Low Carb Diet and Metformin

[kevkevkev]

I am 41 yrs old and have been Type 2 for approx 3 years and now take 4 (500mg) metformin a day and my sugars have always been up and down, I want to give the Low Carb Diet a try but am a bit worried my sugars will dip too low, any advice would be greatly received.

 

[britishpub]

Metformin does not lower your BG so you will be fine.

 

[kevkevkev]

I had heard that before about Metformin so it begs the question why do i take it. Thanks for the reply by the way.

 

[Romeran]

Yes, why have I been taking Metformin, gradually increased from one to three, after meals, for the last 17 years, if it has not helped to keep down my sugar levels? I do lots of walking too which I know is much easier when retired but surely the tablets must be doing something good! I have no neuropathy.

 

[kevkevkev]

I have heard on numerous occasions Metformin has other health benefits but i'm yet to hear what these are?

 

[zand]

Metformin has a very small effect on BGs. If you are overweight though it is excellent because it helps to reduce insulin resistance and can also supress the appetite. I wish I was still allowed to take it as it's a tried and tested drug.

I have seen studies that say it has some protective properties too, especially for the lungs, kidneys and pancreas. Sorry I don't have the links anymore but I'm sure if you google you will find some.

 

[Oldvatr]

As i understand things, Metformin primarily acts to reduce the amount of glucose entering the bloodstream during digestion, so reduces BGL at the start of the chain. It has little or no effect on levels once it is in the bloodstream or in the cells, I am on same Met dose as you, but I also take Gliclazide as well, and this combination puts me at risk of hypo's. I am on LCHF diet now and yes there are times when I have to add in extra carbs to avoid a hypo especially at night. if you are testing during diet, then this should not be major problem. I am currrently reducing my Gliclazide dose to fine tune my body to the diet, and have now had days without any evening meds and followed by a good morning BGL reading. We are all diffferent, so what works for me may not be good for you, but on Metformin alone, you should be fine.

 

[kevkevkev]

I don't consider myself overweight I am 13st 10lbs and 5ft 11" and as for suppressing the appetite it does not have that effect on me. After tea at which i take 2 of my 500mg metformin i continuously eat i try to resist but just feel hungry all evening, i'm fine the rest of the day though?????

 

[Oldvatr]

I don't consider myself overweight I am 13st 10lbs and 5ft 11" and as for suppressing the appetite it does not have that effect on me. After tea at which i take 2 of my 500mg metformin i continuously eat i try to resist but just feel hungry all evening, i'm fine the rest of the day though?????

A few questions.... (1) Are you ok after the morning dose of Metformin? (2) Is your Tea the prime meal of the day? (3) Is tea standard meal or LC?
As an aside, I found out that for me it takes about 15 mins for my meal to start to add glucose to my bloodstream, but Metformin takes around 1 hour to become effective. So I now try to take my Metformin around 1 hour before I start eating, and this gave me a significant drop in post prandials.

 

[Brunneria]

Metformin does not lower your BG so you will be fine.

Actually it does.

Metformin lowers bg by approx 1.1 mmol/l (edited to correct: this should read 1.1%, which equals approx 2.5 mmol/l) for the first 1000mg, and then less for the second 1000mg.

This doesn't seem like a significant amount, until you factor in the benefits long term. The effect, over a 3 month HbA1c could drop the result by an appreciable amount (see diagram) although change in diet will make a far greater difference for T2s. There are other benefits that metformin offers too



The video below gives some very interesting info on the mechanism and effectiveness of metformin, and other D drugs. You just have to get past the speaker's style of presentation to get the info.

https://m.youtube.com/watch?list=LLAHFZspBN2li5eieBK9LSLw&v=pUOC5d0Siws#

 

[kevkevkev]

A few questions.... (1) Are you ok after the morning dose of Metformin? (2) Is your Tea the prime meal of the day? (3) Is tea standard meal or LC?
As an aside, I found out that for me it takes about 15 mins for my meal to start to add glucose to my bloodstream, but Metformin takes around 1 hour to become effective. So I now try to take my Metformin around 1 hour before I start eating, and this gave me a significant drop in post prandials.

1. I dont monitor my bloods (standard practice for my surgery if on metformin). 2. yes it is my main meal. 3. my tea is standard at the moment. I've always been told to take my metformin with my meals

 

[Oldvatr]

Actually it does.

Metformin lowers bg by approx 1.1 mmol/l for the first 1000mg, and then less for the second 1000mg.

This doesn't seem like a significant amount, until you factor in the benefits long term. The effect, over a 3 month HbA1c could drop the result by an appreciable amount (see diagram) although change in diet will make a far greater difference for T2s. There are other benefits that metformin offers too



The video below gives some very interesting info on the mechanism and effectiveness of metformin, and other D drugs. You just have to get past the speaker's style of presentation to get the info.

https://m.youtube.com/watch?list=LLAHFZspBN2li5eieBK9LSLw&v=pUOC5d0Siws#

Hi, the ADA reports a bigger efficacy at 1%-2% change in HbA1c (11-22 mmol.L) but states the results are not fully validated. However, most sites I found show this is achieved by the action of Metformin on the liver and intestine to block the conversion of carbs into glucose in the blood. I.E. it happens before the glucose meter would register it. Thus Metformin is unlikely to drop your bgl into hypo territory by itself unless you really starve yourself, whixh holds for virtually all diets..

 

[Brunneria]

Hi, the ADA reports a bigger efficacy at 1%-2% change in HbA1c (11-22 mmol.L) but states the results are not fully validated. However, most sites I found show this is achieved by the action of Metformin on the liver and intestine to block the conversion of carbs into glucose in the blood. I.E. it happens before the glucose meter would register it. Thus Metformin is unlikely to drop your bgl into hypo territory by itself unless you really starve yourself, whixh holds for virtually all diets..

Agreed.
But i wasn't addressing you, so my post was relevant to other aspects of metformin and intended for other people.

 

[Oldvatr]

1. I dont monitor my bloods (standard practice for my surgery if on metformin). 2. yes it is my main meal. 3. my tea is standard at the moment. I've always been told to take my metformin with my meals

Sorry, i meant Q1 to ask if you get the hunger pangs in the morning, or is it only in response to the Tea. I got the same advice on testing from my GP, but if you press hard enough it can change, I had to bring my laptop in and show my spreadsheet with test results I had done privately. I would strongly advise that you are testing when trying out the LC diet- speak with your doctor about it since you may be able to reduce or change doseage later. With testing you could see how the timing of the meds affects your overall averages, and see if bringing the Metformin earlier is any benefit for you. A further observation point:- LCdiets, they will make the hunger pangs worse, at least to start with (see Carb Flu) but that passes after a short while. Your admission of snacking after your main meal is of concern since it indicates that this bad habit will continue, and negate the benefits of the diet. I find the LC diet reduces my hunger now, and certainly drops my bgl averages. Also my family actually enjoy the new menu.

 

[Oldvatr]

Agreed.
But i wasn't addressing you, so my post was relevant to other aspects of metformin and intended for other people.

Apologise for butting in, but many people are under the impression Metformin acts by boosting insulin or reducing insulin resistance, but these claims are so far unproven. It is important to understand how Metformin and diet interact when making signiificant changes to diet. the original poster was asking if Metformin could cause a hypo when doing the LC diet, and if the actual efficacy is higher than you stated above, then it could be significant. Certainly I get more than a 1 - 2mmol/L drop with my Metformin on the same dosege as the original poster.

 

[Brunneria]

@Oldvatr atr
No worries. We have definitely had people on the forum reporting that they experience hypos when on met - but from what i have seen, they tend to be on very strict low carb diets.

That is a purely personal observation, and not the product of any kind of study!

I guess the best thing for the OP to do is to test his bg carefully while introducing low carb, and see how it affects him.

And i owe you an apology. In my post above, i misquoted (should have checked the facts before quoting) the reduction of 1.1 mmol/l i mentioned should have been 1.1% as you rightly pointed out. That translates as approx 2.5 ish mmol/l

The video i linked to in my post discusses this at approx 7 mins.

Thank you for pointing out my error.

 

[zand]

.... many people are under the impression Metformin acts by ...... reducing insulin resistance, but these claims are so far unproven. ......

Unproven or not, my insulin sensitivity was greatly improved whilst taking metformin. Insulin resistance was the main reason my GP prescribed it for me. There are several links which appear to agree. Here's one of the lighter ones.

http://www.diabeticlivingonline.com/medication/oral/metformin-improving-insulin-sensitivity

 

[Pinkorchid]

I really don't know if this incidence is because of Metformin or not but my husband takes it two tablets twice a day with meals but I don't take it.
My husband has not been eating curry for long he never thought he would like it but he is loving it so I have been making it. Yesterday we thought we would treat ourselves to a take away curry and it was lovely. Before having it we were both in the 5's just over two hours later I was 9.1 that was shock as I am never that high but my husband was only 6.3 We both had the same no rice we had it with salad and my husband also had a seedy flatbread so I wonder if the Metformin that he takes kept his BG down. I tested again half an hour later and I was down to 7

 

[Robbity]

1. I dont monitor my bloods (standard practice for my surgery if on metformin). 2. yes it is my main meal. 3. my tea is standard at the moment. I've always been told to take my metformin with my meals

Well, perhaps it might be a good idea to monitor your glucose levels if you want to try to discover what's going on?

It's standard practice for most type 2s to be told they don't need to test if on metformin, but many of us still choose do so regardless. That way we can find out what foods are good or bad for our glucose levels, and so can get better control of them. The only way you're going to find out if they're going to go low on a low carb diet is:
(a) buy a meter and use it to test before and after meals,
and (b) adjust your carbohydrate intake depending on what your meter tells you about how your body's responding to what you've eaten

We can only give general advice, and that will often be as a result of what you can tell us about what you eat and what your glucose levels do as a result.

Alternatively you could try just reducing the quantity of some of the higher carb foods you're currently eating by a smaller amount - a reduced carb diet instead of going completely low one.

Robbity

 

[Chook]

I had hypos while on metformin and eating the eat well plate type diet (I'm on 2x500g per day) but I haven't yet had a proper hypo on LCMF while on the same dose although I have had one occasion when it dipped very low and I got the shaking but it was early enough that a tomato stopped it.