Does Metformin really help?

[Falcon]

Been on Metformin for a year now I'm concerned that it appears to be doing very little or nothing at all. I've not lost any weight while being on Metformin and it appears not to affect my BG levels. ie my BG levels don't drop after I've taken it. I was given 2 x 500 mg (1000 mg in total) because my Hab1c was at 8.7 it then decreased to 8.1. This decrease could be explained by me returning to school after 7 weeks holiday, I have to walk around alot at school. The doc then increased the dose to 3 x 500 mg (1500 mg in total) and a couple of weeks later to 2 x 875 mg (1750 mg in total). Not wanting to take any more than necessary I foolishly enroled at a gym and attend twice a week. Immediatly my Hab1c fell to 7.0 and the BG levels I monitor averaged out about 10 down from 13, unfortunately my doc has attributed this to the Metformin and will not listen to any thing I have to say about the gym, (he is a very arrogant person). Recently the dose was increased to 2 x 500 mg twice a day (2000 mg in total) as my Hab1c increased to 7.2, again there has been the 7 week Scottish schools holiday, wonderful but lousey on the pay packet. :roll: Have to go back in Sept and get my Hab1c done again. I really feel that it is the gym controlling my BG levels and not the Metformin, which for me does have some of the inconvenient side effects.

 

[Manogwent]

Hi,I was DX a year ago and hba1c was 9.8. started off with metformin and had problems with having to run pretty fast sometimes. i asked to go on SR and that seems to be better although get the occasional hiccup ( reversed of course ). i was on 2 x 500 three times a day with 40 mg simvastatin. with SR went to 4x 500 ( 2x2 ). my fasting were still up 7 and 8's so was put on 40 mg later 80 mg glicazide which seemed to bring them down somewhat. I'm not low carbing just cutting back, changing to wholemeal etc. weight has been pretty consistent at approx 14 stone but recently put a few pounds on. no time for gym,just walk the dog as i also look after wife and work full time. i would say it has been benficial but i would like to be better. i haven't got to the stage where i am getting the other problems with eyes and feet as they tested ok. my cholesterol is down to 3.3 although it was only 4.9 on DX . Thing is GP wants to cut out glicazide to get weight of as ' he says under 7 is ok ', i argued that i wanted to get BG's lower then look at weight. Practice nurse raised eyebrows when i mentioned that getting weight off seemed more of a priority than dropping BG's. my last hba1c in june was 6.3 so am getting there. will rethink after annual review in october, love to all , peter

 

[cugila]

Hi falcon.

Metformin typically can only lower Bg levels by around 1 - 2 points, dependent on the dosage. You are not on the maximum dosage at present. The reduction could be down to a combination of Metformin and Exercise.

You don't say what sort of diet you are using, this too can have a big effect on your Bg levels.

 

[facelift]

Hello everyone I work as an auxiliary nurse on a diabetic clinic and its new to me that metformin gives protection from certain cancers, i do hope this is true but where has this information come from. I think metformin has helped me as i have more energy and do not need to base everything I do on having to sleep all the time. I hope this helps, the only thing i have found is that i struggle to loose weight, but i am in the menopause and i feel i can't cut down on carbs to much because i feel light headed if i don't have solid foods with some bulk to them. Any tips or help will be gratefully received.

 

[cugila]

Hi facelift.

I think that information about protection from certain Cancer's is off the internet. The person mentioning it may have provided a link ? I don't think it has been proved, it may well be only a theory. Do a search on it.

As for losing weight, if you can cut down on the carbs it will benefit you greatly in reducing Bg levels and also has a knock on effect of helping with the weight loss. Portion sizes are also another big factor in losing weight.

Do you test your Bg levels throughout the day ? This can have an effect on you with regards to light headedness ? Depends on your levels ? Of course there could also be many other reasons, which means you should discuss this with your GP.

Much of the advice you get here MAY or MAY NOT be the same advice you would get from your Diabetic Clinic ??? So if you are not sure about something, then please just ask.

 

[susana]

hi am susana, i have diabetes type II, since march 2009, i started taking metformin, straight away and glicazide, metformin, 4x 500 and glicazide 3x 80. i realise that i lost a lot of weight in 3 weeks, and also, my thirsty stop, ( i was drinking up to 4 litres of water a day to the point of being sick), my blood sugar took up to 3 months to get normal, but with a lot of side effects from glicazide, a lot og hypos, eventually the doctor reduce the metformin and took me off the glicazide,
i do believe the metfromin does helps and improves a lot
at the moment am on metformin 2x500 and januvia

susana
london

 

[hanadr]

Jas
Progressing to Insulin is NOT in evitable. My gp said this to me too, but my DSN says she thinks it most unlikely as my HbA1cs are dropping( last one 5.4% this month) and I'm cutting back on medication.
If you eat plenty of carbs and use proressively more medicines, It will definitely happen

 

[metallurgy]

Hi,

I was put on metformin about a year after I was diagnosed and being diet only did not work. I was overweight, but it did nothing towards diminishing my appetite or increasing weightloss. So clinic after clinic, the dose was increased until I was on maximum dose. Two days later Whoops - I was bowel incontinent.

My GP told me never to take it again and In consultation with the hospital I was put on insulin - one of the best things that happened as it is easy to use, convenient and patient controlled. I have had no problems with it at all and was at my happiest and healthiest on it.

Fast forward a decade and we have a new consultant at the local hospital. He thought that I should take less insulin and would achieve this by putting me on Metformin SR. He felt this slow release form would take up the slack.

Whilst on the SR version I was so overwhelmingly tired I would fall asleep anywhere at anytime. As a direct result my job was endangered and my marriage was disintigrating. All the tests showed nothing. Visiting the GP I again I saw a clued up locum who knew that this version of Metformin can cause Vitamin B12 deficiency.

OK the Metformin SR was working and my insulin dose had decreased but I was having quarterly Vit B12 injections too The wonderful consultant thought it would be a good idea to decrease the insulin more and incresed the Metformin doseage 100%. Whoops, we were back to incontinence. At this point I changed consultant.

Nearly 3 metformin free years later I have not needed the Vit B12 injections. However, it has caused severe acute pancreatitis that nearly killed me, erosive gastritis, bulbar and erosive duedenitis and I am being investigated for Crohn's Disease and/or pancreas failure.

So please be aware that for some of us this can be a devil drug. :evil:

Sue

 

[paulineshep]

Hi i have been on metformin for over 19 years and it done nothin form me but if your saying it causes stomach problems i need help because ive got ulcers 2 types of them also i can never go to the loo im on all sorts to make me go to the loo so i would love to no who says it makes you slim cos ive been over weight for 30 odd years i have been slimming every day ive even had surgery to remove all the flab but im back to were i started i also take lots of other medication i take 2 more types of diabetic pills but i think my doctors are rubbish they never listen just send me away sayin take another pill and if that dont work come back and we will give you another so can any one help me out there id love to no also is there any one on this site who is looking in to all of our problems like a Doctor or some one who knows about all the problems a diabetic has thanks P)))))))))))))))))))))))))))))

 

[ChrisSamsDad]

2. Metoformin should be taken before or after food, any later and it is not worth taking it.

Errr, surely anytime of the day or night can be said to be 'before or after food'?

 

[Dalekkiller]

2. Metoformin should be taken before or after food, any later and it is not worth taking it.

Errr, surely anytime of the day or night can be said to be 'before or after food'?

Strictly speaking, yes but Metformin needs to be taken within 20 min either side of eating as it has an effect on the absorption of the food. Therefore, if you take it outside of this window, it won't have any effect (apart from probably giving you its usual gastric problems).

 

[jenrose]

A couple of months after diagnosis the doctor prescribed me 2 x 250 mg metformin for a couple of weeks, and then 2 x 500 mg metformin. At that time he advised me to get a blood glucose monitor and I was prescribed strips (which I do not get on prescription any longer). When I first began the 250 mg tablets my pre breakfast bg reading was about 9.00 mmol/l but a couple of weeks after beginning the 500 mg tablets my pre breakfast bg reading went down to 7.0 mmol/l . As I waited to see the dietician I followed the advice of the Diabetes Uk literature I was given by the doctor I saw when I was diagnosed with type 2, then I saw the dietician about 3 months later and there was not much change in diet then. I would say the Metformin made a difference. I found out that although I had cut down carbs that I could cut down further and this has helped lower to my Hb1AC so that it was 5.8 per cent last time taking the same dose of Metformin as before. I don't know how much difference it would make if I discontinued to take the Metformin now but I do know that the effects of Metformin build up over a couple of weeks so would have to wait for more than two weeks to tell if there was much difference. I have read studies that indicate that metformin helps with regards to reducing heart attacks and cancer so continue to take them.

 

[jenrose]

I would like to add to my earlier post that I have found Metformin will bring my bg down below 4.0 mmol/l, it has even been as low as 2.9, although the nurse said that Metformin is very mild and cannot cause a hypo. This has happened after I have eaten the usual breakfast and taken the tablet as usual but have walked further than normal with the dog. It has happened more than once so I disagree with her. For this reason I would say that Metformin has an effect as this would not happen if I had not taken it. The nurse said that even she goes as low as 3.5 mmol/l - well wouldn't that be normal for someone who doesn't have type 2 diabetes? I am sure she thinks I exaggerate.

 

[carlos]

when i was placed on meterformin in febuary my bs were rangin at 19 to 21.8 after meals was taking three of the sr tabs at night since then have worked incredibaly hard on my diet and the corect amount of exsercise am now only taking one in my own opinion they do work but you cant count on theese alone i know of someone who a relative of mine knows and they were diagnosed last year they are currently taking 4 meterformin and two glizeride they do a lot of activites but they eat what they want ie bread potatoes etc so surely if the tablets alone worked this would be a prime example

 

[markd]

From the various replies, different people seem to respond differently to Metformin; some find it of great value, others far less so.

I wonder if it can be explained thusly: in T2, there are two mechanisms that lead to high BG - insulin resistance and insulin insufficiency.

Metformin works to reduce insulin resistance, so perhaps it works better in those whose high BGs are caused by that.

Those whose high BGs are caused primarily by an underperforming pancreas don't see so much benefit.

I've also read that Met causes a greater drop in BG in certain body types - particularly central obesity, as opposed to less concentrated weight distribution.

Add to this the huge variation in what we all eat and exercise and I suppose it is no surprise that there is such a variation in response!

Mark.

 

[chrishxx]

I'm new here and find this Metformin thread really interesting and it might help me to get a few things off my chest, so forgive me if I rant on a bit! Im a 64 year old male and I was diagnosed T2 in October 08, BG 14.5, cholesterol up to 8.9 (2 yrs ago only 3.9!). I was given 2 X 500mg Metformin and have to say I've had none of the unpleasant side effects reported here (tiredness, gastric problems etc.) I'm not saying I've had NO side effects from Metformin, but it's hard to know sometimes where side effects come from, or even whether they are entirely unrelated to the medication. I should add that I've been on medication for hypertension for 15 yrs now, and on diagnosis with T2 my consultant changed me from Atenolol to Perindopril 4mg as he said Atenolol was no longer the drug of choice.

Betweeen October and Christmas my weight went down from around 15 stone to 13 st 7lb, where it’s stayed until now. Of course, the initial shock of learning the diagnosis incentivised me to be strict about my diet: no sugar in tea or coffee; no biscuits or cakes; no puddings or ice cream; less carbs etc. However in the last couple of months, with BG stable at around 6.5 and HBA1c 6.0 at the last count and cholesterol back down to 6, I have inevitably ‘relaxed’ my dietary constraints, although nowhere near my original sweet tooth diet!

So far, so good; but at my follow up consultation the dreaded statin question arose. I said that I knew there had been bad press re statins and that I had friends who'd suffered bad side effects. Consultant completely waved aside any negative views - 'trials had shown 25% less risk of heart attack, 40% less risk of stroke etc etc'. I wasn't convinced and although I got the prescription I didn't take them until 3 months later when my GP got onto the same bandwagon, so I relented and took them (Simvastatin 20mg) for about 3 weeks. At that time she changed my Perindopril for Ramipril despite my protestation that the Perindopril seemed to be doing the job. Night sweats, muscle aches and pains and generally feeling bad seemed to indicate I should have been more insistent to stay on the original medication. I have subsequently seen a different GP at the practice and had it changed back to Perindopril although at a higher strength 8mg, and I still haven’t started back on the statins – but I still have muscle aches and pains and a sore ankle, which feels like some kind of nerve inflammation.

So, where do I go from here? Do I just carry on with the medication and just hope that the side effects diminish with time, or do I knuckle down and be really strict about my diet? Or could it be that I need to drink NO alcohol instead of the rather lower intake I have managed to stick to compared to what I drank before – I just can’t resist that small glass of malt whisky after a stressfull day at work!

Sorry to go on at length like this, but I’ve been bottling it up for some time now – any observations/constructive criticisms gratefully received.

 

[Andy A]

Interesting reading, I was diagnosed Type 2 in December last year first HBA1C was at 8.2, and was prescribed 3x 500mg Metformin a day along with a statin, after suffering various symptoms, light headedness and gastric problems (which I still have) muscle pain and visual disturbances the statin was removed.

Since diagnosis I think I've worked fairly hard at changing my diet and lifestyle, although I never had a sweet tooth I did used to consume a lot of starchy carbs looking back so I've heavily reduced carb consumption, resulting in my last HBA1C of 5.8 and a 3 stone weight loss so far, although this now appears to have plateaued and the gastric problems and light headedness still persist (the gastric side is a slowdown as opposed to the speeding up that most have reported), which my doctor now wants to see if the Metformin is responsible for by stopping me taking it for a 2 week trial period, which it would appear isn't a long enough period for it to clear my bloodstream, also I notice that the majority have been told to take Metformin with or after food, I was told to spread my 3 tablets evenly throughout the day, ie early morning, early afternoon and last thing at night, having stopped taking them 2 days ago theres no difference in my bg when tested which I'm doing heavily, so I guess its a case of suck it and see...

 

[Annjay]

I was diagnosed with Type 2 diabetes about 3 months ago and told I was 'on the cusp' by the Diabetes Nurse at our local GP surgery. Since I eat a very healthy diet and am a Gym Rat, I was horrified by the news, but gather that it is because I have COPD which is a systemic disease and can cause other body parts to stop operating effectively.

My Hb Ac1 was 6.5 before I was put on Metformin. After 2 weeks of taking the prescribed one a day pill of 500 mg, I was feeling really ill, faint and dizzy. I had asked if I could monitor my blood sugar but was told airily, that it wasn't necessary. I tried to get an early appointment with a doctor or the nurse but had to wait a week, so I decided to halve the pill and within 24 hours felt a whole lot better, so I assume that 500 mg was too much and was causing my blood sugar to drop. I have spoken to both a doctor and nurse since who grudgingly said that they supposed it was ok to halve the dose.

Has anyone else experienced this, please?
Cheers - Annjay

 

[jenrose]

Those symptoms sound like a hypo but they could also be down to a 'false' hypo. A false hyp is where you have symptoms the same as being too low but because a person has had high blood glucose over a long period of time when blood sugars drop to what would be a good blood sugar number produces a false hypo. It is a horrible feeling and I used to get false hypos at 5.0 mmol/l when I first began taking Metformin but over time I feel fine at 5.0 and don't have a hypo type feeling until I go below 4.0 mmol/l. You would only know for sure how low you are going by using a meter. I buy my own strips as I would rather know. I noticed that you said you were a gym rat and I wouldn't be surprised if you were really going too low knowing that I do when I walk further than usual, or go weeding in the morning after breakfast. Sometimes I felt a bit odd but when tested have not been too low if I had eaten some carbs I would have spiked. I think a meter is beneficial and don't intend to go without one.

 

[Annjay]

Those symptoms sound like a hypo but they could also be down to a 'false' hypo. A false hyp is where you have symptoms the same as being too low but because a person has had high blood glucose over a long period of time when blood sugars drop to what would be a good blood sugar number produces a false hypo. It is a horrible feeling and I used to get false hypos at 5.0 mmol/l when I first began taking Metformin but over time I feel fine at 5.0 and don't have a hypo type feeling until I go below 4.0 mmol/l. You would only know for sure how low you are going by using a meter. I buy my own strips as I would rather know. I noticed that you said you were a gym rat and I wouldn't be surprised if you were really going too low knowing that I do when I walk further than usual, or go weeding in the morning after breakfast. Sometimes I felt a bit odd but when tested have not been too low if I had eaten some carbs I would have spiked. I think a meter is beneficial and don't intend to go without one.

Thank you, Jenrose, your input is much appreciated. I don't think my symptoms fall into the 'false' hypo category, since the previous Hb A1C was 5.0. I have a Day Course on Diabetes in September so I will make notes and ask questions then. Meanwhile, I feel fine on the half dose of 250 mg a day.

Have a good weekend.