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Advice wanted on a number of questions please.

Mbaker said:
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.
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It's a shame that happened to you and to many others (who we can't hope to be able to reach).

I think there is a tendency we all have, to be passionate about trying to help others avoid the pitfalls we experienced, which is very good, but I like to try to balance that with knowing everyone is different.

Take it from me, if through no fault of one's own you need a medication, reading post after post about how you should try harder to not need it gets a bit old. I can ignore a lot of these posts because I understand why they are made, but I worry for others. Hopefully my raising this issue helps them to understand it too.
 
miahara said:
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.
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Aside from any gastrointestinal symptoms (d&v) Metformin can act as an appetite suppressant which in my case along with low carb eating has helped me lose weight, so you’d need to discuss this carefully with your GP if your aim is to gain weight.
 
Rachox said:
Aside from any gastrointestinal symptoms (d&v) Metformin can act as an appetite suppressant which in my case along with low carb eating has helped me lose weight, so you’d need to discuss this carefully with your GP if your aim is to gain weight.
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I was thinking the same thing. Over 9 years with Metformin I have found it does reduce my appetite a little.
 
Jenny15 said:
It's a shame that happened to you and to many others (who we can't hope to be able to reach).

I think there is a tendency we all have, to be passionate about trying to help others avoid the pitfalls we experienced, which is very good, but I like to try to balance that with knowing everyone is different.

Take it from me, if through no fault of one's own you need a medication, reading post after post about how you should try harder to not need it gets a bit old. I can ignore a lot of these posts because I understand why they are made, but I worry for others. Hopefully my raising this issue helps them to understand it too.
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We are both coming from a good position on this and for someone just diagnosed it offers balance. There is a tipping point, I don't just come from a diabetes personal position. I have shared an office with my wife's health business for 11 years and have seen her move her physio customers off of drugs - these should be used sparingly and for acute scenarios in my view. Dr David Unwin gives patients a choice of drugs or diet and possibly exercise, most go for the former, he is on YouTube saying this. Similarly Dr Asseem Malhotra is on record of pointing out that when statin patients are given the facts about the viability of drug, the majority say they would not use them.

Metformin for me has been turned into a money spinner, GP's get paid for prescribing this. I have read less than 1 or 2 cases on this site where just diet and exercise was prescribed, when most seasoned Type 2's know diet is key. Right now the 80 / 20 rule is backwards. I feel confident enough to stick my neck out and say the OP would have achieved the same fantastic results on no Metformin.
 
Resurgam said:
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.
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Metformin does lower blood glucose.

It is not as effective in lowering blood glucose as other drugs like insulin or Gliclazide, but it most definitely lowers blood glucose, as proven by the following metastudy which examined the finding of 35 different studies.
https://www.jwatch.org/jw201204030000003/2012/04/03/how-much-does-metformin-lower-hba-1c-level
The metastudy shows that Metformin lowered blood glucose by an average of approx 1.1% (American HbA1c units) which equates to approx 11mmol/l (British finger prick testing units) in patients.

Please do not give out inaccurate information on Metformin, since it is misleading, especially to new members.
 
Brunneria said:
Metformin does lower blood glucose.

It is not as effective in lowering blood glucose as other drugs like insulin or Gliclazide, but it most definitely lowers blood glucose, as proven by the following metastudy which examined the finding of 35 different studies.
https://www.jwatch.org/jw201204030000003/2012/04/03/how-much-does-metformin-lower-hba-1c-level
The metastudy shows that Metformin lowered blood glucose by an average of approx 1.1% (American HbA1c units) which equates to approx 11mmol/l (British finger prick testing units) in patients.

Please do not give out inaccurate information on Metformin, since it is misleading, especially to new members.
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Are you sure we are writing about the same thing?
I understand that the action of metformin would lower Hba1c due to the restriction placed on the liver - however that quite unlike the action of drugs which lower BG by causing the glucose to be excreted or stored.
So often I read that Metformin is prescribed - to be taken with meals - and that is it, end of consultation. The newly diagnosed diabetic then gets the prescription and starts to take the tablets, and if they do not understand that it does not actively lower blood glucose and it is down to them to alter their diet we are not going to be doing them any favours by not pointing that out to them.
If I need to be more careful, I will be -
 
Mbaker said:
We are both coming from a good position on this and for someone just diagnosed it offers balance. There is a tipping point, I don't just come from a diabetes personal position. I have shared an office with my wife's health business for 11 years and have seen her move her physio customers off of drugs - these should be used sparingly and for acute scenarios in my view. Dr David Unwin gives patients a choice of drugs or diet and possibly exercise, most go for the former, he is on YouTube saying this. Similarly Dr Asseem Malhotra is on record of pointing out that when statin patients are given the facts about the viability of drug, the majority say they would not use them.

Metformin for me has been turned into a money spinner, GP's get paid for prescribing this. I have read less than 1 or 2 cases on this site where just diet and exercise was prescribed, when most seasoned Type 2's know diet is key. Right now the 80 / 20 rule is backwards. I feel confident enough to stick my neck out and say the OP would have achieved the same fantastic results on no Metformin.
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I think we have fallen into the trap of discussing the pros and cons of medications generally, when the OP didn't actually ask about that and hasn't posted a second time to clarify. I will leave it there unless the OP raises the issue. Thanks.
 
Mbaker said:
I have read less than 1 or 2 cases on this site where just diet and exercise was prescribed,
Click to expand...

Metformin nor any other drug was mentioned to me when I was diagnosed. I had never heard of it till I joined this forum. I was sent away to lose weight, eat healthily (Eatwell Plate) and lose weight. No tablets.
 
Mbaker said:
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.
Click to expand...

If Metformin is anything like statins then you are right. A 10%> Qrisk score and the dr can't wait to prescribe statins. And my dr said that when my HbA1c reached close to 50 he would prescribe Metformin. He said it would rise almost as if he couldn't wait to prescribe it. Do they receive a bonus for prescribing these drugs I wonder?
I wish I hadn't been so wet behind the ears when first prescribed blood pressure pills as once you are on them there is no coming off them. I really resented that and refused the statin. In fact the BP pill is all I take and only a small dose at that. I really don't seem to have got the hang of low carbing yet, it's all very well saying eat protein and fat and cut down on fruit and certain veg but all the things I like to eat and had always thought of as healthy seem to keep my blood sugar high. I'm not diagnosed diabetic yet but can't help feeling that I'm racing towards it like an express train. Most people would say I eat a healthy balanced diet, take plenty of exercise and am certainly not overweight.
Much emphasis is put on obesity as being a factor for a T2 diagnosis but if that isn't the case then age is perhaps the factor - in my case anyway, I'm 75.
 
Bluetit1802 said:
Metformin nor any other drug was mentioned to me when I was diagnosed. I had never heard of it till I joined this forum. I was sent away to lose weight, eat healthily (Eatwell Plate) and lose weight. No tablets.
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Ha - the Eatwell Plate. Enough to make anyone become cynical about everything the NHS tells us !o_O
 
gardengnome42 said:
If Metformin is anything like statins then you are right. A 10%> Qrisk score and the dr can't wait to prescribe statins. And my dr said that when my HbA1c reached close to 50 he would prescribe Metformin. He said it would rise almost as if he couldn't wait to prescribe it. Do they receive a bonus for prescribing these drugs I wonder?
I wish I hadn't been so wet behind the ears when first prescribed blood pressure pills as once you are on them there is no coming off them. I really resented that and refused the statin. In fact the BP pill is all I take and only a small dose at that. I really don't seem to have got the hang of low carbing yet, it's all very well saying eat protein and fat and cut down on fruit and certain veg but all the things I like to eat and had always thought of as healthy seem to keep my blood sugar high. I'm not diagnosed diabetic yet but can't help feeling that I'm racing towards it like an express train. Most people would say I eat a healthy balanced diet, take plenty of exercise and am certainly not overweight.
Much emphasis is put on obesity as being a factor for a T2 diagnosis but if that isn't the case then age is perhaps the factor - in my case anyway, I'm 75.
Click to expand...
Metformin is not like statins, in prescribing habits or pros & cons.

In the case of Metformin, I don't believe doctors are paid more for prescribing it. That sometimes happens with a small number of drug types and is nowhere near as widespread as some people believe.

Your claim that there is no coming off BP pills is incorrect.

Based on your other posts I don't believe you are destined to become T2 diabetic because reducing your carbs can prevent it.

I think we may have fallen into the trap of discussing diabetes generally in this thread when maybe it would be better to stay focused on what the OP (original poster) needs.

I'm happy to continue this in a new thread or by PM if you would like.
 
gardengnome42 said:
Ha - the Eatwell Plate. Enough to make anyone become cynical about everything the NHS tells us !o_O
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Only if we take that approach. I am cynical about many things, but I pick my battles. A system as large as the NHS is bound to get some things right and some things wrong. I agree the Eatwell Plate is bad science, in relation to preventing and managing T2 diabetes. But that's not necessarily the case with people who are not at risk of T2. For example if a GP or nurse is trying to help an anorexic to get better, it may be a helpful tool.
 
Jenny15 said:
Metformin is not like statins, in prescribing habits or pros & cons.

In the case of Metformin, I don't believe doctors are paid more for prescribing it. That sometimes happens with a small number of drug types and is nowhere near as widespread as some people believe.

Your claim that there is no coming off BP pills is incorrect.

Based on your other posts I don't believe you are destined to become T2 diabetic because reducing your carbs can prevent it.

I think we may have fallen into the trap of discussing diabetes generally in this thread when maybe it would be better to stay focused on what the OP (original poster) needs.

I'm happy to continue this in a new thread or by PM if you would like.
Click to expand...

Sorry, I didn't mean to interrupt the Ops post but got carried away.
 
Gosh, thank you everyone, both for the warm welcome and the wealth of information given. We have been really impressed by the forum and how friendly and supportive you have been. Although the diet has proved to be very successful (for both of us, I've also followed it to avoid having different meals and temptation available and to lose weight), it has been a hard slog and we are both looking forward to starting eating more normally and having the odd treat. From your replies I think we would be best to focus on getting our diet back towards the long-term lifestyle we are aiming for and monitoring his bg levels before we even start considering a metformin reduction.

The information on how metformin works is very interesting, my partner had asked the diabetic nurse about this but couldn't get an explanation so it is great to finally know! Thank you.
 
gardengnome42 said:
Sorry, I didn't mean to interrupt the Ops post but got carried away.
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No need to apologise, we've all done it, it's a habit I have fallen into myself, even in this thread. It's a wider issue in the forum as a whole.

I only responded to your post because some of it wasn't correct, eg the BP meds. I didn't want anyone to think there was no coming off BP meds ever, because that could be dangerous advice for someone new to the forum who doesn't have enough info.
 
gardengnome42 said:
I wish I hadn't been so wet behind the ears when first prescribed blood pressure pills as once you are on them there is no coming off them.
Click to expand...

Jenny15 said:
I only responded to your post because some of it wasn't correct, eg the BP meds. I didn't want anyone to think there was no coming off BP meds ever, because that could be dangerous advice for someone new to the forum who doesn't have enough info.
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I am living proof that you can get off BP meds, I had been on two different ones for some years prior to my type 2 diagnosis. 9 months after commencing low carb eating for my type 2 I had lost a shed load of weight. That combined with my blood sugar control resulted in my BP coming right down to the point where I was getting dizzy if I stood up quickly. So at my last review in February I stopped one med and my BP is now normal. Who knows if I might reduce the other one too eventually?
 
Rachox said:
I am living proof that you can get off BP meds, I had been on two different ones for some years prior to my type 2 diagnosis. 9 months after commencing low carb eating for my type 2 I had lost a shed load of weight. That combined with my blood sugar control resulted in my BP coming right down to the point where I was getting dizzy if I stood up quickly. So at my last review in February I stopped one med and my BP is now normal. Who knows if I might reduce the other one too eventually?
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That's great to hear. I was started on 20mg of Quinapril and got it down to 5mg over time. Every doctor or nurse I have seen over the years has had the view that if your ongoing BP levels reduce, the dosage should be reduced, and if you can keep them under 130/80 without the meds (and you have no other CVD issues) then it's fine to go off them, but to keep monitoring.

I am concerned about people newly diagnosed with very high BP making informed decisions about BP meds, regardless of diabetes or not. For example, a BP of 200/130 is far more likely to cause a stroke or sudden death than, say, a BG of even 20. Yet the focus on diabetes sometimes sees threads with many posts about BGs that are under, say, 13, when someone also has severe high BP.
 
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