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Do I start on metformin?

Discussion in 'Newly Diagnosed' started by Lofty 2, Feb 27, 2018.

  1. Lofty 2

    Lofty 2 Type 2 · Newbie

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    I have recently been diagnosed with diabetes and given a script for metformin. I have a series of tests over the last few years showing pre-diabetic results with HbAlc of 6.0-6.4 and then a recent bump to 7.2 mmol/mol.

    I have purchased a blood glucose machine and started testing and trying to understand the results. For example yesterday, the results were:

    8.00am.....8.9 mmol/L Fasting
    10.20am...7.2 mmol/L Breakfast 8.30am 2 x shortcut bacon slices, 1 egg on mountain bread (35cal 6.75g carb)
    2.15pm.....8.2 mmol/L Lunch 12.30pm chicken tender, 1/2 battered fish and salad
    10.35pm...5.8 mmol/L Dinner 7.15pm Chicken and veges
    10.40pm...6.3 mmol/L Checked 5 mins later

    My fasting BGL has varied between 5.8 and 7.6 mmol/L. The 8.9 was a surprise. I did some reading and it could be the reported Dawn effect and a residue of the previous night. This would make sense as the last thing I ate before going to bed the previous was a chip sandwich ... OK yes I succumbed to temptation.

    My GP who is not available for 2 weeks said I could go on metformin now but if I am getting constantly over 8 fasting then Metformin is a must.

    I have been resisting going on metformin as I have a started a significant weight loss and exercise program and hoping to get the BGL down. I have lost 8kgs and my exercise and activity levels have increased markedly.

    I appreciate advice on whether I should consider starting on metformin or delay the start.

    How easy is it to come off metformin if BGL follows weight down?
     
  2. paulus1

    paulus1 Type 2 · Well-Known Member

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    totally up to you it can assist a little in weight loss and lower your resistance.
     
  3. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Taking Metformin or not is entirely up to you. It may help you, but using your meter before eating and 2 hours after first bite then acting on the information it gives you will help more.

    However, if you want to improve your levels you should have a close look at your diet and see where that can be improved. The battered fish could go, and that would help. (or scrape the batter off and eat the flesh) and of course you already know the chip butty was a bad idea.

    Tagging @daisy1 for the useful information she gives to newcomers.
     
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  4. Daibell

    Daibell LADA · Master

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    Hi. Metformin can be stopped at any time as it's not addictive etc. It's your choice but it won't do any harm but won't help a lot either. I still take it after 15 years with my insulin. If it gives you bowel problems either tolerate it for a week or two or ask for the Slow Release (SR) version. BTE the morning reading probably was the dawn effect.
     
  5. daisy1

    daisy1 Type 2 · Legend
    Retired Moderator

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    @Lofty 2

    Hello Lofty and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will help.


    BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

    There are two approaches to controlling your carbs:
    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic.

    Note: This post has been edited from Sue/Ken's post to include up to date information.
    Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
  6. Phoenix55

    Phoenix55 Prediabetes · Well-Known Member

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    The best advice is to read around about Metformin and the way it works and make up your own mind. Are you prepared to make a permanent change to your lifestyle? Then clear the larder of high carb foods so that the chip butty is not a temptation! Perhaps suggest to your doctor that you try 3 months of diet and exercise and if your bg has not improved then try the Metformin. Make sure you keep a record of test results so that you can show that the levels are dropping, bearing in mind that HbA1c is a record of high bg over the last 12 weeks so any improvement may not be fully appreciated from the test.
     
  7. gardengnome42

    gardengnome42 Prediabetes · Well-Known Member

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    Might the best idea be to try diet first. By that I mean low carbing. I'm not an expert like many people here so that might be wrong thing to suggest. However I am firmly of the opinion that drs shell pills out before giving life style changes a chance. They prescribe Metformin and still advocate the high carb/low fat diet which has been proved not to work. Just my opinion
     
  8. Goonergal

    Goonergal Type 2 · Moderator
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    I went the medication free route, so can’t comment on Metformin from personal experience, but from what I’ve read on here and elsewhere, I don’t think that it is a substitute for an improved diet. It seems to be a safe drug which has a small impact on blood glucose control, but may have other benefits such as supporting weight loss. For some the side effects are too much.

    However, taking it or not, diet is going to have the single biggest impact on your control.

    Good luck - and keep posting. It does help with motivation.
     
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  9. Lofty 2

    Lofty 2 Type 2 · Newbie

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    Thanks all. I purchased the metformin but have decided to hold off. I'm currently basically trying to understand what's going on.

    Firstly, that 8.9mmol/L was an exception. Since then I have had then following: 8.2, 7.6, 7.7, 6.1, 6.2, 6.5, and 5.7. I am going look to control it by diet and see what happens. It's a bit of a learning curve because some foods with carbs are obvious, others less so. I'll some further questions soon. :)

    Thanks
     
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  10. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Dawn phenomenon was a bit of a problem for me, but once I got a few months into low-carbing it calmed down some. I'm still between 5 and 6 in the morning, but no higher than that. It just got better with time and continued diet. You can hold off on the metformin for a while, (till your next HbA1c?) just try diet, see what it does. Good luck!
     
  11. AFM

    AFM Type 2 · Member

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    I hate to be a spoil sport but we all start diet and low carbs, but over time we start on tablets, and then we go to insulin which I have, as diabetes is an illness that has no cure, only continued diligence as we get older
     
  12. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    This is what doctors tell us because it is mostly what they see in their surgeries. It doesn't appear to be the case with people on this forum. There is no cure, but that does not mean we will progress through all the pills and then insulin. In fact many forum members reduce their medication, and some have come off insulin.
     
    • Agree Agree x 2
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