Concerned with diabetes drugs

[justism91]

Hi guys,

As some of you might have heard somewhere or from someone, there seems to be many articles and speeches by doctors informing the public that type 2 diabetes drugs such as metformin are doing more harm than good. They claimed that these drugs are only treating the symptoms and not the root cause of diabetes.

Can i just have some insight on this? To cut the story short, i was diagnosed with type 2 earlier this year in august. Started to take 1000mg of metformin and 100mg of sitagliptin daily in september till present. I have to say that the drugs have effectively lowered my blood glucose be it fasting or post meals. Just that my concern now is whether it is dangerous to continue them or should i find ways to come off the drugs completely.

Best Wishes & Regards,
Justis

 

[ziggy_w]

Hi guys,

As some of you might have heard somewhere or from someone, there seems to be many articles and speeches by doctors informing the public that type 2 diabetes drugs such as metformin are doing more harm than good. They claimed that these drugs are only treating the symptoms and not the root cause of diabetes.

Can i just have some insight on this? To cut the story short, i was diagnosed with type 2 earlier this year in august. Started to take 1000mg of metformin and 100mg of sitagliptin daily in september till present. I have to say that the drugs have effectively lowered my blood glucose be it fasting or post meals. Just that my concern now is whether it is dangerous to continue them or should i find ways to come off the drugs completely.

Best Wishes & Regards,
Justis

Hi @justism91,

As you know -- we can't really give medical advice.

However, I wouldn't really be concerned about the metformin. It seems to be a good drug with few side effects if you can tolerate it. It works by decreasing gluconeogenesis in the liver, increasing insulin sensitivity and slowing the absorption of food. You may want to get your B12 levels checked after a while though as it can interfere with B12 uptake.

Sitagliptin works in a different way by increasing the production of insulin in your pancreas. Some argue that this is not necessarily a good thing because it may stress your pancreas too much and reduce its ability to produce insulin in the long term. Furthermore, there seems to be some evidence that higher insulin levels in themselves are harmful (Type 2s often tend to have too much insulin already even without the effect of insulin-raising medication). I personally tend to agree that the stress on the pancreas and high insulin levels are important problems. Another issue is that you can experience hypoglycemia with Sitaglyptin.

So, if you were able to reduce your blood sugars through diet (and maybe exercise), that would be a good thing. You have to be careful, however, if you are taking a drug that increases insulin production, as you do.

Only do this under medical supervision. The effect of lowering blood sugar through diet and the effect of lowering blood sugar through Sitagliptin might easily combine to a blood sugar level that is too low. This can be dangerous.

If you choose this route, a low-carb higher, healthy fat diet is probably the best way to go. It definitely helped me to get my blood sugar levels down to a normal levels and lose all medication.

Please ask any questions you may have. There are lots of knowledgeable members on this forum, who will be glad to help.

 

[Pinkorchid]

I only take 500mg of Metformin a day but even if I took more I do not think I would have any worry about it harming me. Look around enough and you can always find negative and positive views about everything so we have to decide our self what we believe

 

[Art Of Flowers]

At diagnosis my HbA1C was 99 or 11%. Now it is 43 or 6%. 1000g Metformin can reduce HbA1C by about 1%, so would not have reduced my blood glucose down much. The way I reduced my blood sugars was to cut out high carbohydrate foods such as breakfast cereals, bread, potatoes, rice and pasta. I and stopped drinking fruit juice and cut out fruit such as bananas and grapes.

A low carb diet is far more effective in reducing blood sugars than drugs like metformin.

Getting a blood glucose meter is crucial as it allows you to find which goods spike your blood sugar. You want to be no higher than 8.5 two hours after eating. On ce your HbA1C levels drops you can consider reducing your medications. Discuss with your diabetes nurse. After my HbA1C dropped to 59 I reduced my Metformin to 1x500Mg a day and once I got down to 44 I stopped Metformin. Since then my HbA1C has dropped further to 43, so I no longer need the medication to reduce blood glucose. My blood sugar reading are now getting lower, so I expect my HbA1C will be below 42.

The problem with drugs like Sitagliptin is that it can lead to hypos if your blood sugars are too low. They you need to contact the DVLA and may not be able to drive your car. If you find you are getting hypos or very low blood sugars, then you need to reduce your dosage of Sitagliptin and inform your GP.

 

[justism91]

Wow guys. Thanks for the information. True enough. I take sitagliptin in the morning and at times, after my lunch, my blood glucose would go as low as 4.7. Which is pretty low for a post meal reading. I would talk to my doctor soon about this.

 

[Deleted Account]

The problem with drugs like Sitagliptin is that it can lead to hypos if your blood sugars are too low. They you need to contact the DVLA and may not be able to drive your car.

As I have type 1 and have no choice but to take insulin, I am very aware of the risk of hypos and the need to inform the DVLA. However, this in itself does not result in not being able to drive my car. The DVLA limit my driving license to three years and I need my doctor to agree to renew it. I also have to declare if I have a severe hypo which is one where I need someone else’s help to recover. It is only having experienced severe hypos which would result in my license being taken away. It is not the fact that I may get a hypo.
There are also rules about taking a BG reading and ensuring it is above 5 before driving which is sensible.

 

[Guzzler]

I have not seen or heard of any speeches/articles on the dangers of Metformin. It is considered a safe drug. Having said that, *all* drugs carry a risk but this has to be weighed against the benefits. You pays your money...

 

[Grateful]

Hi guys,
Can i just have some insight on this?
Justis

I will try, with the caveats that (1) like you I was diagnosed relatively recently and (2) I have no professional medical knowledge.

At diagnosis in February of this year, my A1C was 8.3%. At the time I did a fair amount of research about diabetes drugs. Metformin was discovered in the 1920s and has been available on prescription in France and the UK since the 1950s, and in the USA since the 1990s. It thus has a longer "pedigree" than probably any other routinely prescribed diabetes drug. (Not counting insulin, which isn't really a drug, but rather a natural hormone.)

While Metformin does have side effects, which are severe for some people, it does seem to be among the safest of diabetes drugs. The two "drawbacks" that emerged from my research were: (1) in controlled studies, it "only" reduced HbA1c by about 1 percentage point, and (2) like many diabetes drugs, it exposes you to the danger of "hypos" although considerably less than many of the other drugs.

I was lucky that my doctor put me on a low-carb diet with no medicine, plus an increase in daily exercise, and the HbA1C dropped to 4.9% within six months. He was ready to put me on a drug, probably Metformin, if the diet/exercise had not worked.

I may have missed it in your posts: What was your HbA1C at the time of diagnosis? When I was diagnosed, my doctor said something like, "If your reading had been 12 percent or something like that, I would probably have put you on diabetes meds straight away." So the context is important. (Having said that, some people get great results solely with diet/exercise, and no meds, even if they started out with a relatively high HbA1C. We are all individuals and our bodies react individually.)

Good luck with it all, and well done for already lowering the BG! You were diagnosed only a couple of months ago and now is probably the best time to experiment with diet/exercise as a way of lowering, or (maybe) eliminating the dependence on meds.

 

[Art Of Flowers]

All drugs have possible side effects. Metformin has some well documented side effects. See https://www.sepalika.com/type-2-diabetes/metformin-side-effects/

Diarrhoea is the most common side effect and many people have to stop taking Metformin because of this. I experienced tingling in my hands and started to take Alpha Lipoic Acid as a result. I also experienced brain fog from Metformin, so I was keen to stop taking it as it was affecting my memory.

 

[kokhongw]

Jenny Ruhl's Blog "Blood Sugar 101" is a good place to start reading up on Type 2 diabetes...
http://www.phlaunt.com/diabetes/18217337.php

And specifically you may want to read up on concerns about DPP4 inhibitors.
http://www.phlaunt.com/diabetes/18538604.php

 

[kokhongw]

I take sitagliptin in the morning and at times, after my lunch, my blood glucose would go as low as 4.7. Which is pretty low for a post meal reading.

For newly diagnosed T2D, typically we are still able to produce significant amount of insulin, inspite of having up to 80% dysfunctional beta cells. Understanding this is why some of us chose to try the route of a low insulin diet to preserve our existing beta cells and hopefully set the conditions for some of them to be re-awaken...

 

[Guzzler]

I will try, with the caveats that (1) like you I was diagnosed relatively recently and (2) I have no professional medical knowledge.

At diagnosis in February of this year, my A1C was 8.3%. At the time I did a fair amount of research about diabetes drugs. Metformin was discovered in the 1920s and has been available on prescription in France and the UK since the 1950s, and in the USA since the 1990s. It thus has a longer "pedigree" than probably any other routinely prescribed diabetes drug. (Not counting insulin, which isn't really a drug, but rather a natural hormone.)

While Metformin does have side effects, which are severe for some people, it does seem to be among the safest of diabetes drugs. The two "drawbacks" that emerged from my research were: (1) in controlled studies, it "only" reduced HbA1c by about 1 percentage point, and (2) like many diabetes drugs, it exposes you to the danger of "hypos" although rather less than many of the other drugs.

I was lucky that my doctor put me on a low-carb diet with no medicine, plus an increase in daily exercise, and the HbA1C dropped to 4.9% within six months. He was ready to put me on a drug, probably Metformin, if the diet/exercise had not worked.

I may have missed it in your posts: What was your HbA1C at the time of diagnosis? When I was diagnosed, my doctor said something like, "If your reading had been 12 percent or something like that, I would probably have put you on diabetes meds straight away." So the context is important. (Having said that, some people get great results solely with diet/exercise, and no meds, even if they started out with a relatively high HbA1C. We are all individuals and our bodies react individually.)

Good luck with it all, and well done for already lowering the BG! You were diagnosed only a couple of months ago and now is probably the best time to experiment with diet/exercise as a way of lowering, or (maybe) eliminating the dependence on meds.

I have never heard that Metformin causes hypos, not when it is taken alone and I've never heard of people on bg lowering drugs or those on insulin blame the Metformin. Could you tell me where you read that, please?

 

[Grateful]

I have never heard that Metformin causes hypos, not when it is taken alone and I've never heard of people on bg lowering drugs or those on insulin blame the Metformin. Could you tell me where you read that, please?

It's in the Wikipedia article on Metformin: "Metformin has a lower risk of hypoglycemia than the sulfonylureas, although hypoglycemia has uncommonly occurred during intense exercise, calorie deficit, or when used with other agents to lower blood glucose."

 

[Guzzler]

It's in the Wikipedia article on Metformin: "Metformin has a lower risk of hypoglycemia than the sulfonylureas, although hypoglycemia has uncommonly occurred during intense exercise, calorie deficit, or when used with other agents to lower blood glucose."

The caveats speak for themselves, don't you think?

 

[Grateful]

The caveats speak for themselves, don't you think?

Yes. To address your concerns I have edited the original post so that it now says: "... like many diabetes drugs, it exposes you to the danger of 'hypos' although considerably less than many of the other drugs." (The changed word is in boldface.)

 

[Resurgam]

The combined effects of Metformin and Atorvastatin made me think that life was not worth living - for me the danger from the treatment was not caring if I lived or died.
I was in no danger from the diabetes, by the way.

 

[letstalk1]

Just like any other topic in the world going on now - dont believe everything you hear or read , I take 1,ooo mg Metformin with no issues and do low carb eating if I dont take metformin my bs is too high ANYWAY- im T2 and staying on metformin

 

[DCUKMod]

@justism91 - Welcome to the forum.

I'm sure you will learn from reading the forum that there are almost as many opinions on things on here, as there are members. We each form our own views over time, and I have no doubt you will too.

When I was diagnosed with T2, I took a bit of time to see how I could learn to manage my condition without any medication, and I was both lucky and fortunate that went well for me.

At a local Diabetes UK meeting, last month, our local Endocrinologist did a bit of a Q&A, and one of the questions asked was "When will we see something to update and replace Metformin?"

His response was that although Metformin came into use almost 100 years (100 years!?!!) ago, it has shown itself to be a very safe and useful drug for the vast majority of those prescribed it. Of course, some experience side-effects, but few of those are dangerous, they tend to be mainly uncomfortable and inconvenient. When I use uncomfortable and inconvenient it makes no judgement on it's impact on any given individual.

Metformin mainly helps our bodies use our own natural insulin a bit better.

To be honest, managing diabetes is about balance. Balancing what we eat and drink. Balancing any medications we take for maximum benefit from minimum does, and at the same time living a good life with our friends and family.

Some don't need any pharmaceutical help, some need more and some a bit less than others. What I need is unimportant to you. You need to take a bit of time to find your balances. Do your own reading and research. If you don't have a testing kit, please investin one, and use it's feedback to inform your decision making.

Good luck with it all.

Good luck with it all.