Very long term use of Metformin plus reasons for use

[LittleGreyCat]

Metformin is the first drug of choice for newly diagnosed T2s.
My understanding is that Metformin reduces insulin resistance and can also reduce appetite.
The reasoning is that the vast majority of newly diagnosed T2s are suffering from insulin resistance and associated hunger issues.

My main question is, is Metformin still effective for people who have little or no insulin resistance but a reduced production of insulin.

I am heading for a medication review within the next 3 months, prompted by higher HbA1c (7.9%) and lower eGFR (40).

eGFR of 45 is the point at which you should consider reducing or stopping Metformin.

I am having another test to check if my eGFR really has gone that low as it is well below trend.

I am therefore thinking of the implications of stopping Metformin and wondering how much good it is doing me these days.
Diagnosed nearly 16 years now.

Also wondering if I should push for a cPeptide test to see how much insulin I am still producing, as this could be a factor in prescribing SGLT2 inhibitors.

 

[Rachox]

One thing more that Metformin does I believe is to reduce the amount of glucose your liver dumps, another factor to consider.

Edited for typo

 

[EllieM]

My main question is, is Metformin still effective for people who have little or no insulin resistance but a reduced production of insulin.

To be honest, if you reckon you haven't got insulin resistance I would definitely be pushing for a cpeptide test and maybe even GAD tests. (Though after 16 years you've got to think that LADA is unlikely?) My (limited) understanding was that T2 was defined by insulin resistance so maybe other forms of diabetes should be at least considered.

Metformin also can cause issues with B12 absorption. Do you get your B12 levels checked regularly?

And some studies claim that metformin slows the aging process, so there are non diabetic pros to taking it.

Could Metformin Be a Cheap Anti-Aging Solution?

Biohackers and researchers alike are turning to the diabetes drug metformin for its supposed anti-aging benefits. Is the hype real?

www.everydayhealth.com

 

[LittleGreyCat]

@EllieM I think that the pancreas and beta cells can fail gradually with age, much like many other functions.
[That is one thing that can make T2 a progressive disease.]
So regardless of what the causes were on initial diagnosis the causes may now be different.
I am not really thinking of a honeymoon period of over 15 years before an auto-immune reaction sets in.

I do supplement various vitamins and my last full blood screen didn't show up any deficiencies.

 

[KennyA]

Bilous and Donnelly say that Metformin "increases insulin action" - it reduces blood glucose by interfering with the ability of the liver to top up blood glucose from its stores. B&D say that medical science is not entirely clear how it does this, but it definitely happens. I'm not sure if increasing insulin action is always the same thing as reducing insulin resistance.