Alternative to Metformin

I believe that the reason why doctors prescribe Metformin for T1D is not so much for the diabetes condition, but rather to reduce the side effects of being diabetic, i.e. reduces the risk of heart disaease, CVD and strokes. It is a protection mechanism that has been associated with a reduction in mortality rates compared to no metformin therapies.

In this respect there are other strategies that can be effective, but I am not a medic so cannot advise.

cate148 said:

I’m type 1 have been for 7 years. I have humalog but recently my doctors has prescribed me metformin to take along side my injections. I couldn’t get on with metformin so changed it to Tesavel which I’ve had an allergic reaction. Anyone recommend a decent tablet that i can take without weight gain

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Did the doctors tell you why they prescribed you metformin.. that piece of info could maybe be helpful?

Many of us are on both Metformin and insulin as HCPs tend to prescribe it for it's other protective properties and some think, wrongly, that it has a great effect in reducing BS. If you put on weight when on insulin then you need to reduce the carbs as they are the main cause of weight gain. Metformin won't help with that other than by a miniscule amount.

cate148 said:

I couldn’t get on with metformin so changed it to Tesavel which I’ve had an allergic reaction. Anyone recommend a decent tablet that i can take without weight gain

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These two drugs act in different ways.

Metformin reduces the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin.

The active substance in Tesavel, sitagliptin (Januvia), is a dipeptidyl-peptidase-4 (DPP-4) inhibitor. It blocks the breakdown of 'incretin' hormones in the body. Sitagliptin also reduces the amount of glucose made by the liver, by increasing insulin levels and decreasing the levels of the hormone glucagon.

So it's not just a case of swapping one pill for another.

I was surprised to learn through my research that Gliclazide also provides some CVE friendly support similar to Metformin. This may be due to its benefits which are mainly for T2DM, and is not yet prescribable for T1D or other insulin dependants.

By the same token I am taking Gymnema Sylvestre which is a herbal supplement that also is claimed to have CVE protection. Again it is better suited for T2DM, and is also not recognised by the medical profession, but has an extensive track record on the Asian Continent. As with all herbal remedies, Caveat Emptor since quality control is not always to the fore, and some suppliers are better thn others. There are no scienctific studies covering its use so the evidence is anecdotal.

There are other supplemt type pills on the market that also make these claims, but with weaker anecdotal support for those claims. I do not use them so cannot comment further.

I think that the problem for T1D is that these 'alternatives' are basically T2D meds, and operate on the pancreas so like all claims for 'protection;' then there is no upfront proof that they work. It requires long term studies to be carried out and generally requires ambulance following to make the connections to CVE. It also requires larger scale data collection than most meds so is not often covered. It helps that in the UK now, new drugs entering the market only get their licences when they have provided evidence of safety for heart conditions, something that came into the selection process following the Avandia / Actos scandal.

Berberine extract and milk thistle extract also has research that shows they have similar effect to metformin. This is just for interest sake and not a medical advice.