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Does Metformin Make a Difference?

L

lauren_rp

Member
Messages
7
Hi all,

I am type 2 with severe neuropathy and have just started regularly testing my glucose levels, my previous DN did not advocate testing and I was happy as long as my results were good.

My symptoms have got slightly worse over the last year and my latest HBA1C was 9.6, (previously I have been around 6.3 for four years). My meter has gone from everything from 6.8 up to 24 in the last couple of weeks and I am terrified of sustaining further damage.

My DNS, who was very helpful and informative and encouraged me to continue testing, has increased my Metformin from 2 x 500mg to 3 x MR per day. Will this make enough of a difference to my levels or should I be enquiring about a different drug? I am also following a strict diet but I have really been astounded by the huge fluctuations in my levels. Normally I would rather not take more medication to solve the problem but these levels seem really high especially in light of the fact I already have bad complications.

All advice greatfully received

Many thanks
 
Writing from a purely personal point of view Metformin does not seem to make any difference to my blood sugars at all. Usually if I mention that on here the Metformin supporters chime in and say that I am ignoring the evidence that there are other benefits down the line but I am not clear exactly what they are. In my own case this is an unprovable benefit since when I (eventually) die there will be someone who says, "I told you to take the Metformin".

Joking apart I think you will find that even the people who support Metformin will agree that it does not do very much for blood sugar levels.
 
Perhaps time to consider additional meds that lower BG levels. Gliclazide or similar. I believe metformin by itself does not lower blood glucose levels but does provide other benefits. I also take metformin and, wrong as it is, don't really know why ! You've just prompted me to find out more ;-)


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I've been taking metformin since 2005 and testing my BG regularly since I started taking it and, yes, it does make a difference. Even missing one dose makes a difference for me.

Having said that, I went through a period of about six months where metformin seemed to stop working. I was getting unexpected highs and lows and was at a loss as to why. First the endocrinologist agreed that I should go from 1500 mg of metformin to 2000, which helped much less than expected, and I was also showing some symptoms that could be attributed to nueropathy so my diet and meter readings were brought into question.

What was eventually found, thanks to my research and insistence on a test, was a b12 deficiency. Ironically, a side effect of taking metformin long term. Anyone who has taken metformin for more than four years or has signs of neuropathy should be tested to rule it out. A few weeks after starting B12 and calcium supplements and my blood sugar levels were back to where they should be and all the symptoms that were thought to be nueropathy were gone.

Ask for a B12 test, it could be that your GP is overlooking something that could be easily treated simply because the majority of the symptoms are indistinguishable from complications of diabetes.
 
Metformin at the maximum (2000 mg per day) dose only reduces levels by 1- 2 mmol, so won't make much difference at the levels you are experiencing. There are other meds that can be added. Gliclazide, Sitagliptin are tablets, there are injectables such as Byetta and Victoza.
 
I have been on metformin since I was diagnosed and over the years increased to the max of 3000 mg (6 x 500 mg tabs a day) and recently it could not control the BS enough and was put on gliclazide 80 mg a day and it has a vast improvement on my levels.

Also been on B12 injections for several years now, as I was suffering from minor memory problems, thankfully my neuropathy is very minor, at first was treated by an epilepsy medication and now being treated by a antidepressant.
 
Squire Fulwood said:
Writing from a purely personal point of view Metformin does not seem to make any difference to my blood sugars at all. Usually if I mention that on here the Metformin supporters chime in and say that I am ignoring the evidence that there are other benefits down the line but I am not clear exactly what they are. In my own case this is an unprovable benefit since when I (eventually) die there will be someone who says, "I told you to take the Metformin".

Joking apart I think you will find that even the people who support Metformin will agree that it does not do very much for blood sugar levels.
Click to expand...
I am with you on this one squire, I am on metformin, gliclazide and byetta, and I have done some tests, like stopping my metformin, and it does very little to my bs levels, but if i stop any of the other 2, i go hyper, i am on 2000mg metformin, 320gm gliclazide and 20micro grams byetta daily

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My understanding is that Metformin helps the body to use the insulin you produce more effectively.

I notice you say your following a strict diet, but you don't say what sort. If your not reducing your carbs already, that may be something to consider. I can't touch bread, rice, pasta or potatos. If I did I'd prob be seeing the high numbers you get.
 
One of the symptoms of PCOS is insulin resistance and metformin is one of the best treatments for that. PCOS is a complex endocrin condition and metformin is by no means a cure, but restoring a more normal state to glucose metabolism through diet and metformin can reduce other symptoms and for some help to restore their fertility.

Insulin resistance is also feature of T2 diabetes. Metformin helps your body to use the insulin it can still produce by reducing insulin resistance which reduces the stress on your pancreas. Eventually your body loses the ability to produce enough insulin, that happens faster if the insulin resistance isn't treated. When you reach the point where your body can't produced enough insulin eventually even metformin will stop being effective. That's when the medications that increase insulin production or insulin injection become necessary. Interestingly, T1 diabetics can also become insulin resistant.

Studies have shown that starting metformin in the insulin resistance phase of T2 can effectively buy time. It slows the progression of T2 and can delay the onset of the next phase of the disease and subsequent complications for up to ten years. IMHO that makes metformin worth taking and why I've been taking it for the last eight years. I'm buying myself time, and based on my family history, it's working. I am in a better state of health than any of my T2 relatives were at the same age.
That wouldn't be the case for me if I had shunned medication or hadn't asked for an appropriate level of care from my GP.

Metformin can cause B12 deficiency, but that's easily treatable. It needs to be started early and used consistently to be most effective. And it is likely that everyone who uses on metformin will eventually require other medications in conjunction or insulin at the later stages. What I do know from observing the lives of diabetic family members and from being T2 myself is that the earlier you make sensible lifestyle changes and make use of appropriate treatments, the better your outcome will be.

Diabetes is a disease where forward planning is necessary, whether it's making the choice to take medication to try to change an outcome that's perhaps 10, 20, or 30 years in the future or planning your lunch for the day to prevent a high or a hypo.
 
Hi. The simple answer is no i.e. increasing the Metformin dose will not make that much difference. I've been thru a similar scenario over the last 8 years. How old are you and are you normal or under weight? The reason I ask is to eliminate the possibility of Late onset Type 1 diabetes. Yes, there are other meds to be added and I'm on almost all of them! In the end, for me, once-a-day insulin was the answer. I think the important thing as other posters have mentioned is whether you are overweight and hence insulin resistant or like me, underweight and have a pancreas not producing enough insulin. The treatment approach is different.
 
I just want to say thank you all so much for all your comments and advice - you have really helped and given me something to think about also. So sorry for the late reply, I usually check on here everyday but have not been able to this week.

I am overweight and 34. My neuropathy started overnight and very painfully in 2008. I went into denial for about four years and shamefully am only just trying to take control. The nurse always said my hba1c is really well controlled at 6.7 and not to test. Well I feel very dissapointed in myself for turning a blind eye to it. I fell into a bad depression because of the pain which in the beginning never let up, I couldn't even sleep, it has been awful but there is some relief thanks to several different pain medications. now I am trying the low carb diet which is really difficult because I love bread, though now I see it as my enemy. My goal is to get to a normal weight and give up some of the medication I take like blood pressure etc, it does make me angry that I have created the environment for diabetes to thrive and I will always need pain meds - but I will be giving it my all from now on and hope it's not too late.

The first thing I said to the dn was that I didn't think upping the metformin would help me because my readings went really high, I even had a spike of 24 which after an hour went down to 14 - it was my own fault on that one because I slipped and had a slice of rye bread but I had no idea it would go that high. I am back in a month to see how it's going so hopefully at some point I can bring my sugars under control. I will definitely look into the B12 to see if that helps.


Again, thank you kindly for taking the time to reply to me, it is very much appreciated.
 
You would probably do well to read the Wiki article on metformin (particularly the bits closer to the bottom of the article which list its other benefits) - at http://en.wikipedia.org/wiki/Metformin
 
Hi Lauren

Weight loss is something for you to look at. That, in addition to getting better blood sugar levels, could be pointing to one of the more recent medications such as liraglutide, exenatide or dapagliflozin as they all have an effect on weight as well as blood sugar.

Hope this helps

Doug
 
Thanks Toksik and Doug, I will read the article and I will ask at my surgery to see if I would be able to try one of the medications you mention, thanks very much anything to help with weight loss would be very well received - I was told on Thursday that my thyroid needs medication and that ties in with gaining weight I didn't expect.

Kind regards
Lauren
 
Good luck with the meds, Lauren. Sorry to hear about the thyroid problem

Doug
 
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