Increased symptoms after starting Metformin

Hello and welcome to the forum. Tagging @daisy1 for the info pack offered to all newcomers.

Do you monitor your blood glucose levels at home? How is your diet and have you made any changes there? If you could tell us a typical day's menu we may be able to help you tweak it a bit to aleviate your symptoms.

Have a wander around the forum and ask as many questions as you like.

I was started on Metformin immediately on diagnosis. I began needing to pee regularly, At least every hour during the day, and I would be up a couple of times during the night. At the time, I reasoned this was a symptom of diabetes, even though I had not experienced this prior to diagnosis.

In hindsight (such a useful tool, eh?) I think it was my body desperately trying to rid the drug from my system.

Metformin is well tolerated in most people and is rightly regarded as a useful and benign drug. However, not all drugs suit absolutely everybody and I began to suffer from severe breathlessness an chest/upper stomach pains which became worse over time and with increased dosage. I physically struggled to do anything.

I urge you to listen to your own body and contact your doctor if you are concerned in any way. I persevered with Metformin far, far longer than I should have.

Are you perhaps following the normal advice to eat healthy amounts of carbohydrates - which is unfortunately exactly what your body can't tolerate.
I took Metformin and a statin, and was so ill I stopped as life was not worth living.

@doesituk

Hello Doesituk 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 be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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.
  

doesituk said:

Although my symptoms (dry mouth/need to use the loo) at night had been fairly low and variable, sometimes not at all, since going on the Metformin they have increased. They are now back to the same level as when I was first diagnosed i.e needing the loo and parched mouth twice a night, every night.

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I am taking 500mg Metformin x 3 times daily but I have not experienced this problem. However I did read somewhere the advice not to take Metformin too close to bedtime, as that can lead to peeing in the night. I take mine with meals to avoid digestive problems, so I take the last one some hours before bed, and I never have to get up. I wonder if you have started on too high a dose. It is recommended to start with the lowest dose possible ie 500mg daily, or even 250mg if you can manage to cut the tablets in half. (Not a good idea if you are taking the extended release type.) Then one should increase very gradually. You might find this article by a former member of these forums help;ful: http://www.mendosa.com/blog/?p=1261

doesituk said:

Thanks Alexandra. I did reply but I did something wrong because it wouldn't allow me to post and then it did but deleted my text for some reason so here goes again.
I was started with 500mg twice a day 7 days ago. I take one with breakfast and one with evening meal so well before bedtime. Like you, nobody else seems to have reported this effect and it isn't listed in the Metformin leaflet. I also got the slight stomach discomfort but this seems to be reducing. As it has only been a week I will see how it goes over the weekend and if I continue having to run to the toilet frequently I will go see my doc again.

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It wasn't you, I too had a problem with the Forum not letting me reply to a post earlier today. In fact I did see your reply briefly, and then it disappeared. On reflection, I suspect that your dry mouth & need for extra loo trips may be a result of the higher bgs which made your GP offer you Metformin, rather than due to the drug. My suggestion is to step up your bg testing efforts for a while. You might test 2 hours after a meal, and then also 3 hours, as it is possible your bg isn't peaking at 2. Even occasionally go on testing after that to see whether your bg is coming down from the peak, or staying up for hours, which is certainly what mine tends to do.

Alexandra100 said:

It wasn't you, I too had a problem with the Forum not letting me reply to a post earlier today. In fact I did see your reply briefly, and then it disappeared. On reflection, I suspect that your dry mouth & need for extra loo trips may be a result of the higher bgs which made your GP offer you Metformin, rather than due to the drug. My suggestion is to step up your bg testing efforts for a while. You might test 2 hours after a meal, and then also 3 hours, as it is possible your bg isn't peaking at 2. Even occasionally go on testing after that to see whether your bg is coming down from the peak, or staying up for hours, which is certainly what mine tends to do.

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PS I am very much in favour of Metformin, but it can't lower bg anything like as much as low carb. You are still on quite a low dose. Many people see no change until they reach a dose of 2000mg.

doesituk said:

Firstly, thank you all for your replies.

Yes, I have a monitor but only check now and then to see how my GI is trending (say once a fortnight). Since being prescribed Metformin 7 days ago I have obviously checked a few times daily to see if there has been any change. My results before Metformin were typically 7.9 mmol/L before meal and 11.4 after. Tonight I got 5.5 before and 5.8 after a meal of bacon & egg and a few oven chips washed down with a small glass of red wine.
So the drug seems to be working.

I know i only have levels most diabetics can only dream of and I do not worry too much about it. My diet is just a normal one but avoiding all forms of refined sugar and eating less carbohydrates. We don't eat processed "ready" meals or takeaways. My doctor says my weight has not changed in the last three years and the gradual increase in my annual blood test is down to the progression of the disease.

I am just puzzled as to why, after changing my lifestyle, I did not have the symptoms which led to a diagnosis of diabetes five years ago, those same symptoms, which I thought were due to the kidneys trying to flush excess glucose from my blood should reappear when the metformin seems to have lowered my levels.

Maybe Guzzler is correct and my body is now trying to flush the Metformin out.

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It may well have been the red wine that lowered your bloods as well as your fairly (apart from the chips) low carb meal.
Your pre metformin results were fairly high but I think you need to test more frequently to really assess the impact of various foods on your blood sugar levels. the "eating to your meter" technique that a lot of us employ to avoid medication.
Are you happy to share your last few Hba1c results?

Those biscuits are about 2/3rds carbohydrate - a high carb food which is really not a good idea - not much hope of controlling diabetes if you are happy to eat biscuits.

doesituk said:

Any problem with that?

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Test two hours after and see if it is ok for you. We are all different with what we can handle and what we are prepared to reduce.

doesituk said:

Agreed. And the Metformin seems to have suppressed my appetite for them so that's good. The contradictory symptoms seem to have gone as well. Slept 6 hours last night and wasn't desperate for the loo when I awoke. No parched mouth either and bg of 6.6. so it seems the effects were just temporary. All good.
Surely we need some carbs though? They are the body's fuel so the amount you need must depend on how active you are surely? Just about to have my usual breakfast of one Weetabix, a handful of blueberries with semi skimmed and a big spoonful of greek style yoghurt (not fat reduced!). Any problem with that?

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No - carbs are not needed, they are not the body's fuel, and if you ever get into ketosis you'll suddenly find that you are turbocharged.
Your breakfast is a high carb cereal with the highest carb of all the fruits called berries, with some sugary water - the spoonful of yogurt is probably fine, though. You are probably coping with the high carb foods in the quantity you are eating them, but I do wonder if over time the diabetes will progress as the carbs still have to be metabolized.