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Should I try metformin? Advice needed

Totto

Well-Known Member
Messages
2,831
Location
Gotland
Type of diabetes
Type 2
Treatment type
Diet only
I was diagnosed ni February after OGTT of 13.8 at two hours. I have been lowcarbing for some years but since diagnosis I have been strict and cut out all grain and starchy roots. There isn't much more I can cut down on. My bg usually is in the normal range but as soon as something happens, for example if I don't sleep well bg goes up. My GP wants me to go on metformin but I am reluctant to do this as I am not convinced it will help me.

I want him to look into if I am insulin resistant at all first. I have also read that metformin is used mostly when you are over weight and have problems with high fasting bg. Isn't high fasting bg a sign of insulin resistance? My readings have gone from around 4 to around 5.5-6 in five years or so but so far I have never had a reading above 6.2.

Thing is I have slowly lost weight over the past years. It could of course be due to a low carb diet, or that I started meds for hypothyroidism two years ago, but this moderate weight loss doesn't indicate insulin resistance, does it? Come to think of it, the weight loss over the last five years has been considerable or 20%.

I also lack most markers of the metabolic syndrome apart from slightly too large belly.

What do you think? Should I try metformin and see where it takes me, or should I keep insisting GP checks whether I am insulin resistant or lack insulin? Dad and all his siblings had diabetes, as had their mum and all her siblings so there seem there are genes involved. My GP says that as I am fifty MODY is ruled out.
 
Personally, if I could take metformin I'd be on it right now as there are other benefits besides just BG control. You can read a whole lot of information about it here:
http://www.phlaunt.com/diabetes/14045911.php

It's also one of the safest diabetes drugs out there.

No matter what your weight, without a scan you have no way of knowing how much visceral fat you're carrying. If you accept Professor Taylor's research, most people with Type 2 will be carrying a burden of fat on their internal organs.
 
It's a funny one, metformin won't hurt and will help any resistance, but keep insisting GP checks insulin levels, it might be the pancreas not putting out enough for the meal, but enough to cover dawn dump
 
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Hi. Do take the Metformin as it's good drug and will help a bit. Your blood sugar is no indication of which diabetes type you are. AS you have been low-carbing and losing weight any insulin resistance should be quite low? It's possible you could be a Late onset T1 (LADA) so do ask the GP for a GAD and c-peptide test. The latter will indicate whether you have high or low insulin which helps diagnosis. Treatment is very similar overall i.e. low-ish carb diet, one or more tablets and then insulin if that fails
 
I will try to make him check C-peptide. He did GAD but it came back negative.

What I find slightly confusing is that my GP in some instances refuses to prescribe something if the need isn't proved beyond doubt while in other cases he is happy to put me on some meds he has heard is good regardless of any proof I will benefit from it. I think I will follow the evidence based line here and happily take the metformin as soon as there is reliable information pointing towards insulin resistance.
 
Personally, if I could take metformin I'd be on it right now as there are other benefits besides just BG control. You can read a whole lot of information about it here:
http://www.phlaunt.com/diabetes/14045911.php.

Thanks for that link Indy. Very useful as I already have an appointment to see my GP about letting me have Metformin; it's good to see the facts
 
Yes, http://www.phlaunt.com is an excellent site. I have read most of it and I still am not sure I should go on metformin. Morning fb is 4-5 and I generally have no problems with fasting levels, it´s the postprandial that is my problem. So long as I keep to a very strict LCHF everything is fine but if I stray from the very strict path my bg goes high. I can live without pasta, bread, rice and porridge, but I find I can´t even have 10 grams of chocolate and I cant eat apples, not even half an apple. I estimate my current carb intake is 20 grams and quite a lot of it comes from nuts.

As I am middle aged I feel my GP assumes I am type 2 but what is type 2? I have no markers of metabolic syndrome. Isn't the metabolic syndrome vital for insulin resistance?
 
Yes, http://www.phlaunt.com is an excellent site. I have read most of it and I still am not sure I should go on metformin. Morning fb is 4-5 and I generally have no problems with fasting levels, it´s the postprandial that is my problem. So long as I keep to a very strict LCHF everything is fine but if I stray from the very strict path my bg goes high. I can live without pasta, bread, rice and porridge, but I find I can´t even have 10 grams of chocolate and I cant eat apples, not even half an apple. I estimate my current carb intake is 20 grams and quite a lot of it comes from nuts.

As I am middle aged I feel my GP assumes I am type 2 but what is type 2? I have no markers of metabolic syndrome. Isn't the metabolic syndrome vital for insulin resistance?
Is there any way you can get a referral to an endocrinologist or whatever the speciality that deals with diabetes is in the UK? You certainly sound very atypical type 2.
 
Hej Totto! Could you not try the metformin and see if it makes a difference?! As everyone has pointed out it is a safe drug with other benefits? Good luck with whatever you decide to do!
 
I want him to look into if I am insulin resistant at all first...I think I will follow the evidence based line here and happily take the metformin as soon as there is reliable information pointing towards insulin resistance.
There are no tests for this outside of arcane methods used in some clinical trials. That isn't going to happen.

[ quote]I will try to make him check C-peptide. He did GAD but it came back negative. [/quote]
Would that convince you? If you are going to ignore one negative test for T1/1.5 while waiting for the doctor to do the impossible and prove "insulin resistance" then how much good is another negative test going to do?

My bg usually is in the normal range but as soon as something happens, for example if I don't sleep well bg goes up
Hormones affect insulin resistance (c.f. Side effects of cortisone) but not insulin production so this would seem to point towards T2 which you are Mostly able to treat through diet.
 
There are no tests for this outside of arcane methods used in some clinical trials. That isn't going to happen.

[ quote]I will try to make him check C-peptide. He did GAD but it came back negative.

Thank you for your answer. If I understand you correctly T2 diabetes reacts on stress like lack of sleep with higher morning bg readings, but not the other kinds of diabetes? So a T1 or MODY wouldn't have the same effect on bg from lack of sleep?

Would thyroid hormones have any effect on bg?

Thing is, I have an unusually heavy diabetes heritage on my dad´s side and lack all but one markers of insulin resistance.
 
Hej Totto! Could you not try the metformin and see if it makes a difference?! As everyone has pointed out it is a safe drug with other benefits? Good luck with whatever you decide to do!
I will discuss it with him on Wednesday. I refused statins and ACE-inhibitors- BP any lower and I really will pass out - and am very reluctant to try metformin as my tummy isn't my best friend as it is.
 
Is there any way you can get a referral to an endocrinologist or whatever the speciality that deals with diabetes is in the UK? You certainly sound very atypical type 2.
I can´t tell you how flattered I am to hear that you think I live in the UK. I am Swedish.
 
I will discuss it with him on Wednesday. I refused statins and ACE-inhibitors- BP any lower and I really will pass out - and am very reluctant to try metformin as my tummy isn't my best friend as it is.
The only issues I've had are the dizziness! Lycka till! Du skriver felfritt på engelska! Men det måste du ha vetat! X
 
The only issues I've had are the dizziness! Lycka till! Du skriver felfritt på engelska! Men det måste du ha vetat! X
I didn't! And I know my grammar could be better. Spell check is handy though.
 
I didn't! And I know my grammar could be better. Spell check is handy though.
Struntprat! Du skriver alldeles utmärkt engelska! Spell check är hjälpsamt. Vad heter det på svenska?
 
Struntprat! Du skriver alldeles utmärkt engelska! Spell check är hjälpsamt. Vad heter det på svenska?
Jag skulle nog säga rättstavningsprogram. Det vore det korrekta. Annars säger man nog stavningshjälp. Jag har aldrig funderat över vad det heter, bara använt.

Tack för dina uppskattande ord om min skrivna engelska. Det värmer, ska du veta. Men språk är så mycket mer än grammatik och stavning. Jag försöker använda en del engelska uttryck ibland men som svensk vet jag ju aldrig om det blir rätt i sammanhanget. Jag hoppas på att få en eller annan brittisk wwoofare i sommar, det gör underverk för min engelska!

http://www.wwoof.net/
 
Jag skulle nog säga rättstavningsprogram. Det vore det korrekta. Annars säger man nog stavningshjälp. Jag har aldrig funderat över vad det heter, bara använt.

Tack för dina uppskattande ord om min skrivna engelska. Det värmer, ska du veta. Men språk är så mycket mer än grammatik och stavning. Jag försöker använda en del engelska uttryck ibland men som svensk vet jag ju aldrig om det blir rätt i sammanhanget. Jag hoppas på att få en eller annan brittisk wwoofare i sommar, det gör underverk för min engelska!

http://www.wwoof.net/
Det verkar alldeles utmärkt. Ett kul sätt att träffa nya vänner! Pratar du så bra som du skriver?
 
Ek is besig om na die verskilende post deur te gaan en ek sien dat die taal n biekie soos Afrikaans.
Translation: I am busy going through the various posts and see that the above language is similar in a way to Afrikaans from South Africa
 
Can I just say that I love the word 'struntprat' and will be using it extensively from now on once I have invented my own meaning for it.:)
 
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