Alternatives to Metformin prolonged-release

Melgar

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Hi, I’m posting this on behalf of my brother. He is on NovoMix. He takes 12 units before breakfast and 15 units before his evening meal. He was prescribed 500 mg of prolonged release Metformin, but he will not take the Metformin as it makes him ill. His hospital DN will only prescribe him Metformin, but he’s not taking it.

Is there an alternative to Metformin safe for T1’s?

Brief history, he was diagnosed T2 for a number of years. He was able to keep his blood sugars in the pre-diabetic range. Then at the end of 2020 he started losing a lot of weight and was unable to control his blood sugars. He was going into DKA with blood sugars in the 40’s Mmol/Ls) He was diagnosed late onset T1.
Any suggestion would be much appreciated. Mel
 

Melgar

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I should mention I’m just looking for alternatives so he can ask his DN.
 

Antje77

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Any particular reason why they want him to be on metformin and not just insulin if he's a T1?
 
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Melgar

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Any particular reason why they want him to be on metformin and not just insulin if he's a T1?
Not as far as I’m aware @Antje77 . It doesn’t make sense to me either. He just follows the DN’s advice. I do know that he is very slowly losing his pancreatic capacity. When you were diagnosed LADA were you on Metformin at first and if you were for how long? Thanks @Antje77
 

Antje77

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Not as far as I’m aware @Antje77 . It doesn’t make sense to me either. He just follows the DN’s advice. I do know that he is very slowly losing his pancreatic capacity. When you were diagnosed LADA were you on Metformin at first and if you were for how long? Thanks @Antje77
I started on gliclazide when first misdiagnosed as a T2.
I tested a lot so it became clear very soon that that and reducing carbs wasn't going to do the trick, so I begged for insulin a month after diagnosis.
A basal insulin brought me down but it didn't do anything about food, so another month later I begged for a bolus insulin because eating became increasingly frustrating.

I stopped the gliclazide (can't remember if I asked my diabetes nurse first) and have been on a typical T1 basal and bolus regime ever since.

Rediagnosis only happened two years later, it didn't change my treatment though except for being under the care of the hospital team instead of the practice nurse now.

I've been on metformin for 8 months, about two years ago. This was at my own request, I wanted to see if it would make a difference.
My endo didn't expect much of it but didn't mind me trying it out.
She was correct so I stopped it again.

Is your brother being seen by an endo?
The insulin he's on aren't used that much anymore for T1's, they're more often prescribed to T2's who are treated by a GP/practice nurse.
 
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Melgar

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Thanks for all that info @Antje77 . That’s great. Very useful. He’s under the local hospital here. A diabetic nurse. His GP, she was my GP too when I lived here, doesn’t have anything to do with his diabetic regime as all T1’s are managed by the hospital. I’ll pass your info onto him. His blood sugars are way too high like . I think around 15 mmol/ls average. I wish they were lower.