metformin action/timings questions

[jpscloud]

Hi all, I wonder if anyone can shed some light on this for me. Does metformin work in the stomach, the intestines, or once absorbed into the blood - or all of those? I've been taking two tablets a day this week, going up to three next week. I still feel absolutely fine, no side effects.

I would like to take it at the optimum time, and from the little bit I've read so far I gather it delays stomach emptying (thus reducing appetite and giving insulin longer to get going) but also acts at the cellular level and reduces glucose production by the liver? There are numerous other things on google searches, but advice on when to take the tablets varies. One source said it works fine on an empty stomach (although perhaps unless it's the slow release version it won't affect stomach emptying then) but if the stomach is upset by it it's better to take it with food.

I don't seem to have the side effects, at least yet, so would it be more effective at reducing the effect of high morning blood sugar (high fasting level) which I seem to suffer from more than anything, to take it on an empty stomach before bed? And to optimise the appetite reduction, perhaps take the morning one just before eating?

I will experiment with it, but wondered if anyone has this sussed out already.

 

[jpscloud]

Thanks - some of the claims made on behalf of metformin do make it seem like a wonder drug. I was particularly interested in the claim that it decreases appetite because I am a chronic over eater and binge eater. Taking control of that is not something any drug can do for me (at least not any drug I'd be happy to take!) but if metformin does have that effect, I wanted to maximise it (the effect I mean) to help me gain and maintain some control.

 

[dog-man]

I have been on metformin since 2000 and I have seen no evidence to suggest it decreases my appetite.

 

[jpscloud]

Thanks dog-man... it was maybe too good to be true!

 

[dog-man]

Everyone is different though, so maybe some people are affected that way.
I was warned that taking metformin could make me put weight on by my diabetic nurse.

 

[Oldvatr]

Metformin is not a wonder drug, but it is perhaps the safest drug for diabeticsto use. You are unlikely to experience a hypo if it is the only diabetic med you are on. It can also be used safely in conjunction with other meds. I experimented with the timing of my meds, and I found that the extended release (MR) version did not work as well for me, whatever time I took it. So I went back to SR (standard) Met, and found for me taking it 1/2 hour before my main meal gave me optimum results. We are all different, so you may need to explore your own fine tuning. One thing I deduced from various sources is that generally we start to digest our food after 15 mins from start of meal, but the Met tabs I have take approx 30 mins to dissolve. Moving my dose just before my meal gives it best chance for doing its stuff.

 

[Jan30012016]

Help!
why am I still having high readings after 1500mg metformin daily?
Would my levels be even higher if I didn't take metformin?
REGARDS

 

[ladybird64]

Hi Janet. Although Metformin is a good safe drug, it doesn't do much in regard to bringing BG levels down - it is highly likely that you need to examine your diet, how much carbohydrate you are eating, as this will cause levels to rise.
Bread, potatoes, rice, pasta and cereals can all cause significant rises so maybe that's the reason?
Perhaps if you give us some idea of what you eat, we can give you some pointers to help improve things.
Don't worry, it can be done!

 

[Jan30012016]

My usual diet consists of either weetabix or porridge with skimmed milk for breakfast. Mid morning I have a small apple and satsuma. Lunch is mostly salad with tuna, tinned salmon, egg or with a handful of pasta. Mid-afternoon a small apple or small banana and a satsuma. For tea I'm normally starving so have a bigger meal at around 6pm. I don't eat meat at all and eat a lot of quorn products. I will have a Sunday type dinner or home made veg soup with linseed and soya bread. Home made risotto with lots of mushrooms onions. Or stuffed peppers with cous cous. Stir fry prawns and things like that. If I fancy some chocolate I have only 2 squares. And I only eat french fry crisps once or twice a week. Lots of sugar free jelly.
I thought these were all the right things.

 

[Oldvatr]

My usual diet consists of either weetabix or porridge with skimmed milk for breakfast. Mid morning I have a small apple and satsuma. Lunch is mostly salad with tuna, tinned salmon, egg or with a handful of pasta. Mid-afternoon a small apple or small banana and a satsuma. For tea I'm normally starving so have a bigger meal at around 6pm. I don't eat meat at all and eat a lot of quorn products. I will have a Sunday type dinner or home made veg soup with linseed and soya bread. Home made risotto with lots of mushrooms onions. Or stuffed peppers with cous cous. Stir fry prawns and things like that. If I fancy some chocolate I have only 2 squares. And I only eat french fry crisps once or twice a week. Lots of sugar free jelly.
I thought these were all the right things.

Hi I am T2D on 2,000 gm Metformin, and I am currently using Low Carb Higher Fat diet. One benefit is that I can very quickly see what foodstuffs spike me. There are things in your posting above that I would find sending my BS into outer space so to speak. Firstly you seem to be still eating a fairly large carb load. e.g. couscous, rice, Weetabix, porridge french fries. Whilst I do not myself ban them from my diet, I am aware that they will advesrely affect my BS, and represent a risk to me that my meds will not deal with very well. Even a banana can spike me if it is too big or too ripe, and I use bananas to avoid hypos if my bgl reading is on the low side.

This website is running free online LCHF diet training courses, and there is plenty advice on the Forum not just on this diet. but on other Low Carb diets that many are successfully using to control their bgl. That seems to be the secret, that by severely reducing carb intake and replacing the lost calories with fat and protein instead really has a direct effect on reducing the glucose. These diets can also help to reduce weight or increase weight by controlling the proportion of fat taken in. It seems very simple to follow, and does not really need a maths degree to do it.

You should note that I do not jump down you neck over the chocolate. On LCHF we are allowed up to 6 squares a session provided it is the 85% choc type but not the milk choc type.

 

[Jan30012016]

Thank you for all that information.
I do only have very small portions of carbs but I agree I will maybe have to cut out completely.
I worry about gaining weight where the fat comes in and I do try and replace low fat yoghurt with full fat etc.
I am finding it difficult being diabetic. I hate it. I'm always extremely tired to the point I coukd fall asleep at work but then sometimes at night when I should sleep I can't.
Thanks for the tips.

 

[Oldvatr]

Thank you for all that information.
I do only have very small portions of carbs but I agree I will maybe have to cut out completely.
I worry about gaining weight where the fat comes in and I do try and replace low fat yoghurt with full fat etc.
I am finding it difficult being diabetic. I hate it. I'm always extremely tired to the point I coukd fall asleep at work but then sometimes at night when I should sleep I can't.
Thanks for the tips.

You are not alone. Diabetes is the club that no one wants to join. But you have many good people here in the Forum that are going through the same sort of things, and you will pick up loads of tips and info to help you. We all have different journeys, and differing experiences, so not everything written here is necessarily right for you. Experiment, and always remember that you are not mandated to do anything that you don't want to, and that also goes for 'professional advice' too. GP's, DCN's and dieticians are not Gods, and they can be wrong sometimes.

 

[Jan30012016]

I've just been reading the LCHF website and signed up. Gonna start monday. Looks really good and doable.
Cheers for that.

 

[mossycow]

Hi there, I know this question is about metformin and that's why I came to read...but I do think you would find it easy to make some food swaps that would help lower your blood glucose.

I am not a dietician so feel free to take this a pinch of salt. But you may consider replacing your fruit with veg. While fruit has lots of fibre and nutrients it is much higher in sugar than most veg. What about making dips to have with veg? I like mackerel pate, hummus, aubergine dip...just cook veg, add flavours and blitz up. I also love cabbage with black pepper or roast veg..... Just remember that the med veg has higher sugar than say broccoli, cabbage, kale, etc.

Couscous has a high GI (takes less time to break down so raises blood sugar). Its very highly processes pasta so basically its almost digested before you even cook it! I had a look at replacing high GI grains / carbs with low and it was easier than I thought so maybe that might help you (as you helped me with metformin above - thanks)

Suggest less couscous, any highly processed /white pasta, rice, potatoes, processed cereal
Suggest more brown rice, bulgur wheat, sweet potato, oats etc

I cook in batches as so many of these foods take longer to cook, cool quickly and freeze in individual portions. I often take to people's houses / restaurants and reheat instead of say the white rice, chips etc that others are having.

I like this article

http://www.dummies.com/how-to/content/how-to-replace-highglycemic-grains-with-lowglycemi.html