Metformin - time to start?

[LittleGreyCat]

I am due for my diabetic review in a few weeeks, and am doing one of my intermittent testing campaigns in preparation.

My results aren't looking quite as good as those last Autumn - when I was exercising with walking and running I was hitting 6s and 5s, with even one 4.9.

Winter and less recent exercise (threw myself at the ground whilst running in Lanzarote a couple of weeks ago and my big toes have just about recovered now) and my numbers are up a bit.

Recent 4 readings (just started testing) are 8.2, 7.9, 9.1, 6.0.

Now looking back at my records, my BG in general has steadily improved as my weight came down, I reduced carbs, and increased exercise.

However I am now looking at results which suggest that without a significant amount of exercise my readings are going over the allegdly magic 7.8 quite a few times. More testing will show if I just hit a blip or if this is more or less steady for me.

So I think I have reached the state where diet and exercise have made major improvements but I may be just the wrong side of the safety line in BG control, especially if something prevents me from exercising regularly.

Over the last four years I seem to have been having a complicated Metformin dance with my HCPs.
I resisted going straight on Metformin on general principles because it is generally better to avoid drugs if possible.
After a while I became discouraged by my progress and thought about going on Metformin but my HCPs said I was actually doing pretty well and could expect further improvement.
I have been round this loop several times as I have gradually improved my BG control.

So the question is, should I now try Metformin?
An improvement of 1 - 1.5 in my BG readings could take me nicely the other side of the safety line.

Reading through here I see much discussion about day to day side effects such as intestinal problems.

The sticky at the top says

Important safety information:
Dizziness may occur while you are taking Metformin . This effect may be worse if you take it with alcohol or certain medicines. Use Metformin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
Do not drink large amounts of alcohol while you use Metformin . Talk to your GP before you drink alcohol while you use Metformin .
Tell your doctor or dentist that you take Metformin before you receive any medical or dental care, emergency care, or surgery.
Be careful not to become dehydrated, especially during hot weather or while you are being active. Dehydration may increase the risk of Metformin 's side effects.
If vomiting or diarrhea occurs, you will need to take care not to become dehydrated. Contact your doctor for instructions.

Metformin does not usually cause low blood sugar but can in certain circumstances. Low blood sugar may be more likely to occur if you skip a meal, exercise heavily, or drink alcohol. It may also be more likely if you take Metformin along with certain medicines for diabetes (eg, sulfonylureas, insulin). It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar.

Sobering information, and the bit about dehydration and exercise is a bit worrying as exercise is part of my BG control strategy. However it doesn't look to be anything unmanageable as long as I don't turn out to be intolerant to Metformin.

So apart from day to day side effects, are there any long term concerns?
For example, does taking Metformin bring forward the day when you can expect to go on insulin?

Bottom line - are there any good reasons NOT to go on Metformin.

Cheers

LGC

Oh, and

Talk to your GP before you drink alcohol while you use Metformin .

Late night phone call - Doctor, Doctor, I'm just about to drink a pint of lager.
What? You rang me up in the middle of the night to tell me this?????
But....but.....the instructions on the packet say...........

 

[Daibell]

Hi. Metformin is a very safe and well-proven drug with very few ill-effects. It has no effect on the Pancreas so does not bring on the need for early insulin itself. Some people find that the plain Met causes stomach upset so the Met SR (Slow Release) version can avoid that. Metformin doesn't work miracles but might just help your BS a bit. If your HCP recommends it I would go with it.

 

[ladybird64]

Hi LGC

You sound very much like me, I also refused meds to start with. I was just infuriated that there was no real discussion, no information..it was "this is what we are going to do"..loved the "WE" part! :roll: They wanted to start me on Metformin plus statins and I refused both.

Being the stubborn cuss that I am I wanted to prove a point and this I managed dropping my A1C from 7.5 to 6.6.

However..I have food "issues" which I have discussed elsewhere and these have been problematic for a couple of months, I have run out of test strips but know that my bg's are flying up and down because of my snacking. I am trying hard to get to grips with this but felt that now was the time to say that I felt I needed some help in the way of Metformin.

I'm not expecting it to work miracles nor am I using it so I can munch what I want but feel it may help even things out. My GP agreed to it (a very good doc this guy, talks with me, not AT me), told me I need to be careful that my bg's don't dip too low as it can cause that effect. No test strips though! :wink:

I think the time was right for me, I don't see it as a stepping stone on the way to more meds but as an aid to what I am trying to do. I also found out so much info here about how beneficial it can be for the heart and that is from those on portion control, low carb..so it has got to be good.

I am on the ordinary Metformin and although I get some tummy ache, that's about it.

Maybe give it a go.I know exactly how you feel honestly but if the time is right in YOUR mind, I think you are doing the right thing.

Let us know how it goes.

 

[LittleGreyCat]

Just noted the following in a blurb about Metformin

When used for long periods of time, Metformin may not work as well. If your blood sugar has been under control and then becomes hard to manage, contact your doctor. Do not change the dose of your medicine without checking with your doctor.

So is the one downside of Metformin that it has a finite period over which it is effective?
i.e. if you start Metformin then you should be O.K. for 'n' years but after that your control goes haywire?

If so, which is the next stage?

Alternative oral drugs, or is it the Insulin moment?

Any idea how long a "long period of time" is?

Cheers

LGC

 

[Grazer]

Not sure where you got that line from, but I agree with people posting above. metformin doesn't affect the pancreas and doesn't hasten the need for insulin. I would think the line you quoted is misleading - certainly, diabetes is supposedly progressive, so metformin may not help enough if your diabetes progresses too far. That's not because the metformin itself has stopped working, just that it can't cope with your progressing illness. I've looked into this quite a lot, and have decided to start metformin NOT for BG control, which is limited, but because it's a good preventative against future complications to the cardio vascular system. No downside, so I've gone for it. All the side effects can be avoided in the vast majority of cases if you go onto the SR (slow release) version which is what I've done.
Incidentally, I have a hopeful belief that if you control your BGs well enough, so that not too much demand is made of the Pancreas, then the progressive nature of the disease can be held in check. Time will tell if I'm right!

 

[viviennem]

Not sure where you got that line from, but I agree with people posting above. metformin doesn't affect the pancreas and doesn't hasten the need for insulin. I would think the line you quoted is misleading - certainly, diabetes is supposedly progressive, so metformin may not help enough if your diabetes progresses too far. That's not because the metformin itself has stopped working, just that it can't cope with your progressing illness. I've looked into this quite a lot, and have decided to start metformin NOT for BG control, which is limited, but because it's a good preventative against future complications to the cardio vascular system. No downside, so I've gone for it. All the side effects can be avoided in the vast majority of cases if you go onto the SR (slow release) version which is what I've done.
Incidentally, I have a hopeful belief that if you control your BGs well enough, so that not too much demand is made of the Pancreas, then the progressive nature of the disease can be held in check. Time will tell if I'm right!

I agree with Grazer on all points. I settled in to the ordinary Met (500mg three times daily) pretty quickly, and haven't had any side effects for ages. Mind you, I have a cast-iron digestion! Also, metformin is supposed to be an appetite suppressant and also aids weight loss in some people.

That's one wise sheep!

Viv 8)

 

[LittleGreyCat]

Found the information in http://www.diabetesabc-uk.com/metformin-information-t12.html but can't track it down any further.

They have a related link to some product literature but I can't find it there.

Will ask them.

Edit:

from http://www.drugs.com/cdi/metformin.html

 

[catherinecherub]

After a few years, not a few weeks, it may decrease your B12 levels.
http://www.bmj.com/content/340/bmj.c2181.full

It is however heart protective. There are plenty of studies that show people using Metformin have fewer Myocardial Infarctions and Heart Attacks compared with those using other oral drugs.

If you are running high numbers then it is pretty useless if you do not change your eating habits as it only decreases your blood sugars by a small percentage. It is not a miracle pill but is an aid to control.

 

[xyzzy]

Just adding to what's all ready been said LGC. I take 3 x 500mg of standard Metformin on a diet that varies between ULC & LC. Have no side effects and never did except for feeling a bit nauseous after taking the very first pill. A Catherine and others say it will reduce your BG's by at most 1 or 2 but it certainly does protect against spikes and will therefore keep your overall BG's far more stable than without. There is a study that says stability of BG's is generally better than being peaky or spikey so in that regard Metformin is ideal to take. Likewise as Grazer says I would be loathed to give it up simply because of good effects it has on your heart. The only reason I take it is because it doesn't stimulate the pancreas. It works primarily in two ways. First it suppresses the liver releasing glucose when you eat and second it blocks the take up of glucose by the blood. Finally because it doesn't stimulate an insulin release it has no more chance of making you hypo than any other non related reason so its very safe in that regard as well.

 

[lindainsomerset]

Hi,
Just to answer your question on Metformin. I was told it takes around 3 months for it to take any affect, so don't expect miracles. Also I am on 3 x 500mg Metformin per day (not SR), and suffer absolutely no side affects, even after a good night out drinking wine. Unfortunately neither has it had any weight loss benefits! Hope this info helps. X

 

[viviennem]

If only it neutralised the calories in wine . . . :crazy:

Viv 8)

 

[LittleGreyCat]

Thanks - will copy stuff across to the Metformin 101 thread.

 

[volaer]

I think in your case, you will really have to maintain meds like diamicron and metformin.


Sent from the Officially Diabetic