Should I be on Metformin for prediabetes

[FruitOfTheLoom]

Hi there,

I just wondered if I should be on Metformin for Prediabetes to stop me developing diabetes? (Which I feel is inevitable due to my family history)


Background story:

Type 2 diabetes runs in my family, all my 3 siblings have it, my father and everyone on his side of the family have it too. I've been on the prediabetes spectrum for a few years.

In 2018 I started developing tingling fingers and toes, as well as pain in my calf muscles whenever I ate foods with a high sugar content i.e. biscuits or chocolate. This happened within a minute or two of consuming the product. These symptoms would last a day or two.

I told my GP (At the time) about the issue about 1 year after I started getting the tingling/pain sensation and he said it "doesn't sound very nice" and it "doesn't sound anything serious", adding "sugary food was a good way to get fat".

Anyway, fast forward to today and I'm still getting the issue with sugary foods. As a result I very rarely consume anything with sugar in. Problem is a few months ago the tingling/pain sensation reemerged and hasn't subsided within a few days like normal. I'm stuck with it and GPs can't seem to explain my issue :-(

I asked a GP from an out of hours surgery about diabetic nephropathy because these symptoms are affecting my sleep and asked if could I get it as a prediabetic. The GP said I would need to have untreated diabetes for years to get nephropathy? No GP I've spoke to has seemed to know what's causing it or given any advice on how I proceed from here.


So, my questions are this:

1) Should I be on Metformin as a preventive measure considering most of my family have Type 2?

2) Can I still get/develop nephropathy despite only being classed as prediabetic?

3) Has anyone else had the pain in calf muscles and tingling in fingers/toes a minute or two after consuming sugary food?


Much appreciated, thank you.

 

[bulkbiker]

Can't answer your questions directly but please remember that carbohydrates all turn into "sugar" of one form or another once eaten so it might not simply be "sugar" but also carbohydrates that are causing your problems.

Best way to lower blood sugars and stop the neuropathy is stop (or dramatically reduce at least) the carbs you eat.

Have you had an HbA1c recently?

 

[Buzzer81]

I can’t help.... but I also mentioned what I suspect to be neuropathy to my doctor. And he was equally as dismissive, I have only had diagnosed diabetes type 2 for 14 months but he seems to think I can’t have it. But my fingers and feet tingle. It certainly makes me focus on keeping my blood sugar levels down.

Good luck with getting your answers

 

[ZiggyM]

while I never really post here, I have been reading this forum for years and have had type 2 diabetes for 21 years.


Your best solution for help is your doctor.


I do have neuropathy. I’m not an expert but what your describing does not sound like neuropathy. I could be wrong and someone will let me know.


My neuropathy last day and night it never goes way. It does not all of sudden start because I just ate a piece of candy, a potato, egg or cheese. It does not get worse all of sudden based on a food I just ate and then go away in a few days.


And before someone says anything yes I know in the long run sugar/ carbs make it worse, but from my knowledge not moments after you eat them.


Even people without diabetes can get neuropathy.


For your question about Metformin. You need to talk to your doctor about all your questions but keep in mind all medication have side effects.

I do sometimes get tingly after foods I eat, but that is because I have food allergies. For me it is sign that I just ate something with sesame seeds and I’m about to break out in a rash/hives.

 

[KennyA]

Hi there,

I just wondered if I should be on Metformin for Prediabetes to stop me developing diabetes? (Which I feel is inevitable due to my family history)


Background story:

Type 2 diabetes runs in my family, all my 3 siblings have it, my father and everyone on his side of the family have it too. I've been on the prediabetes spectrum for a few years.

In 2018 I started developing tingling fingers and toes, as well as pain in my calf muscles whenever I ate foods with a high sugar content i.e. biscuits or chocolate. This happened within a minute or two of consuming the product. These symptoms would last a day or two.

I told my GP (At the time) about the issue about 1 year after I started getting the tingling/pain sensation and he said it "doesn't sound very nice" and it "doesn't sound anything serious", adding "sugary food was a good way to get fat".

Anyway, fast forward to today and I'm still getting the issue with sugary foods. As a result I very rarely consume anything with sugar in. Problem is a few months ago the tingling/pain sensation reemerged and hasn't subsided within a few days like normal. I'm stuck with it and GPs can't seem to explain my issue :-(

I asked a GP from an out of hours surgery about diabetic nephropathy because these symptoms are affecting my sleep and asked if could I get it as a prediabetic. The GP said I would need to have untreated diabetes for years to get nephropathy? No GP I've spoke to has seemed to know what's causing it or given any advice on how I proceed from here.


So, my questions are this:

1) Should I be on Metformin as a preventive measure considering most of my family have Type 2?

2) Can I still get/develop nephropathy despite only being classed as prediabetic?

3) Has anyone else had the pain in calf muscles and tingling in fingers/toes a minute or two after consuming sugary food?


Much appreciated, thank you.

Before I forget, welcome to the forum.

have you had an HbA1c test recently? it would help to know what it was and what the change has been. I don't have any experience with metformin or other diabetic drugs, but I think you would have to be classed as diabetic (ie with an HbA1c reading of over 48) before you would be prescribed it. I also have no experience of tingling (neuropathy?) after eating sugar. In my experience neuropathy is there all the time but gets worse at night.

In any case you seem to have had back luck with your unhelpful medical advisors - many of us have. In my case I had a range of diabetic symptoms for +10 years but was firmly told they weren't due to diabetes as I didn't have diabetes as my A1c reading wasn't high enough. But I still had the symptoms.

While they did eventually go away or lessen dramatically when I returned my blood glucose to normal levels, that only happened after I was (eventually) diagnosed. This is a bit of a long-winded way of saying that yes, from my experience, you can be suffering from diabetic symptoms even if your BG isn't high enough for formal diagnosis. The level is set where it is for diagnosis simply because it's convenient for the medical profession - it's at 48mmol/mol apparently because "moderate retinopathy is rare below this HbA1c threshold" (Handbook of Diabetes).

What you can do right away to lower your BG rising and to (hopefully) reduce your symptoms is to change your diet, do a bit of exercise and lose some weight. Actually I found that the change of diet alone was enough to get me back to normal BG levels in a few months. Weight loss followed along. Just about all my symptoms went, although some new ones emerged briefly only after my BG was at normal levels. I reduced my carbohydrate intake to around 20g/day. This meant cutting out bread (including cereals and anything made with flour), rice, pasta, potatoes and root vegetables, and sugar. It worked for me and I'm 18 months into it now.

This is a great forum and you will find lots of helpful advice and support. You'll also find a range of opinions, and you should choose what works for you , not what I or anyone else says you "must" do. Best of luck, and keep asking questions.

 

[FruitOfTheLoom]

Can't answer your questions directly but please remember that carbohydrates all turn into "sugar" of one form or another once eaten so it might not simply be "sugar" but also carbohydrates that are causing your problems.

Best way to lower blood sugars and stop the neuropathy is stop (or dramatically reduce at least) the carbs you eat.

Have you had an HbA1c recently?

Hi,

Thanks for your reply.

yeah, my last two I believe were 44 in Jan and then 40 a few months later. The 40 was a fasting bloodtest and because of the pain/tingling I was getting I was scared to eat things and massively restricted my calorie intake for 2 months prior to last test (As well as eating a lot more fresh fruit/veg).

With regards to carbs it could be an instigating factor too I don't know. With potatoes, crisps, pasta I don't experience the pain and tingling, only things like biscuits, chocolate or drinks like regular soda or regular fruit cordial you add water to.

 

[FruitOfTheLoom]

while I never really post here, I have been reading this forum for years and have had type 2 diabetes for 21 years.


Your best solution for help is your doctor.


I do have neuropathy. I’m not an expert but what your describing does not sound like neuropathy. I could be wrong and someone will let me know.


My neuropathy last day and night it never goes way. It does not all of sudden start because I just ate a piece of candy, a potato, egg or cheese. It does not get worse all of sudden based on a food I just ate and then go away in a few days.


And before someone says anything yes I know in the long run sugar/ carbs make it worse, but from my knowledge not moments after you eat them.


Even people without diabetes can get neuropathy.


For your question about Metformin. You need to talk to your doctor about all your questions but keep in mind all medication have side effects.

I do sometimes get tingly after foods I eat, but that is because I have food allergies. For me it is sign that I just ate something with sesame seeds and I’m about to break out in a rash/hives.

while I never really post here, I have been reading this forum for years and have had type 2 diabetes for 21 years.


Your best solution for help is your doctor.


I do have neuropathy. I’m not an expert but what your describing does not sound like neuropathy. I could be wrong and someone will let me know.


My neuropathy last day and night it never goes way. It does not all of sudden start because I just ate a piece of candy, a potato, egg or cheese. It does not get worse all of sudden based on a food I just ate and then go away in a few days.


And before someone says anything yes I know in the long run sugar/ carbs make it worse, but from my knowledge not moments after you eat them.


Even people without diabetes can get neuropathy.


For your question about Metformin. You need to talk to your doctor about all your questions but keep in mind all medication have side effects.

I do sometimes get tingly after foods I eat, but that is because I have food allergies. For me it is sign that I just ate something with sesame seeds and I’m about to break out in a rash/hives.

while I never really post here, I have been reading this forum for years and have had type 2 diabetes for 21 years.


Your best solution for help is your doctor.


I do have neuropathy. I’m not an expert but what your describing does not sound like neuropathy. I could be wrong and someone will let me know.


My neuropathy last day and night it never goes way. It does not all of sudden start because I just ate a piece of candy, a potato, egg or cheese. It does not get worse all of sudden based on a food I just ate and then go away in a few days.


And before someone says anything yes I know in the long run sugar/ carbs make it worse, but from my knowledge not moments after you eat them.


Even people without diabetes can get neuropathy.


For your question about Metformin. You need to talk to your doctor about all your questions but keep in mind all medication have side effects.

I do sometimes get tingly after foods I eat, but that is because I have food allergies. For me it is sign that I just ate something with sesame seeds and I’m about to break out in a rash/hives.

sorry to hear about your neuropathy.

None of family members who've got Type 2 diabetes have the same issue with food that I have, instant pain in calfs and tingling in fingers and toes, it's really weird. A sibling does have neuropathy (pain only) in their calf muscles, no tingling in fingers/toes. Not impacted by food, just constant like yours and worse at night.

Like I said the issue normally subsided after a day or two but this time it's been constant and worried it's now chronic.

 

[bulkbiker]

sorry to hear about your neuropathy.

None of family members who've got Type 2 diabetes have the same issue with food that I have, instant pain in calfs and tingling in fingers and toes, it's really weird. A sibling does have neuropathy (pain only) in their calf muscles, no tingling in fingers/toes. Not impacted by food, just constant like yours and worse at night.

Like I said the issue normally subsided after a day or two but this time it's been constant and worried it's now chronic.

Then maybe simply avoid the foods that you think cause it?
You seem to have identified them so avoid completely (none are "essential" foods).
You seem to be verging on pre-diabetes as your 40 HbA1c is not usually considered as pre-diabetes in the UK.

 

[Daibell]

Hi and welcome. You need to cut down on all carb foods and not just sugar. I had tingling when first diagnosed but that has faded over the years so don't panic. Get yourself a glucose meter to check you BS occasionally. Metformin might help a bit but cutting the carbs will have the most effect.

 

[FruitOfTheLoom]

Before I forget, welcome to the forum.

have you had an HbA1c test recently? it would help to know what it was and what the change has been. I don't have any experience with metformin or other diabetic drugs, but I think you would have to be classed as diabetic (ie with an HbA1c reading of over 48) before you would be prescribed it. I also have no experience of tingling (neuropathy?) after eating sugar. In my experience neuropathy is there all the time but gets worse at night.

In any case you seem to have had back luck with your unhelpful medical advisors - many of us have. In my case I had a range of diabetic symptoms for +10 years but was firmly told they weren't due to diabetes as I didn't have diabetes as my A1c reading wasn't high enough. But I still had the symptoms.

While they did eventually go away or lessen dramatically when I returned my blood glucose to normal levels, that only happened after I was (eventually) diagnosed. This is a bit of a long-winded way of saying that yes, from my experience, you can be suffering from diabetic symptoms even if your BG isn't high enough for formal diagnosis. The level is set where it is for diagnosis simply because it's convenient for the medical profession - it's at 48mmol/mol apparently because "moderate retinopathy is rare below this HbA1c threshold" (Handbook of Diabetes).

What you can do right away to lower your BG rising and to (hopefully) reduce your symptoms is to change your diet, do a bit of exercise and lose some weight. Actually I found that the change of diet alone was enough to get me back to normal BG levels in a few months. Weight loss followed along. Just about all my symptoms went, although some new ones emerged briefly only after my BG was at normal levels. I reduced my carbohydrate intake to around 20g/day. This meant cutting out bread (including cereals and anything made with flour), rice, pasta, potatoes and root vegetables, and sugar. It worked for me and I'm 18 months into it now.

This is a great forum and you will find lots of helpful advice and support. You'll also find a range of opinions, and you should choose what works for you , not what I or anyone else says you "must" do. Best of luck, and keep asking questions.

Hi, thanks for reply and advice, appreciated.

my last two HbA1c tests were 44 mmol/mol in Jan and 40 mmol/mol a few months later. The 40 result was a fasting test and because of the pain/tingling I kinda starved myself between the 44 and 40 test for a couple of months.

I've tried to eat more healthily as a result. Easier said than done I know. Tried to stay away from processed foods as much as possible of late. The only plus side of this pain/tingling is for the past 4 years is i removed all added sugar and tried my best to avoided things items with a high sugar content (Occasionally giving into to the add biscuit once every 3months or so) . I will have to cut down more on the carbs.


As I said to another member none of my other diagnosed Type 2 diabetes family members have this pain/tingling issue with sugary foods. One sibling has constant pain in their calfs but no tingling in toes/fingers and not affected by food.

The symptoms always used to disperse within a day or two, but after that last moment of temptation a few moths back it's stuck with me ever since.

 

[FruitOfTheLoom]

Then maybe simply avoid the foods that you think cause it?
You seem to have identified them so avoid completely (none are "essential" foods).
You seem to be verging on pre-diabetes as your 40 HbA1c is not usually considered as pre-diabetes in the UK.

I do avoid foods that cause it, but sometimes everyone gives into temptation. Once every 3 months for a couple of biscuits with a cup of tea isn't too much to ask?

40 result was my last blood test previously it was 44 in Jan. Like I said I literally starved myself between the two tests during those 2 months. I'm testing my bloods in the morning, getting 7.5 first thing after I wake up. I do it again 2 hours after a meal the result reading is 9-10.

 

[KennyA]

Hi, thanks for reply and advice, appreciated.

my last two HbA1c tests were 44 mmol/mol in Jan and 40 mmol/mol a few months later. The 40 result was a fasting test and because of the pain/tingling I kinda starved myself between the 44 and 40 test for a couple of months.

I've tried to eat more healthily as a result. Easier said than done I know. Tried to stay away from processed foods as much as possible of late. The only plus side of this pain/tingling is for the past 4 years is i removed all added sugar and tried my best to avoided things items with a high sugar content (Occasionally giving into to the add biscuit once every 3months or so) . I will have to cut down more on the carbs.


As I said to another member none of my other diagnosed Type 2 diabetes family members have this pain/tingling issue with sugary foods. One sibling has constant pain in their calfs but no tingling in toes/fingers and not affected by food.

The symptoms always used to disperse within a day or two, but after that last moment of temptation a few moths back it's stuck with me ever since.

That says to me that you can bring your BG down - you already have, well done - and what you need to do is keep going in the right direction. You are very close to normal levels. I don't think starving yourself is necessary - there are other techniques - eg a thing called intermediate fasting, for about 12-16-18 hours at a time (includes overnight), or the One Meal A Day approach, allied to cutting carbs. You need to find what works for you, as if you hate the way you have to live you're less likely to keep up any progress. I find IF works for me, and I like the ~20g carb/day approach. I'd sooner not have any pizza than have to try to stop after two slices....

 

[FruitOfTheLoom]

Hi and welcome. You need to cut down on all carb foods and not just sugar. I had tingling when first diagnosed but that has faded over the years so don't panic. Get yourself a glucose meter to check you BS occasionally. Metformin might help a bit but cutting the carbs will have the most effect.

hi there,

Thanks for your encouragement, glad yours went away, - gives me a glimmer of hope, it's driving me insane :-/

How long did your tingling start after eating food? Mine starts after a minute or two. Stayed for a day or so then went. But this time it's stuck around.


will deffo cut down on carbs, but what should I replace it with, more protein? Or do you mean just replace the cruddy carbs with more complex carbs like broccoli and cauliflower?

Thanks.

 

[TriciaWs]

I have non-diabetic neuropathy, caused by long term low folic acid that previous GPs failed to test for.
But I was lucky in that I already knew low carb could help T2 diabetes and my T2 diagnosis was the flag I needed to finally do this seriously and that prevented any additional neuropathy developing.
I basically replaced most of the carbs in my diet with some extra unprocessed fats and a little more protein.
I tested before and after every meal at first to check which foods I could eat and how many carbs I could have.

It was hard giving up most of the fruit I loved as well as cake and rice but I'm now used to the swaps I introduced such as cauliflower rice, 90 second almond bread, 85% dark chocolate in small amounts, raspberries with full fat Greek yogurt, etc. plus a low carb breakfast of 'porridge' based on milled flaxseed and chia seeds with nuts, coconut milk, etc.
And I now have extra chicken, salmon, eggs, limited extra cheese, double cream in coffee, as well as loads of green veg. If I'm hungry I put butter or oily dressings on my salads and veg.
I make a rhubarb crumble with ground almonds and a bit of butter instead of the usual crumble mix, sweetening the rhubarb with a stevia/erythritol mix or an occasional low carb mug cake made with coconut flour or ground almonds.

 

[Brunneria]

Check out the symptoms of vit B12 deficiency.
It can often be mistaken for neuropathy.
If you think the description fits, your doc can run a test to check for deficiency.
The tests are also available privately, if you doc isn’t interested.

regarding the prescription of Metformin during pre-D, nope, my CCG won’t prescribe Metformin for anyone with an HbA1c below 53 mmol/mol

 

[bulkbiker]

I do avoid foods that cause it, but sometimes everyone gives into temptation. Once every 3 months for a couple of biscuits with a cup of tea isn't too much to ask?

40 result was my last blood test previously it was 44 in Jan. Like I said I literally starved myself between the two tests during those 2 months. I'm testing my bloods in the morning, getting 7.5 first thing after I wake up. I do it again 2 hours after a meal the result reading is 9-10.

With those levels I'm surprised your HbA1c was 40 mmol/mol.

And for me a couple of biscuits with a cup of tea would not be a good idea if they caused days worth of feeling bad.

 

[Daibell]

hi there,

Thanks for your encouragement, glad yours went away, - gives me a glimmer of hope, it's driving me insane :-/

How long did your tingling start after eating food? Mine starts after a minute or two. Stayed for a day or so then went. But this time it's stuck around.


will deffo cut down on carbs, but what should I replace it with, more protein? Or do you mean just replace the cruddy carbs with more complex carbs like broccoli and cauliflower?

Thanks.

Hi. My tingling wasn't related to meals but was present much of the time so was a bit different from yours. You can replace carbs with proteins and fats. Forget anything the NHS has told you about a 'healthy diet' as much of it isn't based on good science.

 

[FruitOfTheLoom]

That says to me that you can bring your BG down - you already have, well done - and what you need to do is keep going in the right direction. You are very close to normal levels. I don't think starving yourself is necessary - there are other techniques - eg a thing called intermediate fasting, for about 12-16-18 hours at a time (includes overnight), or the One Meal A Day approach, allied to cutting carbs. You need to find what works for you, as if you hate the way you have to live you're less likely to keep up any progress. I find IF works for me, and I like the ~20g carb/day approach. I'd sooner not have any pizza than have to try to stop after two slices....

yep, it came down from 44 to 40 which I was happy about. Unfortunately the pain/tingling has stuck around. The thing about the 40 blood test result is that was fasting, whenever I eats food I'm getting 9-10 on the meter reading 2 hours post meal.

I would ideally like to have one of those blood tests where you do a fasting test, then drink some glucose and then come back in two hours for another blood test. I know these tests aren't that practical but I feel it could through more light on my circumstances maybe?

 

[FruitOfTheLoom]

Check out the symptoms of vit B12 deficiency.
It can often be mistaken for neuropathy.
If you think the description fits, your doc can run a test to check for deficiency.
The tests are also available privately, if you doc isn’t interested.

regarding the prescription of Metformin during pre-D, nope, my CCG won’t prescribe Metformin for anyone with an HbA1c below 53 mmol/mol

Hi, thanks for your input.

Vitamin B12 was checked and all ok.

Maybe I approached the issue in this thread back to front (Talking about Metformin and prediabetes), but my main gripe is the pain and tingling, apart from diabetes I don't know what else can cause the body to develop this kind of reaction from the consumption of sugary foods? Just looking for answers to find out why my body reacts the way it does (And if Metformin would have helped me in my current capacity). Latest blood test was 40 mmol/mol which I managed to get down from 44. Weird thing is blood glucose monitor still shows 9-10 two hours after a meal. So something's not right.

Anyway, would be cool hearing from others who've faced/facing the same.

 

[VashtiB]

Hello and welcome,

It must be very frustrating to have your concerns dismissed by your doctor. We cannot diagnose anyone here. Also not every symptom is caused by diabetes even for someone with diabetes. So your symptoms could be caused by something else. I'm not sure whether an intolerance or allergy to a food could cause your symptoms but maybe that is worth considering.

My initial thoughts is to speak to another doctor. Ideally every doctor should take all patients symptoms seriously but sometimes it does appear that a doctor isn't doing that. As a lawyer I am always happy for a client to seek a second opinion. As a patient I also consider whether I should get a second opinion. It may be worth logging the foods you are eating and the time you get the symptoms- that may reveal another pattern.

Good luck

By the way my personal opinion is that reducing sugar consumption and indeed carb consumption is not a bad idea for anyone even those without diabetes. If you consider doing that- read around to find out more about it.