Is Metformin damaging your quality of life, or killing you?

Hotpepper20000

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2,065
I’m not sure that metformin has made much of a difference with my BG levels. But I know combined with low carb and high fat it has relieved many of my PCOS symptoms.
My understanding is that here Canada doctors do prescribe it for women with PCOS with out a type 2 diagnosis.
 

Brunneria

Guru
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No.

But I don't think that the negative experiences of a few people who have an intolerance to Metformin should mean that the drug itself should be characterised as "pernicious"

Many thousands of people Worldwide are prescribed Metformin daily, and get huge benefits from taking the drug, and the ultimate cost to the NHS would certainly be phenomenal if lots of newly diagnosed T2D were "frightened" into refusing the drug by the very vocal but also very few people who do suffer unfortunate side affects.

Absolute agreement.

I have noticed when we get threads about Metformin, it is usually people who have had bad experiences of the drug who are the most vocal. Which might give the impression that most people have problems with it. I do not think this is the case.

I have also noticed that posters have started making statements such as 'Metformin won't affect your blood glucose'.
This is incorrect, and when I see this stated, I have started giving some accurate information on the effectiveness of the drug. Many people worldwide find it invaluble to control their type 2, and it would be tragic if those people's health was negatively affected by a vocal minority who get contraindications from Metformin.

Regarding the effectiveness of Metformin in lowering blood glucose.
This meta study
http://care.diabetesjournals.org/content/35/2/446
showed
A total of 35 trials were identified for the main analysis and 7 for the dose-comparison analysis. Metformin monotherapy lowered HbA1c by 1.12% (95% CI 0.92–1.32; I2 = 80%) versus placebo, metformin added to oral therapy lowered HbA1c by 0.95% (0.77–1.13; I2 = 77%) versus placebo added to oral therapy
monotherapy is when only one drug is used

In case anyone is wondering, the 1.12% figure mentioned is the % shown at the top of the arc (image below) equates to approx 11 mmol/mol (as used in UK HbA1c results).

As a real life example, that means someones HbA1c would lower from 70 to 59 mmol/mol on the chart below
Another way of looking at it, is to understand that those same people would see each of their home finger prick tests drop by an average of 1.5mmol/l
(depending on dose and individual physiology, of course)
hba1c-chart.jpg


I am not going to pretend that Metformin doesn't cause contraindications, some of which are very unpleasant. No drug suits everyone. And no one should continue to take a drug that disagrees with them. However I don't feel it is approriate to state that Metformin in ineffective at lowering blood glucose, when the trials exist proving otherwise.

Regarding Metformin causing B12 deficiency.
Yes, it is proven that long term (months or years) of Metformin use may cause progressive B12 deficiency in some, but not all patients.
https://www.bmj.com/content/340/bmj.c2181
Since Metformin acts to reduce B12 absorption in the gut, it is possible to supplement with sublingual B12 or have supplements by injection on prescription.
The quoted study suggests that all patients prescribed Metformin longterm should be given periodic tests for B12 deficiency.
Anyone not offered these tests can ask for them from their doctor.
This seems very sensible, and I would encourage anyone to supplement with B12 if they feel concerned.
It is always going to be up to the patient, and their doctor, to weigh up the risks and benefits of any drug treatment, and make informed decisions. Once again, I personally prefer that those decisions are based on evidence from scientific studies. Then I use personal experience of taking the drug to decide whether it will suit me personally.
 
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Resurgam

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What annoyed me was that despite my problems no notice was taken - as far as the NHS is concerned I am a naughty non compliant patient, not someone who went through a terrible experience trying to take the tablets.
 

Alexandra100

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What annoyed me was that despite my problems no notice was taken - as far as the NHS is concerned I am a naughty non compliant patient, not someone who went through a terrible experience trying to take the tablets.
Absolutely infuriating, I agree. But Metformin is not the only drug to cause patients problems, and you are, alas, not the only patient to have your valid concerns and theories about your symptoms ignored. Whenever I am prescribed a new (to me) drug, before taking it I READ the leaflet enclosed, particularly nowadays to check if it may be expected to raise my bg. Then I check on the internet, because some leaflets are less informative than others. For Metformin, it was my choice to request it from my GP, having first read the recommendations in Dr Bernstein's "Diabetes Solution" and Jenny Ruhl's "Your Diabetes Questions Answered".

I find that much of the time health professionals are ill / mis - informed. It absolutely is not safe to follow their suggestions without question. When I have to disagree and even refuse a drug, as I have done quite recently, I think it is important to remain polite and pleasant and try to save their face as much as possible. Luckily I have a female GP who seems to have remarkably little ego, and a young male one who has come to think of me as a bit of a laugh, with my "wild" ideas. I think he appreciates me as light relief in his boring day, and most fortunately is willing to indulge me by granting at least some of my requests.

I am pragmatic. I have got my Glucophage XR. I have changed from Apixaban (which can raise bg) to Dabigatran (which as far as I can find out doesn't). If my doctors think I'm nuts, I can live with that!
 

ickihun

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What annoyed me was that despite my problems no notice was taken - as far as the NHS is concerned I am a naughty non compliant patient, not someone who went through a terrible experience trying to take the tablets.
I'm intolerant of all other diabetes meds. Why I'm on insulin. Metformin possible side effects were confused with IBS symptoms so I will be try back on it on Monday. Wish me luck?
Ps. I've had to double my insulin units in metformin's absence. :(
 
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Paul_Harris

Member
Messages
6
Type of diabetes
Type 2
I used to take metformin at the rate of 2 x 500mg three times a day, but now thankfully I'm no longer taking any meds for diabetes, but still keep a good check on my glucose levels because I also have got COPD & when I get a chest infection it does affect my glucose levels. If I was having problems with meds I have words with my GP & get them changed. Thankfully I have not got any problems my diabetes.
 

Freema

Expert
Messages
7,346
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the year I took metformin it only had an effect on my sleep quality by making me have to pee every second hour during my sleep, that was so annoying that I ended up eating the whole dose in the morning instead of taking it twice a day, and maybe also had an effect on my kidneys by raising my blood pressure. I´ve never had raised blood pressure before unless I was extremely ill
 

Freema

Expert
Messages
7,346
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Type 2
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I was losing the will to live on Metformin and a statin, started and stopped at the same time after five weeks of dreadful side effects.
I have been urged to restart them whenever I saw anyone involved in my care, diabetes education people and nurses - but the last time I asked if no record of the state I got into was put into my notes, and it had not been - I said it should be recorded and reported, but was told that as I was taking two tablets it was not possible, as it was not clear which one was the problem.
I would bring it up with my doctor but I have not seen him since diagnosis.


here in Denmark, we can ourselves report side effects of medication, I wonder if there might be such an online medical side effect site where the patients themselves can report the side effects they have endured in Great Brittain too ?
 

Resurgam

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here in Denmark, we can ourselves report side effects of medication, I wonder if there might be such an online medical side effect site where the patients themselves can report the side effects they have endured in Great Brittain too ?
When it is not clear which of two medications - or if it was both of them acting together, it can't be reported, according the the nurse I saw.
 

moleman

Member
Messages
14
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi Alicia,
I couldn't tolerate Metformin either. One a day was ok, but two, no way. I couldn't move too far from a loo. My nurse put me on one, Gliclazide a day and I git my life back. Had 2 hypo's but ate 5 glucose pills and was sorted 5-10 mins later. Good luck.
 

NewTD2

Well-Known Member
Messages
1,563
Type of diabetes
Type 2 (in remission!)
Treatment type
Tablets (oral)
I could never tolerate Metformin, I really suffered while I was on it. And I took it for couple of years and honestly, my sugar was always high regardless the medication. Until last three years when I switched to Amaryl then it’s a miracle drug to me besides Alogliptin. My sugar haven’t been this stable in a long time.

Can you please tell us more about Amaryl?
 

AdamJames

Well-Known Member
Messages
1,338
Type of diabetes
Type 2
Treatment type
Diet only
Absolute agreement.

I have noticed when we get threads about Metformin, it is usually people who have had bad experiences of the drug who are the most vocal. Which might give the impression that most people have problems with it. I do not think this is the case.

I have also noticed that posters have started making statements such as 'Metformin won't affect your blood glucose'.
This is incorrect, and when I see this stated, I have started giving some accurate information on the effectiveness of the drug. Many people worldwide find it invaluble to control their type 2, and it would be tragic if those people's health was negatively affected by a vocal minority who get contraindications from Metformin.

Regarding the effectiveness of Metformin in lowering blood glucose.
This meta study
http://care.diabetesjournals.org/content/35/2/446
showed
A total of 35 trials were identified for the main analysis and 7 for the dose-comparison analysis. Metformin monotherapy lowered HbA1c by 1.12% (95% CI 0.92–1.32; I2 = 80%) versus placebo, metformin added to oral therapy lowered HbA1c by 0.95% (0.77–1.13; I2 = 77%) versus placebo added to oral therapy
monotherapy is when only one drug is used

In case anyone is wondering, the 1.12% figure mentioned is the % shown at the top of the arc (image below) equates to approx 11 mmol/mol (as used in UK HbA1c results).

As a real life example, that means someones HbA1c would lower from 70 to 59 mmol/mol on the chart below
Another way of looking at it, is to understand that those same people would see each of their home finger prick tests drop by an average of 1.5mmol/l
(depending on dose and individual physiology, of course)
hba1c-chart.jpg


I am not going to pretend that Metformin doesn't cause contraindications, some of which are very unpleasant. No drug suits everyone. And no one should continue to take a drug that disagrees with them. However I don't feel it is approriate to state that Metformin in ineffective at lowering blood glucose, when the trials exist proving otherwise.

Regarding Metformin causing B12 deficiency.
Yes, it is proven that long term (months or years) of Metformin use may cause progressive B12 deficiency in some, but not all patients.
https://www.bmj.com/content/340/bmj.c2181
Since Metformin acts to reduce B12 absorption in the gut, it is possible to supplement with sublingual B12 or have supplements by injection on prescription.
The quoted study suggests that all patients prescribed Metformin longterm should be given periodic tests for B12 deficiency.
Anyone not offered these tests can ask for them from their doctor.
This seems very sensible, and I would encourage anyone to supplement with B12 if they feel concerned.
It is always going to be up to the patient, and their doctor, to weigh up the risks and benefits of any drug treatment, and make informed decisions. Once again, I personally prefer that those decisions are based on evidence from scientific studies. Then I use personal experience of taking the drug to decide whether it will suit me personally.

Thanks for the balanced perspective. I "remember reading somewhere" about the reduction of 1%, which is significant, but I'd forgotten where I'd read it.

I'm very likely to be re-starting Metformin soon, but hopefully only temporarily. It's good to know what adverse side-effects to look out for as well the possible benefits. I figure that so long as one gets one's kidney function checked every now and then, and is aware of issues like the B12 absorption reduction, then it has to be worth a go.

It certainly has to be worth giving it a go if you've already made huge diet and lifestyle changes and are still struggling to keep levels low, which is the position I'm finding myself in now.

Perversely, my blood sugar levels have increased since I started doing a lot of walking at weekends, which my records show (and for once I made an accurate long while out this weekend) results in over-eating. It's like my body is desperate to maintain 100kg of weight. The less I eat and the more I walk at the weekend, the more ravenous I get in the day or two afterwards, and I always stop feeling ravenous just after I get back up to 100kg! It's like the crash-diet-then-regain-the-weight-and-then-some scenario but played out over 4 days rather than months! So I'm hoping that Metformin will give me that advantage that some people also report: reduction in appetite and assistance with weight loss.
 
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eddie1968

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Pasta, sorry to me it's vile, yeuch lol (and full of nasty carbs)
I had 90% of my colon removed years ago and the practice nurse put me on Metformin. Diarrhoea and vomiting was extensive and was hospitalised. My Colorectal Surgeon was very annoyed with this as it is contradicted for GI surgery/disease. I’m under a consultant diabetologist who has written to my GP stating I am not suitable for oral meds or a GLP-1 agonist. Only insulin for me. Anyone who has serious GI issues should not take Metformin in my opinion.
 

h884

Well-Known Member
Messages
385
Type of diabetes
Type 1
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Pump
eddie1968 your story very familiar to mine. I was tried on about 5/6 drugs before I started on insulin. I did query this at the outset, however when it came to the final pill I asked to be referred to the local Diabetic Clinic.
 

ickihun

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the year I took metformin it only had an effect on my sleep quality by making me have to pee every second hour during my sleep, that was so annoying that I ended up eating the whole dose in the morning instead of taking it twice a day, and maybe also had an effect on my kidneys by raising my blood pressure. I´ve never had raised blood pressure before unless I was extremely ill
On early diagnosis I had lower blood pressure on higher bgs and excellent bgs gave me higher blood pressure and had to have BP tablets. First pregnancy was when I took my first BP tablet. Never before.
Looking forward to less BP tablets after bariatric op. Awaiting bariatric team to make a start with plans for me now. Everything else has been tick boxed.
 

ickihun

Master
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Metformin's side affects somehow softened my tummy fat which in turn allowed my ovaries space to move/breathe. Hence ovulate and give me 2 gorgeous little boys.
I'm sure my 10yr old could benefit too but no referral as yet.
I'm working on it.
 

Freema

Expert
Messages
7,346
Type of diabetes
Type 2
Treatment type
Diet only
On early diagnosis I had lower blood pressure on higher bgs and excellent bgs gave me higher blood pressure and had to have BP tablets. First pregnancy was when I took my first BP tablet. Never before.
Looking forward to less BP tablets after bariatric op. Awaiting bariatric team to make a start with plans for me now. Everything else has been tick boxed.

Well an interesting point maybe my better blood control was what raise my blood pressure , well I dont know about that .

I am happy to hear that your operation is soon to be , hope you are feeling well dear
 
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AFC London

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I have stopped taking insulin and found my bs to be more stable and read lower than when I was taking medication. I was diagnosed as a Type 1 Just last December after a horror reading of 33.1 after suddenly feeling very thirsty and constantly getting up to go loo. I was told to take insulin 4 times a day and after about a week my bs started to slowly come down.
After about 10 weeks I went to see my little cal doctor and she gave me the good news and said my boood test came back empty for all type 1 relations. She suggested I go on metformim but after I came off insulin I think I have managed to stay quite low on bs readings. It’s been a good three months I haven’t taken any medication.,I take a few natural supplements and keep off the sugars and alcohol and I feel better than I ever did. I’m due for another blood test soon .