Type 1 Type 1 and Metformin

Brandy1978

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22 yrs as type1. Been on metformin whole time. Seen a new endocrinologist and she told me to stop metformin… is this normal?All my research says being on metformin weather type 1 or 2 can be good. Any thoughts or anyone been through the same situation?
Thanks everyone!
 

In Response

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I have had Type 1 for nearly 20 years and never used Metformin.
My understanding is it is only used when you experience insulin resistance.
Has your insulin sensitivity improved recently.
 

NaijaChick

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Why would she say that? Did you ask?? Metformin is known to prevent cardiovascular issues associated with ALL types of diabetes.
Even a small 500mg daily dose.
 

david4503

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22 yrs as type1. Been on metformin whole time. Seen a new endocrinologist and she told me to stop metformin… is this normal?All my research says being on metformin weather type 1 or 2 can be good. Any thoughts or anyone been through the same situation?
Thanks everyone!
Why did your former doctor have you on it? From what I’ve read, it’s not standard therapy for Type 1 and wouldn’t be prescribed without a good reason. And it’s not a slam dunk in any case since it has side effects like weight gain.
 

EllieM

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And it’s not a slam dunk in any case since it has side effects like weight gain.

Do you have a link for that? I've heard of plenty of metformin side effects (from gastric to B12 deficiency) but weight gain is not familiar to me....

My GP has offered to give it to me if I wish...
 

david4503

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Do you have a link for that? I've heard of plenty of metformin side effects (from gastric to B12 deficiency) but weight gain is not familiar to me....

My GP has offered to give it to me if I wish...

https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-017-0228-9

This is a quote from the study. It doesn’t seem like it would normally be prescribed for a Type 1 with good control.

“Metformin is an oral anti-hyperglycemic agent and commonly used in the treatment of type 2 diabetes. It increases both hepatic and peripheral insulin sensitivity in the liver by inhibiting basal hepatic glucose production, as well as in skeletal muscles and adipocytes, by increasing glucose uptake [4, 14, 15]. Thus, it enhances insulin action and improves glycemic control. Metformin leads to reduce insulin dose requirement as well as weight gain because it increases insulin sensitivity. In this respect, compared with insulin monotherapy, the addition of metformin to insulin therapy improves metabolic control and decreases complications in type 2 diabetes [16]. Metformin has been shown to increase insulin sensitivity [17] and reduce metabolic syndrome incidence in people with prediabetes [18]. The addition of metformin to insulin therapy in type 1 DM is still under debate. Until now, a limited number of studies have investigated the addition of metformin to insulin therapy in type 1 diabetics [4, 19,20,21,22]. Metformin as an adjunctive therapy is not formally recommended in type 1 diabetes unlike in type 2 diabetes [23].”
 

EllieM

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Metformin leads to reduce insulin dose requirement as well as weight gain because it increases insulin sensitivity.

That is a bit of an ambiguous sentence. I would interpret it to mean that weight gain is reduced? And elsewhere in the study (in the abstract)

Recently-published findings from the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial suggest that metformin therapy in type 1 diabetes can reduce atherosclerosis progression, weight and LDL-cholesterol levels.

Looks like the weight loss is pretty low though. (I took part in the REMOVAL study, though I never found out if I was taking placebos or not:bigtears:).
 

david4503

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Yes, the weight aspect seems unclear. You would think that if Metformin could significantly reduce insulin dosages, patients would lose some weight. Maybe ten pounds at least, something like that? Not clear that’s what happens. Although, if these patients are having lower blood sugars, maybe they’re also eating more which wouldn’t help. Anyway, what’s clearer is that Metformin seems to be used in some cases where insulin therapy alone isn’t working well. IOW, not for everyone.
 

NaijaChick

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Metformin reduces your weight and is actually given to women with PCOS to help reduce their testosterone/insulin sensitivity and to help reduce body weight.
I think T1D see Metformin as a type 2 drug and are like “No, that’s not for us, its for them”
The benefits of Metformin as a cardiovascular drug and possible dementia drug should be investigated more by some of you.
 

david4503

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Metformin reduces your weight and is actually given to women with PCOS to help reduce their testosterone/insulin sensitivity and to help reduce body weight.
I think T1D see Metformin as a type 2 drug and are like “No, that’s not for us, its for them”
The benefits of Metformin as a cardiovascular drug and possible dementia drug should be investigated more by some of you.
All I can say is that I’ve looked at it and I’m not inclined to be asking my doctor for it. I have no doubt that it works for weight loss and other purposes in some people but with Type 1 there are various factors to consider. It’s not some kind of prejudicial or emotional judgement in my case. If I had any reason to think it could do me some good without doing any harm, I would pursue it.
 

EllieM

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To take with insulin?

If so, what is the benefit of having it with insulin

Yes, to take with insulin. (After over 50 years of T1 I'm pretty sure I'm making negligible quantities). It may help with the dawn phenomena (reduce morning glycogen/sugar production from my liver) and insulin resistance (my current insulin ratio is 1 unit to 3g.)