Advise me please

[lgadsden]

I have been diabetic for some years controlling it with tablets. I used to take Gliclazide and Metformin. Two months ago following my yearly check my doctor chamged me to insulin. Although it took a few weeks to reach some stability I am now taking 30 units twice a day. However, the down side is I have gained one and a half stone. I was quite thin and a bit of weight was quite good to add on but enough is enough. When the doctor stopped my tablets she described the Metformin as fat tablets and told me I didn't need them. My mother syays that when she first went on insulin she took Metformin as well what I need to know is if anyone else does before I visit the doctor at this rate I shall be like the Mitchelin man at Christmas. Does everyone on insulin gain weight? :roll:

 

[Dennis]

Hi Igadsden,
Yes, insulin and weight gain do go hand-in-hand. This article by Prof.David Russell-Jones confirms it.
http://www.ingentaconnect.com/content/b ... rmat=print
(Prof. Russell-Jones is widely regarded as one of the foremost experts in diabetes in the UK.)

I am very interested in why your doctor would have switched you from oral medication to insulin. Were you having difficulty in maintaining control of your sugar levels?
Were alternative oral meds suggested?
Does your doctor believe that your pancreas is no longer producing insulin - if so was a c-peptide test done to confirm this?
I'm not quite sure what was meant by "fat tablets"! Did your GP mean they cause fat or that they prevent fat? In fact metformin isn't responsible for weight gain - they can encourage a small amount of weight loss but usually not a significant amount. Their primary use is to reduce insulin resistance, which is something that most Type-2s have - and this applies whether your insulin is injected or or self-produced. So if you needed metformin before, then putting you on injected insulin doesn't change that need.

If you can let us know what your BS readings are and your last few HBA1C readings then we might be able to make some suggestions that could help you.

 

[hanadr]

There seams to be a trend to put T2 diabetics onto insulin. If your control was good on metformin, you could have refused. Didn't you gain weight on gliclazide? I have stopped using it, because it did that to me. If you cut your carb intake, and minimise your insulin, you might reverse the weight gain. What were the grounds on which your insulin dose was calculated? or did they just pluck a number out of the air? there are formulae for this, but since they depend on body weight, you may need to see them again to get it changed. that can lead to the weight gain spiral.

 

[lgadsden]

Dennis
At my yearly check my average was 12 hence the move to insulin no other oral medication was suggested. I don't even know what a c peptide is but the only thing that was checked was ketones which were 4 (according to the doctor that is high). My doctor indicated that Metformin prevents fat. My current readings tend to be between 5-9 dependant on the time of day.

Handar

I did not gaim weight on Gliclazide in fact over the past three years I have lost three stone, hence my eagerness not to put it all back on.
As to calulating my insulin thats a laugh I was started on 8 units twice a day and told to raise it by 3 units every three days until my sugar levels reached the acceptable limits. I felt ill for a few weeks and lost my first days from work through illness in ten years. I appear to be okay now except for the weight gain which really concerns me.

 

[Trinkwasser]

Metformin reduces insulin resistance. I really don't understand why they have discontinued it as *excess* insulin, whether self-produced or injected, is one of the factors causing weight gain.

If you'd been kept on the met then you'd need less insulin.

The other side of the coin of course is diet. With fewer carbs you'd also need less insulin to cover them so there are two ways to avoid gaining weight - BE CAREFUL reducing your carb input on insulin without going to the extent of causing hypos.

The third side of the coin is exercise: growing and using muscle improves glucose disposition and reduces IR, however even this would work better alongside the metformin.

Any chance of seeing a DSN or someone more clueful than your current doctor?