reducing Metformin

Dobbs

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I've been on 2x 500mg Metformin since dx last August. I've recently bought my own meter and am trying the low-carb approach, with good results so far. Therefore I'm (maybe a bit prematurely) thinking of reducing my medication. So I wondered: has anyone experienced going from 1000mg Metformin a day to 500mg? What difference does it make to your readings? Is it a massive shift, or just a delicate flutter? And are there any other consequences I should know about?
 

cugila

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Hi Dobbs.

The dose of Metformin you are on is not a high dose at all. As such it will only have made a small impact on your Bg levels typically about 1 or 2 mmol/l drop, maybe even less. I f you reduce the dose it may well have little effect.

You say you have 'good ' results so far ? Without knowing the sort of readings you are getting we cannot know if they are good or not ?

If you are thinking of reducing your medication you should discuss this with your GP before doing so.

Ken.
 

Dennis

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Dobbs said:
are there any other consequences I should know about?
Hi Dobbs,

You need to be aware that metformin does two things. Firstly it reduces insulin resistance, which allows your body's insulin to work more efficiently. The second thing is that it stops your liver from producing unwanted glucose. A problem that most type 2s have is that the liver loses the ability to calculate how much glucose it needs to produce in order to keep your blood sugar levels stable. In many cases it can produce as much as 3 times more than it should. Metformin can reduce this overproduction by 30%.

So the result of dropping metformin is that your insulin resistance doesn't improve, resulting in your pancreas needing to produce more insulin than it should to process the blood sugar (which can eventually lead to your pancreas burning out), plus there's nothing to prevent your liver from going back into serious overproduction of glucose.
 

Doczoc

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Dennis said:
Dobbs said:
are there any other consequences I should know about?
Hi Dobbs,

You need to be aware that metformin does two things. Firstly it reduces insulin resistance, which allows your body's insulin to work more efficiently. The second thing is that it stops your liver from producing unwanted glucose. A problem that most type 2s have is that the liver loses the ability to calculate how much glucose it needs to produce in order to keep your blood sugar levels stable. In many cases it can produce as much as 3 times more than it should. Metformin can reduce this overproduction by 30%.

So the result of dropping metformin is that your insulin resistance doesn't improve, resulting in your pancreas needing to produce more insulin than it should to process the blood sugar (which can eventually lead to your pancreas burning out), plus there's nothing to prevent your liver from going back into serious overproduction of glucose.


Thanks Dennis for this response, I'm somewhat in the same boat as the original poster.
I stopped taking Meformin (1x500mg) 3 months ago. I'm the sort of person who doesn't like taking tablets but have always had the niggle in the back of my head about my pancreas burning out eventually.

Since stopping Metformin my fasting BG levels have been low 4s usually and various readings through the day have been low 5s, although I've been testing nowhere near as rigidly as I was initially diagnosed. I'm having my 3rd HB1AC in a couple of weeks time so will find out the real score then - did have a carb frenzy for a week a couple of weeks ago though LOL I am thinking that I should continue with the Metformin, although as I understand it 1x500mg will have little effect. I tried discussing with the doctor about increasing it after my second HB1AC but she insisted that it was 'doing it's job' when it was actually due to diet really. I guess I felt at the time that it wasn't worth taking for the limited impact it was having. Am I being stupid thinking this?
 

Dennis

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Hi Doczoc,

You are right in that a single 500mg tablet won't have an enormous effect, either on the insulin resistance or on glucose supression. And of course it could be that the combination of weight loss through your low carb diet, plus metformin in the early days has now reduced your insulin resistance considerably. I suggest that you carry on as you are and see what the HBA1C results show in a couple of weeks. That test will cover the full 3 months that you have been off metformin. If they are the same or no worse then you know that you can get away without it. If they are higher than the last test then know you'll need to restart the metformin.
 

Doczoc

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Dennis said:
Hi Doczoc,

You are right in that a single 500mg tablet won't have an enormous effect, either on the insulin resistance or on glucose supression. And of course it could be that the combination of weight loss through your low carb diet, plus metformin in the early days has now reduced your insulin resistance considerably. I suggest that you carry on as you are and see what the HBA1C results show in a couple of weeks. That test will cover the full 3 months that you have been off metformin. If they are the same or no worse then you know that you can get away without it. If they are higher than the last test then know you'll need to restart the metformin.

Thanks Dennis, will do.

Bit (a lot) annoyed with myself that I fell off the wagon for a week, it'll skew the HB1AC but I'm trying to convince myself it was worth it to realise how **** I feel when eating lots of carbs
 

Dobbs

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thanks cugila, Dennis and Doczoc, really helpful. When I have a successful low carb day (about two days out of three :lol: ) my morning fasting level tends to be 6.0 - 6.7; before meals roughly 5.3 - 5.7; an hour after meals 6.4 to 7.2; two hours after, between 5.5 and 6.3 (My last HbA1c, before I started low carbing, was 6.1).
 

Dennis

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Hi Dobbs,

That's pretty consistent control and you must be very pleased, but it's not really possible to say how much the metformin is contributing towards it. Even your GP won't be able to answer that, but you could discuss with your doc the idea of reducing the metformin to see what affect that has.
 

hanadr

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Since Metformin is very unlikely to cause hypos and has several beneficial effects and does not thrash the pancreas, I personally have chosen to keep using it. It is a VERY safe medicine.
 

Doczoc

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hanadr said:
Since Metformin is very unlikely to cause hypos and has several beneficial effects and does not thrash the pancreas, I personally have chosen to keep using it. It is a VERY safe medicine.

Hmmm good point.
 

Trinkwasser

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Doczoc said:
hanadr said:
Since Metformin is very unlikely to cause hypos and has several beneficial effects and does not thrash the pancreas, I personally have chosen to keep using it. It is a VERY safe medicine.

Hmmm good point.

Yes on the one hand if you've gotten over the squits and are tolerating it well it has cardiovascular benefits over and above the BG lowering. OTOH some people have found on stopping it that they have noticed certain side effects they hadn't related to the drug have stopped.

Do you feel lucky? <G>
 

Dobbs

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just curious - do you know which side-effects people have reported stopping once they come off Metformin?
 

dipsticky

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dobbs.

I would think all the side effects, if you had any, would pretty soon stop when you stopped the metformin. Is that what you mean ? I have seen some info on here all about the stuff. You should take a look.

D.
 

Trinkwasser

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Dobbs said:
just curious - do you know which side-effects people have reported stopping once they come off Metformin?

Apart from the reducing farting, strange things like a reduction in muscle aches or bruising and improved concentration, mainly low level things that they hadn't previously connected to the met

It's generally well tolerated once you get over the initial effects, except for people who just don't do well on it. But like all drugs it may have minor side effects
 

dinosaur

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my diabetic nurse just reduced mine in half as well
also 1000mg a day to 500mg.

it was because i had a few hypo`s.

hopefully on my next 1ac my levels are still the same in the 5`s.
 

hanadr

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dinosaur
It's very unusual for Metformin to cause hypos
Wer you doing something else to cause them?
 

dinosaur

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i have been dieting and cardio and weight training very intensly for the last 5 months , so i guess i run low sugar levels most of the time.

i work very long hours in the middle of nowhere outdoors and have to take my food with me but sometimes i forget to include something like a normal coke or sugar lump just in case, and as a result sometimes i have left it to long between meals , and then i feel the shakes, and when i have tried to get food/drink in my system it instantly comes back up, and then it is to late and i was not able to get enough sugar in my system before i was able to look after myself.

i have been carted off in the ambulence a few times so far, albeit i come around quickly .

my diabetic nurse said that the levels my body is currently running at, they would never diagnose me as being diabetic now.

wish i could turn the clock back 5 months.