NHS Direct doctor says... NO testing when taking Metformin

ButtterflyLady

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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
I have type 2 Diabetes on Metformin, I was told I don't need to test my blood sugar . If the reading was high there is nothing I could do about it.
There is plenty you can do about a high blood sugar reading. If you start your own thread, we can go through it with you, and all the info will be in one easy to find place.
 
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fergiedee

Newbie
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3
Type of diabetes
Type 2
Hi Croc,
Yes I take 500mg Metformin twice a day.
I cannot recall the last time I had breakfast since my childhood. Instead I go for the occasional morning snack once I've been up a while and my juices have settled.

As for "NICE guidelines" I believe their only reason for saying this is financial, not medical!
I have type 2 and am on Glicazide (took a bad reaction to Metformin some time ago). I recently had to take steroids for Occular Myasthnia Gravis. Blood sugars went wild, and soon came into control although higher than comfortable. Doctor and Practice Nurse told me no need to monitor. They say 3 monthly check up is sufficient. But how can one attempt control if no monitor tools...
Are they all stupid? I monitor daily and now having been off steroids for 5 weeks, blood sugars still between 8.5 and 11. They just keep telling me to stop monitoring, and if nothing changes they can give me insulin..... That's after been assured that sugars would return to pre-steroid levels....
 
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richard256

Well-Known Member
Messages
61
Type of diabetes
Type 2
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Tablets (oral)
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Being on call
Sorry for the length of this, it is all relevent...

I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.
 

ptrmet

Newbie
Messages
2
Type of diabetes
Type 2
I haven't read all 15 pages of this thread but I am staggered by some of the information given. I am was diagnosed asT2 diabetic over 25 years ago and I was taken off metformin some time ago because of its apparent effect upon kidneys although recent articles would seem to refute that. I take rapid acting insulin before each meal and long acting insulin once a day. Although there is always 'pressure' to reduce the amount of testing it is imperative that I test my blood sugar levels before eating and also late at night before bed to avoid a hypo during the night. I get the test strips needed on prescription.
However there is also another reason for regular testing and this is a requirement by the DVLA for persons using insulin to test levels before driving. If blood sugar readings are not taken within the DVLA guidelines before driving there is a strong possibility that an application for renewal of your driving licence will be refused arbitrarily. For many of us that would be a drastic life-changing event. I am not prepared to let cost led pressure on me to reduce testing to jeopardise my life style. Am I unreasonable in this? .

ptrmet
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
I haven't read all 15 pages of this thread but I am staggered by some of the information given. I am was diagnosed asT2 diabetic over 25 years ago and I was taken off metformin some time ago because of its apparent effect upon kidneys although recent articles would seem to refute that. I take rapid acting insulin before each meal and long acting insulin once a day. Although there is always 'pressure' to reduce the amount of testing it is imperative that I test my blood sugar levels before eating and also late at night before bed to avoid a hypo during the night. I get the test strips needed on prescription.
However there is also another reason for regular testing and this is a requirement by the DVLA for persons using insulin to test levels before driving. If blood sugar readings are not taken within the DVLA guidelines before driving there is a strong possibility that an application for renewal of your driving licence will be refused arbitrarily. For many of us that would be a drastic life-changing event. I am not prepared to let cost led pressure on me to reduce testing to jeopardise my life style. Am I unreasonable in this? .

ptrmet
Not unreasonable at all. Access to adequate numbers of testing strips for people on insulin is a necessity. Those who try to reduce access have no understanding of the risks.
 

AloeSvea

Well-Known Member
Messages
2,051
Type of diabetes
Type 2
Treatment type
Other
Your post was so long I forgot you had said you had a good GP. You had made it sound like the test strips situation was so bad (when I have never had a problem getting the strips from my GPs) that trying someone else seemed the obvious solution. Still, it's handy to know you don't like getting suggestions - I'll know for next time.

Lol. Righto CatLady.
 

BevTam

Newbie
Messages
1
Type of diabetes
Type 2
Treatment type
Insulin
Sorry for the length of this, it is all relevent...

I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.
I used to test daily and was prescribed tests etc until one doctor decided to stop them, just twelve months later my metformin was doubled, six months on, I started insulin (novo rapid and levemir) and have to tests three times a day. I could never have reported my T2 as I did had I not ordered strips online. I have never returned to the bad mannered g.p who took the strips and lancets away from me, I could never trust him.
 

billiejean

Newbie
Messages
2
I have been diagnosed with type 2 a couple of years ago and got told that I do not need to test my sugar levels. I have been to see my doctor today. I informed him that I am following a low GL diet and have bought myself a glucose monitor, so I can keep a check. He said that the new guidelines are that as Metformin does not lower your levels you don't need to test, it is only when you go on other medication or insulin. He was very good and advised best time to test is first thing in the morning. I am so determined to loose weight and get off my medication, so I believe you do need to monitor your levels especially if you start to feel unwell and don't know the cause.
 
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hoodlum

Newbie
Messages
1
Type of diabetes
Type 2
Sorry for the length of this, it is all relevent...

I felt paticularly unwell the other day, and having gone without food for over 12 hours I tested my blood. My mmol/L was 12.0, which is high (for me).

I was preparing my lunch at the time and wondered if I should still eat my main meal with this high reading, or not? My thinking being - if my reading is already high then eating could raise it even more.

So, before cooking, I thought I'd ring "111" and ask their opinion (as it was a Bank Holiday and my options were limited).
I talked with a very nice lady on the phone. She checked with her superior and came back to me to say it was OK to still eat it. She said a doctor would call me back within the next couple of hours, but if I felt worse to ring 111 again.

Sometime later, after having cooked and eaten, I got a call from another lady saying the doctor was busy but would still call me back at some point. No problem I thought.

When the doctor eventually did call me he asked some routine questions but then launched into a lecture on blood testing!
He insisted I SHOULD NOT BE TESTING at all, as I was on Metformin. According to him, nobody on Metformin should be testing as it interferes with doing so (?!).
I tried to explain I have always tested once a day, originally on my G.P.s instruction (and whilst taking Metformin). I told him the doctor stopped issuing test strips about a year ago (£££), however I have been buying them to continue testing myself (normally only once a day).
I also pointed out to him if I didn't test my blood HOW was I supposed to know whether my diabetes was "under control" or not?
I had only tested twice on this occasion as I felt so unwell. Without testing I wouldn't have known my blood sugar level was the (probable) cause of me feeling ill.

The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
I have been diagnosed with type 2 a couple of years ago and got told that I do not need to test my sugar levels. I have been to see my doctor today. I informed him that I am following a low GL diet and have bought myself a glucose monitor, so I can keep a check. He said that the new guidelines are that as Metformin does not lower your levels you don't need to test, it is only when you go on other medication or insulin. He was very good and advised best time to test is first thing in the morning. I am so determined to loose weight and get off my medication, so I believe you do need to monitor your levels especially if you start to feel unwell and don't know the cause.

He's incorrect, metformin does lower BG levels, by up to 1 mmol/mol. In rare cases it can cause the BG to go under 4, which is not very pleasant and can sometimes cause problems. Perhaps he was meaning it doesn't have a high risk of lowering them dangerously like some of the other meds and insulin.
 

pmailkeey

Member
Messages
9
...The doctor grew increasingly stroppy saying I was making up my readings, as what I had told him wasn't possible!
WHY would I do such a thing? I even agreed with him that, the longer I went without food, I would have expected my reading to get lower, not higher.

For information my reading(s) that day were:

On waking (my normal testing time) my reading was 7.4
I don't eat breakfast, as a rule.
At 1215 (before eating) and after 12 hours + without food it was 12.0
(Lunch was eaten about 1300)
At 1410 it had reduced to 8.1
At 1515 it was 5.8
I ate again at teatime.
But at 2355 it was back up at 10.4 and I was feeling quite ill again. This time I didn't phone 111, as my previous dealings with their doctor had scared me off doing so!
I live alone, and I went to bed wondering if it would go higher in my sleep and (perhaps) never wake up.

Anyway, if you are still awake after reading all this...
Has ANYONE else been told NOT to take blood glucose readings whilst using Metformin? It's the first time since being diagnosed Type 2, in 2008, that I've ever heard of it.

How the hell is a sufferer supposed to take control of their diabetes WITHOUT knowing what their blood glucose is?

Puzzled.

Totally agree with the doc - the values are silly. What the real question is is why? If you can't find a reason, atrip to your GP is in order.
 

Brogon

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I had a similar issue with my doctor. He was pleased I had managed to get my BG level down and I told him that was because I had learnt what to eat and what to avoid through testing. As soon as I mentioned testing his eyes widened and he told me I shouldn't test because that would cause me anxiety and there was no need. I just told him that if it wasn't for the testing I would be on medication by now (I'm T2 diet only).
My Doctor told me not to test, i told him that was the only way for me to check my BG . I told him i was starting the Newcastle diet and he did not know what it was. I was on 1500mg of metformin each day and i stoped taking them last week and my BG has dropped to 5.5mmol and i have not told my doctor, and i feel more incontroll of my T2 . So isay take controll of your life and try the Newcastle Diet as you have nothing to loose . i will post my findings when i finish the diet i am it to my 2 week all going well.
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
My Doctor told me not to test, i told him that was the only way for me to check my BG . I told him i was starting the Newcastle diet and he did not know what it was. I was on 1500mg of metformin each day and i stoped taking them last week and my BG has dropped to 5.5mmol and i have not told my doctor, and i feel more incontroll of my T2 . So isay take controll of your life and try the Newcastle Diet as you have nothing to loose . i will post my findings when i finish the diet i am it to my 2 week all going well.
Glad things are going well for you. It might still be a good idea to take metformin though, because it has other benefits, and it's best to discuss with your HCP first before you stop a medication.

To give you an example, my HbA1c is now 33 and has been for some time, but I still take 1000mg of metformin a day and I plan to keep doing it unless I develop bad side effects or I see research showing it's a bad idea for me.
 
G

graj0

Guest
He's incorrect, metformin does lower BG levels, by up to 1 mmol/mol. In rare cases it can cause the BG to go under 4, which is not very pleasant and can sometimes cause problems.
Metformin helps to lower blood glucose levels by reducing the amount of glucose produced and released by the liver, and by increasing insulin sensitivity. (Source: Diabetes.co.uk)
I've never seen anything that mentions by how much it can reduce BG levels, can you quote a reference please?
It is rare for someone taking Metformin to have BG going below 4, but you probably shouldn't blame Metformin, even by your calculations that suggest that Metformin lowers BG by up to 1 mmol/mol, without Metformin the BG would be below 5.
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
Metformin helps to lower blood glucose levels by reducing the amount of glucose produced and released by the liver, and by increasing insulin sensitivity. (Source: Diabetes.co.uk)
I've never seen anything that mentions by how much it can reduce BG levels, can you quote a reference please?
It is rare for someone taking Metformin to have BG going below 4, but you probably shouldn't blame Metformin, even by your calculations that suggest that Metformin lowers BG by up to 1 mmol/mol, without Metformin the BG would be below 5.
By way of a re-cap, I was responding to another poster saying their doctor had said:

"He said that the new guidelines are that as Metformin does not lower your levels you don't need to test, it is only when you go on other medication or insulin."

I wanted to correct that info, because metformin does lower BG levels, as it is intended to. It can cause false hypos, especially in the newly diagnosed (or newly low-carbing), and these can be uncomfortable. Iff the person overcompensates with carbs, their BG increases. I've been having a lot of false hypos lately, so my mind is focused on how horrible I feel when my BG is under 6, and a memory of it being 3.5 after a fast before surgery.

So I said:

"He's incorrect, metformin does lower BG levels, by up to 1 mmol/mol. In rare cases it can cause the BG to go under 4, which is not very pleasant and can sometimes cause problems."

My source for the first point is (emphasis added):

"Metformin

Though many people find that they can bring their blood sugar back into the normal range simply by limiting their carbohydrate intake, blood sugar control is not a short term project. When you have abnormal blood sugars you will have to spend the rest of your life keeping them under control, and not everyone is willing or even able to stick with a restrictive diet for the rest of their lives.

For this reason, most doctors assume that dietary changes will not solve their patient's blood sugar problems. So immediately after diagnosing diabetes they prescribe what are known as oral anti-diabetic drugs. Chief among these is metformin.

You may well be asking, if these drugs are effective, why bother with complex and restrictive dietary regimens?

Effective, But Not Effective Enough
Unfortunately, the catch lies in how you define "effective." Just as research has shown that the current criteria for diagnosing diabetes ignore the blood sugar levels at which damage occurs, other research shows that none of these drugs brings blood sugar levels down to anywhere near normal levels. So while an oral anti-diabetic drug might be "effective" by the FDA definition of the term, that effect might only be to lower a diabetic person's fasting blood sugar from a dangerously high 250 mg/dl (13.8 mmol/L) to an only slightly less dangerous 180 mg/dl (10 mmol/L) --a level which is still high enough to encourage the development of serious complications. Even when prescribed for people whose blood sugar is only impaired, as we will see, these drugs may only lower the OGTT 2-hour reading by 20 or 30 mg/dl (1.1 or 1.7 mmol/L)--which still leaves their blood sugars higher than a damaging 140 mg/dl (7.8 mmol/L) most of the day.
So metformin alone will not be likely to bring your blood sugars back into the normal range."
http://www.phlaunt.com/diabetes/14045911.php

I must have said up to 1 instead of 1.1-1.7 because I was working from memory instead of checking the source. I wasn't far off the ballpark figure.

Now, when it came to writing the second sentence, I made a mistake and forgot about the difference between hypos and false hypos (maybe I was having a false hypo at the time, lol). In any case, this is the part of the above source that I was thinking of:

"Can Metformin Cause Low Blood Sugar?
Metformin is not supposed to cause dangerous hypos. A very few people have found that it causes their blood sugar to drop low enough to make them uncomfortable. This may be because of the phenomenon called False Hypo. You can read about false hypos HERE."

Thanks for picking up the mistake in the second sentence.
 
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Protea

Member
Messages
23
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
High carb food. Processed food. Any cold drinks.
Most interesting. I am T2 and managing on diet only. Am now age 79. Diagnosed by a family member about 14 years ago and given a standard high "good" carb low fat diet. On returning to South Africa purchased a meter and strips. Investigated on the internet and found that such a diet was dubious. Switched to low carb. Now still on low carb but also high fat. Take my levels in the morning between 7 and 8am. Evening meal no later then 7pm. Find that by 9 or 10am they have risen quite a bit. Today at 7am a level of 7.7. Not so good but not terrible. Will enter into my self made Excel program which gives me moving averages for 10, 20 and 70 days. The 70 day one is the most important and is currently 7.4. I'm happy with that as is my family member and my RSA GP. A meter is essential. Diabetes is the problem and not an hypo. I have never been overweight - BMI of 25. Your comments have caused me not to consider metformin.
Blood pressure check by GP a bit low. Only problem is vertigo. All other checks Ok. Keep on using a meter. Cost is minimal and with a low carb high fat diet you should be OK . My family member says I won't die of diabetes ! Just take it day at a time !
 
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ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
Most interesting. I am T2 and managing on diet only. Am now age 79. Diagnosed by a family member about 14 years ago and given a standard high "good" carb low fat diet. On returning to South Africa purchased a meter and strips. Investigated on the internet and found that such a diet was dubious. Switched to low carb. Now still on low carb but also high fat. Take my levels in the morning between 7 and 8am. Evening meal no later then 7pm. Find that by 9 or 10am they have risen quite a bit. Today at 7am a level of 7.7. Not so good but not terrible. Will enter into my self made Excel program which gives me moving averages for 10, 20 and 70 days. The 70 day one is the most important and is currently 7.4. I'm happy with that as is my family member and my RSA GP. A meter is essential. Diabetes is the problem and not an hypo. I have never been overweight - BMI of 25. Your comments have caused me not to consider metformin.
Blood pressure check by GP a bit low. Only problem is vertigo. All other checks Ok. Keep on using a meter. Cost is minimal and with a low carb high fat diet you should be OK . My family member says I won't die of diabetes ! Just take it day at a time !
I'm confused, which comments caused you not to consider metformin, and why?
 

Protea

Member
Messages
23
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
High carb food. Processed food. Any cold drinks.
I'm confused, which comments caused you not to consider metformin, and why?
Comments about side effects concerned me. Also my local GP and the family doctor said beware of any reactions. Decided I would carry on with diet alone. A 70 day average of 7.4 not too bad but may get a HbA1c when my vertigo problem solved. HbA1C a bit expensive here and my GP may decide my daily readings to suffice.
 

dmh

Newbie
Messages
1
My doctor also told me the NHS are trying to save money so they do not like doctors to prescribe testing strips.
When I told him I usually only check twice a WEEK is kindly prescribed me the strips
 

Brogon

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Glad things are going well for you. It might still be a good idea to take metformin though, because it has other benefits, and it's best to discuss with your HCP first before you stop a medication.

To give you an example, my HbA1c is now 33 and has been for some time, but I still take 1000mg of metformin a day and I plan to keep doing it unless I develop bad side effects or I see research showing it's a bad idea for me.
Glad it works for you, im in the mind that i take controll of my T2 and its working ok on low carbs. The newcastle diet is worth ago, so im on it now, no metformin and all is good so far.