Fasting until 2pm. Do I still take my morning Metformin ?

[NoMoreBeerAnymore]

Hi,
I got diagnosed 3 weeks ago with a HBA1c of 120, after my annual health MOT at my GP. My BMI had got up to 35, as I have had to work double shifts the last six months and never had time to either eat properly or exercise. This has stopped because I can't do that anymore. I was breaking out in a Cold sweat every day, usually an hour after eating, and feeling extremely anxious (more than usual) and exhausted, plus I got urinary infection which was truly miserable.

So I am on a low-carb diet (mostly Mosely 800), which I am finding easy to follow. However, I am also Fasting until 2 pm because it is too much hassle to eat in the morning.

I am not having a problem with taking Metformin with coffee before work, and then keeping going until 2 pm. This should keep my circulating levels of Metformin steady, so when I do eat its not going to give me high blood glucose?

I intend to keep this going until I have a BMI of 20, having lost 5 kg already.

Is taking metformin going to stop my weight loss?


Should keep taking my metformin?

[Edited by moderator to remove emoji]

 

[Lakeslover]

Taking Metformin shouldn’t hinder weight loss. However it is advisable to take Metformin after or with food because otherwise it can cause digestive problems.

 

[LittleGreyCat]

We can only advise, but metformin is a background medication and doesn't have an instant effect if taken with a meal.
It should be taken regularly as it has a long term effect.
It is usually taken with meals to reduce the chance of stomach upsets, but if you can tolerate it there is no reason not to take it on its own.

 

[NoMoreBeerAnymore]

Taking Metformin shouldn’t hinder weight loss. However it is advisable to take Metformin after or with food because otherwise it can cause digestive problems.

Thanks for taking the time to answer my question!

So if Metformin is not causing me digestive problems, I can just keep going like I am.

My concern is that the Liver will be busy making glucose from fat (I got NASH as well) whilst I am fasting, and will keep the BG high. So keeping the Metformin circulating will allow this BG to get used up rather than making me hyper-thirsty and needing the bathroom.

 

[KennyA]

Hi,
I got diagnosed 3 weeks ago with a HBA1c of 120, after my annual health MOT at my GP. My BMI had got up to 35, as I have had to work double shifts the last six months and never had time to either eat properly or exercise. This has stopped because I can't do that anymore. I was breaking out in a Cold sweat every day, usually an hour after eating, and feeling extremely anxious (more than usual) and exhausted, plus I got urinary infection which was truly miserable.

So I am on a low-carb diet (mostly Mosely 800), which I am finding easy to follow. However, I am also Fasting until 2 pm because it is too much hassle to eat in the morning.

I am not having a problem with taking Metformin with coffee before work, and then keeping going until 2 pm. This should keep my circulating levels of Metformin steady, so when I do eat its not going to give me high blood glucose?

I intend to keep this going until I have a BMI of 20, having lost 5 kg already.

Is taking metformin going to stop my weight loss?


Should keep taking my metformin?

Hi NoMoreBeerAnymore and welcome to the forums.


I have never taken metformin, so can't speak from experience here. However, according to Bilous and Donnilly's Handbook of Diabetes, metformin doesn't itself lower your blood glucose. What it does (and how it does it isn't fully understood) is prevent your liver topping up your blood glucose from time to time from body stores.

Just to point out that we don't do taking/stopping medication advice or diagnoses on this forum. You need to discuss all that with your medical team.

What raises your BG after eating is carbohydrates (all digestable carbs, starches and sugars) being digested to glucose. You don't say whether you're testing your blood glucose levels or not with a glucometer - the NHS won't tell you to do it, although the advice you'll get from me (and from most folks here) is that it's the only way to understand how well your system can handle whatever carbs you're putting in to it.

Tagging @Rachox for the meter list

The method is to take a baseline test just before you eat, and then a second test two hours later. The second test is not to see "how high you go" - your high blood glucose point will almost certainly be reached somewhere in the first 20 to 60 minutes. You're looking for the +2 hr test to be as close as possible to the first - within 2mmol/l of the first, and not above 7.8mmol/l.

What the second test is for is therefore to show how well your system handles that glucose - how quickly it's removed from the blood and transferred to muscle tissue for fuel.

Insulin resistance - which is almost a definition of T2- can mean that muscle tissue won't allow glucose to be placed there. You don't want prolonged high blood glucose levels, and neither do you want the excess glucose being stored as fat. Sio if your system can't deal with the glucose produced, the advice is to limit that food.

This link (written by a forum member) is a good explanation. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

Best of luck. This forum is a great resource. Keep asking questions.

PS - there are decent low carb beers. Example - 1.6g carbs per 440ml

 

[KennyA]

Thanks for taking the time to answer my question!

So if Metformin is not causing me digestive problems, I can just keep going like I am.

My concern is that the Liver will be busy making glucose from fat (I got NASH as well) whilst I am fasting, and will keep the BG high. So keeping the Metformin circulating will allow this BG to get used up rather than making me hyper-thirsty and needing the bathroom.

I think it's unlikely that your liver will at this stage be using bodyfat to make glucose - because it's unlikely but not impossible that you're in ketosis (ie using bodyfat for fuel). Ketosis both lowers blood glucose (the body only makes what it needs, and it needs only around 130g a day) and uses up bodyfat. I'm in my fifth year of being in ketosis 95% of the time.

If you are, that is (in my view) a good thing as it shows that your carb intake from food is low, and that your body has started to adapt and use up bodyfat. You would be able to test for this either by using a glucometer that also tests for ketones, or by checking for ketones in your urine with "weestix".

Metformin will simply interfere with your liver adding glucose to your bloodstream. You only have about 4g of glucose in your blood at any one time, so you will still need to liver to be doing something - just not dumping massive amounts. Livers are slow learners and will have got used to a higher blood glucose level being "normal" - they will keep trying, but eventually adjust to a new lower "normal". That took me months.

 

[HSSS]

This should keep my circulating levels of Metformin steady, so when I do eat its not going to give me high blood glucose?

Plenty of people take met for in just once a day. Spreading it across the day is typically to prevent digestive upset more than anything else. It’s slow to act and slow to disappeared so a few hours one way or other isn’t going to matter if it suits you.

Metformin will not stop you going high after you eat. It doesn’t work that way. It slows down the background tops ups from the liver into the blood of stored glucose. Changing what you eat is what stops it going high after eating or taking other medications that do act directly on blood glucose.

My concern is that the Liver will be busy making glucose from fat (I got NASH as well) whilst I am fasting, and will keep the BG high. So keeping the Metformin circulating will allow this BG to get used up rather than making me hyper-thirsty and needing the bathroom.

Many type 2 have fatty livers. It’s part of the same metabolic syndrome that type 2 is part of too. At this stage it’s far more likely your liver will be burning up that unwanted fat around itself - which is a great thing to happen - if it runs out of stored glucose to use, which takes a while when it’s been well stocked previously.

Over time the liver learns to recognise that the new (better) lower levels of glucose are the normal and stops seeking to top up so easily. Sticking to low carb meals and time are what will get you there. It‘ll take months not days to get there though if you look just at fasting levels. Look at the whole day and the hba1c and you’ll see improvements there faster. Fasting in the mornings won’t slow that process down and if you do fat burn then it’ll come from the places you want to lose it most anyway.

 

[Sarah69]

Im on metformin 2 twice a day and I don’t take them with food.

 

[LittleGreyCat]

I got diagnosed 3 weeks ago with a HBA1c of 120, after my annual health MOT at my GP. My BMI had got up to 35, as I have had to work double shifts the last six months and never had time to either eat properly or exercise. This has stopped because I can't do that anymore. I was breaking out in a Cold sweat every day, usually an hour after eating, and feeling extremely anxious (more than usual) and exhausted, plus I got urinary infection which was truly miserable.

So I am on a low-carb diet (mostly Mosely 800), which I am finding easy to follow. However, I am also Fasting until 2 pm because it is too much hassle to eat in the morning.

I forgot to say "Don't Panic!".
It takes a while to get your head round what works for you in controlling your diabetes.
I certainly spent at least 6 months after diagnosis chasing around trying to work out what I should do.
It takes a while before you really get your head round long term strategies, so keep asking questions.

You certainly seem to be on the right track, cutting right down on carbohydrates.

Have you considered something easy in the morning in place of a meal?
I have coffee with butter and double cream to get the day going.
This gives a boost to good fats and takes away hunger pangs.
I can go without eating until mid afternoon if I have my morning fortified coffee.

 

[filly]

I do an extended fast 16/8 and take my Metformin after lunch.

 

[Rachox]

Thanks for the tag @KennyA , @NoMoreBeerAnymore , here’s some info with links for UK meters, and to be clear I have no commercial connections with any of the companies mentioned.



HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/



Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/



Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/





SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular:

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793



The strips are to be found here:

https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.



Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)

 

[aylalake]

I am on Metformin twice a day, and I was also concerned about the morning dose whe I started intermittent fasting.
However, I carried on taking it as usual, and I haven’t noticed any difference.