Advice wanted on a number of questions please.

Forgive my ignorance but what are the health benefits of Metformin other than lowering blood glucose? Given that it can be done by low carbing apparently.

Welcome @scallywagger ! My first impression is that your partner is doing very well indeed and that his diet is clearly keeping his BG well within the target limits. I would guess, and it is a guess as I'm not a medic that after the next HbA1c test your GP may suggest stopping medication or at least reducing it as your partner seems to be pretty well diet controlled. What would perhaps be a better indication of base BG levels would be a fasting BG test before eating in a morning, though given what you've shown I'd guess that it too will be fairly low.
I can't comment regarding reducing the dose of metformin as I've no experience of that medication as I'm on gliclazide which is somewhat different, though I'm quite sure others with experience will soon pop up with suggestions. You are doing well and I wish you continued success!

Hi Scallywagger and welcome to the Forum. First I’ll tag in @daisy1 for her welcome post which is full of loads of useful info.
Reversal, remission, cure or well controlled, there is a lot of differing thoughts on this. I consider myself well controlled (I know my avatar says in remission but that’s the description available here that I’m most happy with). Anyway my day to day blood sugar levels are within these guidelines: https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html for Type 2s and 99% of the time the numbers for non diabetics. However I eat between 40-60g of carbs per day and I take 3 x 500mgs of Metformin per day. I sincerely believe that if I raise my carb levels my blood sugars will go back up to diabetic levels. As my HbA1c has been non diabetic since last Sept my GP has agreed to discuss reducing my dose at my next review. I’m happy to stay on a small dose for it’s other benefits. Here’s an article about them @gardengnome42, this will interest you too:
http://www.lifeextension.com/magazine/2001/9/report_metformin/Page-01

gardengnome42 said:

Forgive my ignorance but what are the health benefits of Metformin other than lowering blood glucose? Given that it can be done by low carbing apparently.

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Metformin doesn't lower blood glucose - it is supposed to help diabetics but just how seems a bit obscure - stopping the liver releasing glucose is one benefit often mentioned.

Numbers are looking pretty good. Well done to P and to you for your obvious support. I can't give you any advice on medications as, at the moment, I am diet and exercise.
What I can say is that you've come to good place to find people who will be supportive and often make suggestions / give advice on their experiences.
Good luck and I wish you both well.

gardengnome42 said:

Forgive my ignorance but what are the health benefits of Metformin other than lowering blood glucose? Given that it can be done by low carbing apparently.

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There are 5 things Metforim does in the body, I forget all of them but if you look in the Metformin subforum you will find the list soon enough. I take it because it reduces glucose output by the liver. Lots of people need a bit of helping reducing BG - low carbing isn't always enough for them.

scallywagger said:

Hello, I'm a new member, posting on behalf of my partner. Partner has type 2 diabetes and takes 2000 g Metformin slow release daily. Since December he has been following a strict low carb diet having seen the publicity surrounding the possibility of reversing diabetes and has lost lots of weight. In December his blood test (Hba1c) gave a reading of 51, this had reduced to 36 in May. We decided to get a meter and started testing before and after meals as advised here. The readings have been:
25/5 - pre 5.1, post 4.9.
26/5 - pre 5.5, post 6.8
30/5 - pre 4.6, post 5.4
31/5 - pre 5.3, post 5.0
01/6 - pre 5.6, post 7.7

We have a number of questions if you could help with any answers please. Is it possible to say whether his diabetes has reversed given the above readings? If not, how do people find out when it has? Do people tend to reduce down off the medication to test readings? Given the reported health benefits of Metformin, is there a dose that people are advised to still take?

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It is possible to reverse the symptoms of T2 diabetes (blood sugar levels) but the underlying dysfunction that causes T2 will always remain. If your partner stops managing his carb intake, then his BGs will rise again, bc his body is not able to process carbs "normally."

I prefer to say T2 is in remission rather than reversed, because there is a risk that if the person sees it as reversed, we can get complacent and it creeps back. This happened to me more than once.

There will probably come a time when medical science finds a way to improve this situation but until then, once the carb processing ability in a person's body has shown itself to be not working correctly, there is always the ability to get high BGs again.

IMO anyone ever diagnosed with T2 needs at least an annual HbA1c test to ensure it stays away. I would also do a home fasting BG test at every 6 month point in between these tests.

As soon as BGs start rising, testing should be every 3 months until they fall.

gardengnome42 said:

Forgive my ignorance but what are the health benefits of Metformin other than lowering blood glucose? Given that it can be done by low carbing apparently.

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Hello, forgive your ignorance, you dont have ignorance, I just wish more doctors and the system out there inform /recommend the same as your post. Excellent post well explained.

Not a doctor, but I view the same as yourself, and if not wrong, yes it does lower blood glucose, which is the symptom of Diabetes 2 yes? and my understanding lowering is all it does, other than on the negative side, has most people if not all running to the toilet, sent me after just 1 hour and 1 tablet, yet inbetween, what is happening to the crux of the problem the Cause, it surely does not get any better as the metformin is simply just lowering blood glucose and nothing else? Also, lowering reversing blood levels can be achieved by low carb exercising and intermittant fasting one or all three, depending on ones situation. I do three and it reversed my levels to normal fasting, 2hr and random, over one year, consistently, reversed levels A1C from 8.1% although an error, down to now 5.5% 5.3% 5%.

pollensa said:

Hello, forgive your ignorance, you dont have ignorance, I just wish more doctors and the system out there inform /recommend the same as your post. Excellent post well explained.

Not a doctor, but I view the same as yourself, and if not wrong, yes it does lower blood glucose, which is the symptom of Diabetes 2 yes? and my understanding lowering is all it does, other than on the negative side, has most people if not all running to the toilet, sent me after just 1 hour and 1 tablet, yet inbetween, what is happening to the crux of the problem the Cause, it surely does not get any better as the metformin is simply just lowering blood glucose and nothing else? Also, lowering reversing blood levels can be achieved by low carb exercising and intermittant fasting one or all three, depending on ones situation. I do three and it reversed my levels to normal fasting, 2hr and random, over one year, consistently, reversed levels A1C from 8.1% although an error, down to now 5.5% 5.3% 5%.

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Metformin doesn't cause diarrhoea in most people who take it. I forget what the data says but IIRC it's something like a third? Slow release form often cures it, but not always.

I took 1000mg immediate release Metformin for 8.5 years with no diarrhoea from it. When it was increased to 1500mg 6 months ago, I got diarrhoea. BUT I didn't think about the Metformin being the cause, since it had never done that before.

After SIX months of constant diarrhoea adding to my already rubbish quality of life because of very high BGs, one of the other doctors in my team twigged to what was going on. Within days the problem was resolved.

I don't want others to go through what i went through. I read about someone here yesterday who was left to suffer on Met for longer than 6 months and now has IBS that will probably be there for life, and it could have been prevented!

I encourage everyone to read up on a drug BEFORE taking it, or as soon as possible after. There is plenty of info about each drug somewhere on this forum but most people are happy to provide the info if you start a thread about it.

If we give up on a drug because of side effects that could have been treated in some way, we miss out on the potential benefits of it. That can be a problem too.

Just to clarify how Metformin works, for those of you that are interested, here’s a paragraph from the article I linked above:

“An ideal anti-diabetic drug would enhance cellular insulin sensitivity, inhibit excess intestinal absorption of sugar, reduce excess liver production of glucose, promote weight loss and reduce cardiovascular risk factors. Metformin (Glucophage) is the one drug that does all of this and more.
Metformin works by increasing the number of muscle and adipocyte (fat cell) insulin receptors and the attraction for the receptor. It does not increase insulin secretion, it only increases insulin sensitivity. Therefore, metformin is not associated with causing hypoglycemia. This activity reduces insulin levels by increasing the sensitivity of peripheral tissues to the effects of insulin by rejuvenating the response, and restoring glucose and insulin to younger physiological levels that may cause weight loss and most certainly a decrease in the body's total fat content.”

Jenny15 said:

There are 5 things Metforim does in the body, I forget all of them but if you look in the Metformin subforum you will find the list soon enough. I take it because it reduces glucose output by the liver. Lots of people need a bit of helping reducing BG - low carbing isn't always enough for them.

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Well I think that may well apply to me. I'm soon to be 76 and reading Rachox's link to Life Extension magazine Metformin, the author suggests ageing causes insulin resistance and hypertension and some cholesterol problems amongst other things [I've got all of those]. He suggests Metformin reduces those things and other things too and recommends it to prediabetics to prevent it becoming full diabetes. Sounds useful - should I ask my GP to go on it?

gardengnome42 said:

Well I think that may well apply to me. I'm soon to be 76 and reading Rachox's link to Life Extension magazine Metformin, the author suggests ageing causes insulin resistance and hypertension and some cholesterol problems amongst other things [I've got all of those]. He suggests Metformin reduces those things and other things too and recommends it to prediabetics to prevent it becoming full diabetes. Sounds useful - should I ask my GP to go on it?

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No harm in asking.

gardengnome42 said:

Well I think that may well apply to me. I'm soon to be 76 and reading Rachox's link to Life Extension magazine Metformin, the author suggests ageing causes insulin resistance and hypertension and some cholesterol problems amongst other things [I've got all of those]. He suggests Metformin reduces those things and other things too and recommends it to prediabetics to prevent it becoming full diabetes. Sounds useful - should I ask my GP to go on it?

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I can't comment on individual drug choices but in general I have found it best to get my carb intake down as much as I can, then study my BG over several days before thinking about asking to add a medication.

Metformin appears safe, but there have been doubts raised. Given the initial HbA1c and the turn around I would remove this drug and in its place go for the best qualitative LCHF as possible, with as much diversity as possible. My views are biased on this, as I was incorrectly prescribed Metformin. It did not work well with my kidneys, additionally I believe in minimal drugs unless absolutely essential - I think your case should have been diet and exercise as a first step.

I think with the numbers so far the status is transitive diabetes in remission (I have added the word transitive as I think several quarters of non-diabetic numbers should pass). Others such in the Newcastle Diet trials say remission is below 48 I.e. pre-diabetic and below.

Mbaker said:

Metformin appears safe, but there have been doubts raised. Given the initial HbA1c and the turn around I would remove this drug and in its place go for the best qualitative LCHF as possible, with as much diversity as possible. My views are biased on this, as I was incorrectly prescribed Metformin. It did not work well with my kidneys, additionally I believe in minimal drugs unless absolutely essential - I think your case should have been diet and exercise as a first step.

I think with the numbers so far the status is transitive diabetes in remission (I have added the word transitive as I think several quarters of non-diabetic numbers should pass). Others such in the Newcastle Diet trials say remission is below 48 I.e. pre-diabetic and below.

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I think your first sentence can apply to most drugs if you swap the name.

I agree that anyone who has known problems with Metformin either before or during treatment with it should weigh up whether to use it or not.

It's not an essential medication by any means. IMO if a person at diagnosis wants to try dietary changes alone, they should feel able to, and then review results after three months.

Not everybody wants to focus on their eating habits with the intensity others do, and IMO that is OK. We can't know what is going on in the lives of others, so I try to be cautious about firmly stressing the benefits of dietary changes, at least until I get to know the person a bit more.

Mbaker said:

Metformin appears safe, but there have been doubts raised. Given the initial HbA1c and the turn around I would remove this drug and in its place go for the best qualitative LCHF as possible, with as much diversity as possible. My views are biased on this, as I was incorrectly prescribed Metformin. It did not work well with my kidneys, additionally I believe in minimal drugs unless absolutely essential - I think your case should have been diet and exercise as a first step.

I think with the numbers so far the status is transitive diabetes in remission (I have added the word transitive as I think several quarters of non-diabetic numbers should pass). Others such in the Newcastle Diet trials say remission is below 48 I.e. pre-diabetic and below.

Click to expand...

Excellent post information, puts it into perspective in avoidance of any doubts out there especially referring to kidney situation, which is a problem also for many, and yet not for others. Valued comments.

Mbaker said:

Metformin appears safe, but there have been doubts raised. Given the initial HbA1c and the turn around I would remove this drug and in its place go for the best qualitative LCHF as possible, with as much diversity as possible. My views are biased on this, as I was incorrectly prescribed Metformin. It did not work well with my kidneys, additionally I believe in minimal drugs unless absolutely essential - I think your case should have been diet and exercise as a first step.

I think with the numbers so far the status is transitive diabetes in remission (I have added the word transitive as I think several quarters of non-diabetic numbers should pass). Others such in the Newcastle Diet trials say remission is below 48 I.e. pre-diabetic and below.

Click to expand...

Jenny15 said:

I think your first sentence can apply to most drugs if you swap the name.

I agree that anyone who has known problems with Metformin either before or during treatment with it should weigh up whether to use it or not.

It's not an essential medication by any means. IMO if a person at diagnosis wants to try dietary changes alone, they should feel able to, and then review results after three months.

Not everybody wants to focus on their eating habits with the intensity others do, and IMO that is OK. We can't know what is going on in the lives of others, so I try to be cautious about firmly stressing the benefits of dietary changes, at least until I get to know the person a bit more.

Click to expand...

Jenny15 said:

I think your first sentence can apply to most drugs if you swap the name.

I agree that anyone who has known problems with Metformin either before or during treatment with it should weigh up whether to use it or not.

It's not an essential medication by any means. IMO if a person at diagnosis wants to try dietary changes alone, they should feel able to, and then review results after three months.

Not everybody wants to focus on their eating habits with the intensity others do, and IMO that is OK. We can't know what is going on in the lives of others, so I try to be cautious about firmly stressing the benefits of dietary changes, at least until I get to know the person a bit more.

Click to expand...

The problem for me with this perspective, is that the default position is to push Metformin (and most likely statins) on an ignorant recipient for me this is bad practice. I had a HbA1c in old money of 134, within 1 week dropped my blood sugar readings by 20%, yet was still prescribed Metformin when I was wet between the ears; had I been given non biased advice I could have dropped more as I was still having carbs like home made soda bread and home made banana cake (thinking these were good for me).

For me it is the perennial question of affirmative action or not, my perspective is based on Diabetes not waiting around and that it was most likely lifestyle that triggered the condition.

@scallywagger

Hello Scallywagger and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it helpful. Ask as many questions as you need to and someone will help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

Rachox said:

Just to clarify how Metformin works, for those of you that are interested, here’s a paragraph from the article I linked above:

“An ideal anti-diabetic drug would enhance cellular insulin sensitivity, inhibit excess intestinal absorption of sugar, reduce excess liver production of glucose, promote weight loss and reduce cardiovascular risk factors. Metformin (Glucophage) is the one drug that does all of this and more.
Metformin works by increasing the number of muscle and adipocyte (fat cell) insulin receptors and the attraction for the receptor. It does not increase insulin secretion, it only increases insulin sensitivity. Therefore, metformin is not associated with causing hypoglycemia. This activity reduces insulin levels by increasing the sensitivity of peripheral tissues to the effects of insulin by rejuvenating the response, and restoring glucose and insulin to younger physiological levels that may cause weight loss and most certainly a decrease in the body's total fat content.”

Click to expand...

VERY INTERESTING, thanks @Rachox ! I'm a skinny diabetic and just cannot seem to put on weight, I've next to no fat having lost about 14 or more pounds.I'm currently about 8st. After diagnosis I was prescribed 80mg Gliclazide and this with LCHF brought my HbA1c into 'remission levels' and the GP reduced the dose to 40 mg and then stopped medication as my HbA1c was still good. My numbers then rose and I'm back on gliclazide now. The GP did suggest Metfomin, but having heard about the digestive side effects I said I'd stick with the glilazide as I knew it worked as far as my BG was concerned.
The article has got me thinking that in my case Metformin may help me gain some fat and weight.