Would like to talk about Metformin

orchidlady

Well-Known Member
Messages
89
Dear all, Am newly diagnosed, have been taking all you lovely people's wonderful advice bought the BG machine reduced carbs, trying to do more excercise but nothing seems to be changing, average fasting readings are around 16, during the day 2 hours after eating can be high as anywhere between 12 and 19. Have had long chat with nurse today and she feels the way forward is to start on Metformin. Really really hate the thought of taking drugs but cannot stay at these levels I know and the diet changes just does not seem to be working. Worried about any side effects, will it make me put on weight? make me feel ill. Despite the BS levels, I feel extremely well, am not over weight and have loads of energy
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
Hi orchidlady and welcome to the forum :)

Give Metformin a try - you can always come off it if it doesn't suit you. It can help you to lose a little weight and bring your sugars down by a maximum of 2 mmol/l. This isn't nearly enough but it's a start. On the minus side it can, but not necessarily will, give you stomach upsets. You could also try the SR version which is a bit kinder on the stomach. It has a beneficial effect on the heart.

Here is the information we give to new members which I hope will be interesting and useful to you. As you see, it is a good thing to further reduce the carbs you are eating.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 well over 30,000 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 ... rains.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

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 blood glucose 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.
----------------------------------------------------------------------------------------------------------------------------------------------------

Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.
 

MaryJ

Well-Known Member
Messages
842
Hi Orchidlady

what have you been eating. What carbs have you been having? If you have been really trying low carb the reads you are still getting are a bit of a surprise really.

It's all a matter of choice. I decided from the beginning I really didnt want to go on any meds if I could help it. To that end, I have more or less ditched all carbs except those which come in veg,milk and of course wine :)

So far, so good. now also off my bp tablets.

however, if you are already trully low carbing I''d be surprised if your body is going to be able to keep your BG's under control without help.

If you're not low-carbing and still getting those kind of numbers - well it's up to you, go lower or have meds to help. There isn't a right or wrong answer to that just what you feel you can live with (or without more accurately)

Good luck

Mary x
 

orchidlady

Well-Known Member
Messages
89
Hi Mary

Well in answer to your question, have cut out Bread, other than the odd Brown Pita, No White Rice, no cereal other than oats, tons of veg, lean protein and fish, Cheeky drink at the weekend ( but this seems to make no difference to levels) lots of pulses, very limited potatoe portion. The odd occasion I have been naughty this seems to make no difference. A bit weird really. I have low blood pressure not over weight, and feel good and absolutlly dread taking a drug but not sure what else I can do.
 

Mushroom

Well-Known Member
Messages
179
Hi, perhaps still some space to reduce the carbs. I started by cutting rice, bread and potatoes because I knew I could not eat 'just small portion' and I looked at low GI ie noodles, pulses, beans and considered oats which don't usually eat. I wasn't blood testing then. Now I have progressed to avoiding anything obviously carb at all. My one concession is Special K but have nuts and seeds with that and can just about get away it when testing. The obvious one may be the pulses - they are still starch (carbs). My present results are not high but higher than I expected considering how little obvious carb I now eat. Depends how well our pancreas works, I suppose. Also like my wine and believe it lowers BS so have it when eating out. And I get drunk quicker because I am not so used to it as don't have it so often these days.
 

Mushroom

Well-Known Member
Messages
179
Also, if you want to actually count your carb intake, I use an android app - Sparkpeople. That may reveal a carb count higher than you thought. Very low carb would be around 30g a day.
 

xyzzy

Well-Known Member
Messages
2,950
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Undeserving authority figures of all kinds and idiots.
Without wishing to be nosey how old are you orchid?

Metformin will reduce your levels by a bit but your levels do seem high considering the changes to diet you have made by the sounds of things. You also say you aren't overweight. Did they check you out for Ketones in your urine and such like? Have you lost weight recently for no good reason? If you are cutting carbs and getting no real progress then you should go see the doctor, explain your diet changes and ask for a c-peptide and GAD test just to make sure you really are T2.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. I agree with xyzzy ref age, weight and diagnosis. Metformin will not cause weight gain. It may help you reduce weight a little bit as it normally reduced your appetite. It is a good drug but if you are prescribed the plain, non SR (Slow Release) version, and suffer stomach problems then do insist you are prescribed the SR version.
 

GraceK

Well-Known Member
Messages
1,835
Dislikes
Marzipan
Insincere people
Big cities
Vulgarity
I've been on Metformin SR for 2 months now and have had no tummy probs with them. I always take them with or straight after my main meal, never on an empty stomach.
 

orchidlady

Well-Known Member
Messages
89
Dear all, thanks for your replies, in answer to your questions, I am 47, yes I have been loosing weight but it has been a fairly gradual thing I think, not owning a par of scales till last week. Never had a urine test. I am within the ideal weight range but top end if that makes sense, so if continue to loose a few more pounds that that would be beneficial. Some mentioned pulses, I thought they were good, trouble is not terribly into meat and cheese is not the best for fat content. One good thing my Cholesterol has come down over the past couple of months. I ws only officially diagnosed very recently, maybe I am being in impatient?
 

xyzzy

Well-Known Member
Messages
2,950
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Undeserving authority figures of all kinds and idiots.
What I would do orchid is drastically cut back on carbs just for a few days and see if that begins to have a noticeable effect on your BG's. By drastic I really do mean no sugar and just the tiniest quantities of rice, pasta, potatoes, cereals, bread and flour based products or better still none. If after doing that for a few days you still don't see a reduction in levels I really would go back to the doc and get some extra tests done. Many of us would say that getting your cholesterol lowered is great but getting your levels sorted is far more important as running levels in the high teens is very likely to be causing you damage.

What I and Daibell are suggesting is you don't meet the standard profile of a T2. Most T2's are producing a fair amount of insulin so effectively cutting carbs as a T2 allows the insulin you are producing to work against a restricted amount of carbohydrate and therefore you see a very noticeable drop in levels pretty soon after starting a low carb regime. There are T2's who like yourself are not particularly overweight but they do see their levels get better if they drop their carbs enough. Alternatively there are other types of diabetes such as late onset (LADA) which mean you may not be producing hardly any insulin at all. In these cases low carbing will normally only have a minimal effect on levels and therefore needs to be treated differently. The c-peptide test and GAD tests will allow the doctor to distinguish between the two types. It is quite common for doctors not to recognize that they have a case of LADA on their hands rather than plain T2 and many members have had to "help" their GP find out what's what in those circumstances. Around 3 in every 100 T2 diagnoses are thought to be wrongly diagnosed.
 

orchidlady

Well-Known Member
Messages
89
Hi Xyzzy, OK will give that a go next week and see what happens any suggestions on what to eat, not eating bread anyway for past 2 weeks. The strange thing is I don't seem to get huge spikes regardless of what I eat, When I ate a chocolate bar once it made no difference, my levels seem to go down during the day and lowest in the evening, is this normal? really can't get my head around all this. I can low carb but to think I would need to live on protein and veg alone for the rest of my last would be a very terrible thought
 

xyzzy

Well-Known Member
Messages
2,950
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Undeserving authority figures of all kinds and idiots.
Long term it's not that bad in fact I enjoy my diet far more now than before my diagnosis! When I got diagnosed last December I thought much the same but within a few weeks and finding out what was safe to eat and the choices available I don't miss the starchy foods at all anymore. Take a look here http://www.dietdoctor.com/lchf and at this Swedish docs recommendationshttp://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in for ideas.

Normally mine and other members advice would initially be to cut out sugar and halve your starchy carbs (rice, potatoes, bread, pasta, cereals and flour) then using your meter as a guide up or down what's left until your levels respond. Also swapping to brown basmati rice, brown or tri colour pasta and buying Burgen Soya bread (get it from most supermarkets) will help a bit but don't expect miracles. Also you need to realise that "healthy" things like pure fruit juices are full of sugar as of course are non diet fizzy drinks. Fruit itself is also high sugar so I tend to eat it along with my main meal as I find it helps my levels that way.

As you said you weren't overweight and that you had reduced your carbs with little effect then you need to be aware that you may not be classic T2. The quickest way to see this is just to stop all carbs and sugar for a few days and see if your levels respond. If they do it means you are producing some insulin so you are likely to be plain vanilla T2. If they don't respond you need to get the doctor to take things seriously. Running your levels long term in the teens is not an option.

Having your lowest reading just before your main meal in the evening is entirely normal. Most peoples highest readings are when they wake up and then they gradually drop throughout the day but obviously rise after each meal. For some reason insulin works better as the day progresses in most.

The problem you have is that your levels are way to high. Metformin will help a bit but it isn't a magic bullet. At some point if you are T2 you will need to make a long term lifestyle choice. Essentially you have to recognise that running levels high will damage you. It can and does lead to blindness and amputations and can knock 15 years off your lifespan if you don't get it under control. To get control as a T2 you can either choose to try and control it by diet so cutting out as much sugar and carbs as necessary to normalise your levels or you have to accept you're going to need to take drugs far stronger than Metformin to allow you to continue a moderate level of carbs. The trouble is those strong drugs tend to only work for a while, make you gain weight and some say accelerate the progression of the disease so that in the end you have no option but to take insulin. Injecting insulin will allow you to eat more carbs but it comes with its own set of danagers such as hypos and again weight gain unless you keep to a pretty strict healthy diet.
 

Cynthia6

Member
Messages
20
I am on Metformin and I don't have any side effects and have felt really well since I have been taking them, I am pleased to be on them and not just edit control, my only problem is being on Metformin means they won't give me testing strips so I don't know how my bg levels are
 

mrawfell

Well-Known Member
Messages
97
To me Metformin ( Glucophage SR ), is both a blessing and a curse. It definitely keeps my glucose level in check, last HbA1C was 4.4, doctor seems concerned about it being too low, so suggested cancelling the Glucophage. However my FBS is now higher than I would like, 6.5.
The side effects are my main concern, it makes me constipated, ( apparently normal side effect is a loose bowel movement ! ). I have retired out of the UK, and all drugs I have to pay for. ( I have a good relationship with my doctor, and don't pay her, if I did the cost would be about 3 GBP ). This goes for testing as well. I opted to buy my own kit, I am concerned about my life, so no contest. So if you don't get a meter and test strips on the NHS, weigh the cost against what it could cost you in terms of life span, eyesight, feet. As somebody once wrote on here, " I want to die with my feet on "
 

mrawfell

Well-Known Member
Messages
97
Sorry I should have added, I drink black tea and coffee, no sugar. No potatoes, rice, pasta etc. I have 2 slices of whole meal bread a day. However I do have fruit, tomatoes, and a couple of beers.
 

orchidlady

Well-Known Member
Messages
89
So started on Metformin yesterday, feeling a bit weird so hope this will pass. Nurse said could take a few weeks before I see any improvement. Just wondered other people experiences with this. Hate the thought of taking a drug but with levels going into the 20's and no matter what I ate seemingly making little difference, had to do something. Still low carbing.
 

Daibell

Master
Messages
12,642
Type of diabetes
LADA
Treatment type
Insulin
Hi. Don't expect miracles from Metformin. It does help reduce your BS by about 1-2 mmol and is most helpful if you are overweight. It should reduce your appetite a bit which helps. If you have a slightly metallic taste with your food, it will fade. If you are on the standard Metformin and you have any stomach problems do ask to be swapped to the Slow Release (SR) version.
 

orchidlady

Well-Known Member
Messages
89
The last thing I need is my appetite to go, struggling to eat enough as is. Really don't need to loose weight. If Metformin does not really help with BS levels what is the point then?. Now really starting to feel a bit frustrated. I am really low carbing, cut out bread, Rice, Sugar etc. Been diagnosed since Aug and there is absolutely no change in BS, sure I am doing myself damage running levels in the late teens most of the time. I need to control this but don't know what else I can do.
 

Superchip

Well-Known Member
Messages
512
Dislikes
GP's, Diabetes Nurses.Crazy NHS guidelines on diet for Diabetics, they are seeing off millions.
Cheap Whisky !
We are led ( I use the term loosely ! ) to believe that it can reduce LDL levels and trigs as well as a marginal lowering of BG.
I have ceased taking met since 13/9/12 and haven't noticed any difference in BG's, but my appetite has returned nicely.
Also I no longer suffer from the ' starting block ' syndrome for the loo ! brought on it must be said by a combo of met and red wine.

Regards Superchip