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Alternative to metformin I should ask for?

A

Alexia94

Member
Messages
7
Type of diabetes
Type 2
Treatment type
Diet only
Hello Everyone

My HB1ac levels are 6.2. I was on metformin 500 mg ER for 6 months and it did not do what it claimed.
- I did not lose any weight
- It did not suppress my appetite
- My morning fasting levels remained high ( between 6.8- 8.0)

I am going to the GP this week to ask for an alternative that may help me. My biggest concern is weight. I eat healthy and exercise every day and cant lose any weight.

While my HB1ac is only in pre diabetes range that may not require medical attention, my fasting sugar levels in the morning are high and can be classified as within diabetes range.

I spoke to another GP for a second opinion and she told me I could do without any medication because everything is fine in terms of thyroid, cholesterol and blood pressure.

My body is not processing food correctly because no matter what I eat Im not full even really low carb foods and when I get full I get sleepy.

Should I ask for Janumet? A combination of metformin and sitagliptin? I need something to lose weight and supress hunger and also lower my sugar levels. Just upsetting metformin didnt help.

Has anyone tried anything when metformin was not working for them?
 
Hi. The advantages of Metformin tend to be oversold by the medics. It reduces BS and appetite just a bit and reduces the livers output of glycogen (glucose). A dose of 500mg will have minimal effect and may need to go up to the full 2000mg as well. There is no equivalent to Metformin and Janumet is Met with Sitagliptin added. The gliptins suppress the DPP-4 enzyme which in turn switches off insulin after a meal. The gliptins reduce BS spikes. The other common drug that is often prescribed is Gliclazide but that works by stimulating the pancreas and that is not helpful if you already have too much insulin due to insulin resistance. Can you let us know your typical daily total of carbs? Also whether you have enough protein and fat to help you feel full. There are some people like my wife who always feels hungry and that's probably genetic. There are injectables such as Victoza which help those who have a lot of excess weight and can reduce that.
 
Thankyou for replying!

I mix and match with the following. Please tell me whether this is appropriate food for a pre diabetic/ diabetic with insulin resistance.


I mix and match with the following foods for breakfast lunch and dinner, so each meal for breakfast, or lunch or dinner obviously not all in one day!! hahah
  • Quinoa bean salad

  • Baked egg in roasted capsicum

  • Shakshuka ( 2 baked eggs with tomato simmer sauce and mixed beans, avocado)

  • Roasted egg plant ( 2 long slices) with tomatos, mozzarella cheese and basil leaves.

  • Spinach and mushroom quiche

  • Roasted zucchini tomatos, mozzarella cheese and basil leaves.
  • 1 slice of toast with peanut butter and protein shake for breakfast ( this is never really filling)

This is what I will eat over the course of one week mixing and match

What do you think?

I am still hungry?

While hb1ac is 6.2 my fasting sugar levels every morning at 6.8-8.0
and 1 hour after a meal they sky rocket to 11.0 !!!!

What could this mean?

Metformin did not help over the 6 months
Should i ask for janumet?
Any other oral drug you can think of? I dont want to try injections
 
Hi. I'm no expert but that diet sounds pretty good. Make sure the protein shake doesn't have much if any carbs. You blood sugar readings are quite good and test 2 hours after a meal not 1 hour as it will be peaking at 1 hour. If it was me I would be suggesting the GP increases the Metformin. Adding a gliptin (as in Janumet) may help a bit. NICE doesn't suggest adding an injection med until your HBA1c is over 7'ish (have a look at the NICE Diabetes Guidelines on the web). I went onto insulin at 8.2% - a bit too late. In summary your figures are quite reasonable so just suggest an increase to the Metformin via the GP?
 
Yeh i certainly think some form of treatment is required as diet and exercise alone is not enough at the moment.
So will continuing the diet and increasing metformin with januvia so janument help with the appetite?
 
Does metformin stop working when you eat lots of carbs? I remember there was a time where I would have over 250 g of carbs everyday not realising how bad it was for me. I use to sometimes have 3 bananas esspecially before going to bed and I did not lose any weight rather I gained despite being on the medication. Is this all to do with the high carb intake?
 
Metformin may work with a vengeance if you eat too many carbs while taking it, as it can give you the runs as well as wind and bloating under these circumstances. See http://www.phlaunt.com/diabetes/14045911.php and scroll right down to find Side Effects.

I've actually found that a low carb higher fat diet has done far more to help me both lose weight and stabilize my glucose levels than taking metformin, which I just regard as a bit of a helping hand. I didn't start losing weight until I started my LCHF diet, which was a couple of months at least after I was prescribed metformin. But other people may have different results...

Robbity
 
@Alexia94 there are a few people here who manage their diabetes with a low carbohydrate high fat (LCHF) vegetarian diet. If that interests you, perhaps you could post on the Low-carb Diet Forum, and identify yourself as vegetarian in the title. That might draw some of the LCHF-vegetarian folks to give you feedback on your diet.

If you prefer a low fat, high (whole foods) carb diet, The End of Diabetes (2014) by Joel Fuhrman is the least restrictive on healthy fats, which I think we need.

I can't eat a whole foods, plant based diet that includes grains and legumes. Much too high in carbs for me.
 
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