Am I taking too much metformin?

[pdc1981]

Hi Everyone

I'm new here, have been reading the forums for a while and finding the range of information very valuable.

I was diagnosed with type 2 diabetes in 2017 with a Hba1c of 102. I was immediately put on Metformin at 500mg 3 times a day and there was a small improvement in my readings going down to 90 and then 80. It was at this point I moved house and changed GP practice and the new GP immediately reviewed my medication and increased my dose to 850mg 3 times a day. I then got to grips with my diet and my readings dropped significantly and my last 3 Hba1c results have been between 42 and 48.

I have queried with my GP whether I should be reducing my metformin given that I now have better control and her response was no because that is the reason for the improvement whereas I feel that the improvement is more a combination of weight loss/lifestyle adjustment and medication.

As advised by GP I take 2 x 850mg every morning and 1 x 850mg with my evening meal. I wondered if anyone had any views on whether this seems excessive?

Many Thanks.

 

[mouseee]

The dosage is interesting to me. I have only personally noticed people taking a max dose of 2000mg a day. I take 2 x 500 morning and evening.

I got my hba1c from 101 to 46 quickly but my DSN suggested we kept on with the dose as it was at least helping my reduction if not the main reason for it.

No one here can advise on dosage or medication but definitely discuss it with your DSN or dr if you want to reduce it.

 

[Resurgam]

I'm not a gambler, but I'd bet on it being the diet.

 

[Goonergal]

Hi @pdc1981 and welcome

Firstly congratulations on reducing your HbA1c so much. No-one here can say whether you’re taking too much metformin, but if that’s your feeling and you’d like to test the effects of taking less to see how that impacts your blood sugars, that should be your choice. I’d have another chat with the GP.

 

[pdc1981]

Thanks for the replies. I just wondered if there were other people on high dosages like this. GP just seems to put it all down to the Metformin ‘doing its job’. Ideally I’d like to stop taking it altogether although I understand it needs to be carefully managed. I can’t monitor my blood sugar as GP will not prescribe me with more test strips or needles as they consider my blood sugar to be relatively under control so I’m just relying upon hba1c results. GP says to test blood once a year but I’ve insisted I want to do it every 3 months. I’m due for another test this month so I’ll have a chat with her after these results and hopefully a further reduction will give me some ammunition to reduce my level of metformin

Paul

 

[bulkbiker]

I can’t monitor my blood sugar as GP will not prescribe me with more test strips or needles as they consider my blood sugar to be relatively under control

You could always buy your own meter and test many of us here have done exactly that..

A doctor is there to advise not issue orders.

 

[slip]

Paul - you could always buy your own testing kit, the main cost is testing strips but there are at least 2 that are fairly cheap and reliable if you search this forum you should be able to find the names of them - sorry I can't remember them myself....Tee-2? and theres discount codes for test strips for the other one, search for 'New T2' and post #5 from Rachox has all the info in fact!

Congratulations on getting control of things and as already been suggested I suspect the life style changes has had more of an effect than the medication. Metformin is quite a safe drug to take though (apparently).

 

[pdc1981]

Paul - you could always buy your own testing kit, the main cost is testing strips but there are at least 2 that are fairly cheap and reliable if you search this forum you should be able to find the names of them - sorry I can't remember them myself....Tee-2? and theres discount codes for test strips for the other one, search for 'New T2' and post #5 from Rachox has all the info in fact!

Congratulations on getting control of things and as already been suggested I suspect the life style changes has had more of an effect than the medication. Metformin is quite a safe drug to take though (apparently).

Thanks I’ll look into that. I was quite shocked that the doctor wouldn’t prescribe new strips as I thought it would just be a case of re-ordering them. Would like to keep an eye on my BG.

 

[Rokaab]

I was quite shocked that the doctor wouldn’t prescribe new strips as I thought it would just be a case of re-ordering them.

Unfortunately most T2's (unless on blood glucose lowering medication) do not get test strips prescribed at all - something to do with cost I believe. So many T2's who want to test have to self-fund.

 

[Brunneria]

Metformin comes in different doses, depending on whether it is normal release or slow release (often called SR).
This means that the doses will give different total mg amounts.

From memory (which is not necessarily accurate!) my understanding is that the some Metformin comes in 500 or 1000mg doses, allowing a nice round number of 2000mg for a typical maximum dose.
While the other versions come in 850s which means that 2 tabs add up to 1700 and 3 tabs to 2550mg, and so on.

I have also read that larger doses are permissible on the SR version because it is slow release, and therefore gentler on the guts, but I am afraid I read that ages ago, and no longer have the reference.

@pdc1981 do you have any kidney issues which need monitoring and which might affect the safe use of Metformin?
and
Have you checked the patient information leaflet for advice on max safe levels of the form of Metformin you are taking?

Only you and your doc (or health team) can make an informed decision on how much Metformin is best for you.

Just found this, which lists up to 3000mg for someone with excellent kidney function (and presumably a digestive system made of cast iron):
https://www.medicines.org.uk/emc/product/7348/smpc

edited to add the link