how much does metformin actually help ?

[Freema]

a lot of people in here are not using metformin and control their blood glucose by diet and excercise alone... wow

I was put on metformin right from the start but didn´t actually know anything about anything about diabetes type 2 except from that it had something to do with sugar which diabetics could not eat ....

now I think I have managed to get my number in control into the non-diabetic area... but now wonder is metformin doing its job , and how much does metformin in fact help lowering peoples blood glucose...

do any of you know more of how much in general metformin does help lowering blood glucose ?
I just read this study : https://www.ncbi.nlm.nih.gov/pubmed/9428832
http://care.diabetesjournals.org/content/35/2/446

but as I read it it seems metformin only lowers blood glucose like something in between 0.6% and 2.0% and in my eyes that is yes ridiculously little... like if one had a raise of blood glucose of 100mmol it would only lower the number by 2.0% and that would leave the person with a number of at least 98mmol then...

did I totally misunderstand the results here ... hope so but I am not that clever in reading Scientific texts...
what do you know of this ?

 

[NoCrbs4Me]

I read a paper once that said that metformin works better for people with a high fasting (i.e. first thing in the morning) blood glucose level than for people with only high post-meal blood glucose levels.

2% can be the difference between diabetic and non-diabetic, so nothing to sneeze at. Still, I would think a low carb diet would generally do more than metformin to lower average blood glucose levels.

 

[Energize]

Hi Freema

My understanding is that Metformin helps the insulin in your body get utilised better by the cells, especially if there is Insulin Resistance, which Type 2s tend to have, at least initially. I don't think it actually lowers your glucose levels as such, other than help the insulin be more effective, hence glucose levels may well drop a little bit.

 

[JohnEGreen]

It does have other benefits though, or so I have been told so if you can tolerate it it may be best to continue with it.

 

[Energize]

I read a paper once that said that metformin works better for people with a high fasting (i.e. first thing in the morning) blood glucose level than for people with only high post-meal blood glucose levels.

I would suggest that this ties in with the Metformin helping cells utilize the insulin where Insulin Resistance is present which is most evident if the 'fasting' glucose levels are high

 

[NoCrbs4Me]

I would suggest that this ties in with the Metformin helping cells utilize the insulin where Insulin Resistance is present which is most evident if the 'fasting' glucose levels are high

Yes, I think that it helps tell the liver to stop producing so much glucose when it doesn't need to.

 

[Bluetit1802]

It is of more help to those with a lot of weight to lose due to being a recognised appetite suppressant. It works on the liver helping to reduce the amount of glucose the liver produces in times of fasting, stress, illness and so on, but this "help" is to a limited extent. It doesn't do anything at all as regards reducing post meal spikes.

 

[Pinkorchid]

Metformin is also supposed to protect the heart as those with diabetes are more at risk of having heart problems. My doctor thinks it is worth taking it for that

 

[GrantGam]

but as I read it it seems metformin only lowers blood glucose like something in between 0.6% and 2.0% and in my eyes that is yes ridiculously little... like if one had a raise of blood glucose of 100mmol it would only lower the number by 2.0% and that would leave the person with a number of at least 98mmol then...

Hi @Freema, I think you may be interpreting the results wrong here...

I'm pretty sure the percentage reference is with respect to the old fashioned HbA1c DCCT units of measurement. So a reduction of 2% is actually huge.

5% (31mmol/mol) = Avg BG 5.4mmol/l; non diabetic

7% (53mmol/mol) = Avg BG 8.5mmol/l; diabetic.

That's how I'm interpreting the results anyway; I could be wrong...

 

[Freema]

Hi @Freema, I think you may be interpreting the results wrong here...

I'm pretty sure the percentage reference is with respect to the old fashioned HbA1c DCCT units of measurement. So a reduction of 2% is actually huge.

5% (31mmol/mol) = Avg BG 5.4mmol/l; non diabetic

7% (53mmol/mol) = Avg BG 8.5mmol/l; diabetic.

That's how I'm interpreting the results anyway; I could be wrong...

2% that is of a number of 6.0mmol only about 0.12 mmol i think that is hardly anything....
if one has an average blood glucose of HbA1c 50 (IFFC) then the reduction is 1.0 and the result would be an HbA1c of 49 then...

would you count that in another way ?

 

[Squire Fulwood]

It does have other benefits though, or so I have been told so if you can tolerate it it may be best to continue with it.

Yes I have heard that but in this world of evidence based information I would like to hear what that benefit is exactly. If I am to get an unspecified benefit when I am 110 years old you may lose my attention.

 

[MikeTurin]

IIt doesn't do anything at all as regards reducing post meal spikes.

From what I recall it works also against insuline suppression from fatty acids, so it should help a bit to averaging the spikes. Another effect is that reduces the colon cancer risks.
Anyway I think that if one tolerates the metformin well, there is no reason to stop taking it.
Statines and anti inflammatory drugs have worse side effects.

 

[Freema]

Metformin is also supposed to protect the heart as those with diabetes are more at risk of having heart problems. My doctor thinks it is worth taking it for that

yes thats what all doctors are tought from the medical company/ science and probably it does help but if that help of protecting the heart is like like helping 0.001% is it then worth to take the risk of not being able to uptake vitamin B12 over time and risk neuropathy just from a lack of a vitamin one would otherwise have been able to uptake....?

 

[Freema]

maybe I do not understand the way they use the percentage- this writng seems to tell of a much higher reduction, like up till 12 mmol of the HbA1c which is a lot more and something more substatial...

http://care.diabetesjournals.org/content/35/2/446

 

[GrantGam]

2% that is of a number of 6.0mmol only about 0.12 mmol i think that is hardly anything....
if one has an average blood glucose of HbA1c 50 (IFFC) then the reduction is 1.0 and the result would be an HbA1c of 49 then...

would you count that in another way ?

From the first link you provided:

"The corresponding between-group differences in glycated hemoglobin (HbA1c) ranged from 0.6% to 2.0% at dosages of 500 to 2000 mg daily, respectively."

HbA1c used to be expressed as a percentage, and I think in this example is with reference to the DCCT units of measurement.

So a 2% reduction in HbA1c is (for example) 7% to 5% or 53mmol/mol to 31mmol/mol.

From the above example, a 2% decrease in HbA1c (measured in old DCCT standards) equates to a reduction of 22mmol/mol (measured in IFCC new standards).

 

[JohnEGreen]

One thing it does do is suppress apatite and in that my doctor agrees though when I said about protecting the heart and nervous system as possibilities I had heard mentioned he did laugh to my chagrin but then what does he know he wants me to take statins that's when I laughed.

 

[Freema]

From the first link you provided:

"The corresponding between-group differences in glycated hemoglobin (HbA1c) ranged from 0.6% to 2.0% at dosages of 500 to 2000 mg daily, respectively."

HbA1c used to be expressed as a percentage, and I think in this example is with reference to the DCCT units of measurement.

So a 2% reduction in HbA1c is (for example) 7% to 5% or 53mmol/mol to 31mmol/mol.

From the above example, a 2% decrease in HbA1c (measured in old DCCT standards) equates to a reduction of 22mmol/mol (measured in IFCC new standards).

oh in that way it is a lot more... than I understood..


that would mean that my resent number of 34 / 5.8 have been helped down with about 2.0% and would have been like 7.8 if I didn´t take my metformine , if the metformin works optimally in my case ?????

 

[Freema]

i

One thing it does do is suppress apatite and in that my doctor agrees though when I said about protecting the heart and nervous system as possibilities I had heard mentioned he did laugh to my chagrin but then what does he know he wants me to take statins that's when I laughed.

It suppresses the appetite in some people not in all

 

[GrantGam]

oh in that way it is a lot more...

That's how I'm reading it @Freema; but I may be completely wrong

 

[Freema]

That's how I'm reading it @Freema; but I may be completely wrong

you are probably better at understanding this tekno-chinese than I am..