.

Metformin is a generally well tolerated drug (some dodgy tummies aside).

Here is a study about it and Type 1's

http://www.ncbi.nlm.nih.gov/pubmed/17199734

Best

Dillinger

Thank you Dillinger, that's really interesting to read. It's so useful to me to hear of your experience of it. Hmmmm i too have a high carb ratio at some times too, 1:1 and one slightly higher for a period in the afternoon so that might be one of the Endo's deciding factors. I think, with all I've gone through recently, i must have just "panic listened " and he didn't explain himself as well as he could resulting in my worries about it. I just needed to hear it from real Type 1's on Met and not from scholarly articles ;-)

Oh, already having dodgy tummies from time to time with all the heart meds ;-). So that's something I'll hopefully just get on with lol.