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Just saying hello! Metformin, Simvastatin, Fenofibrate

E

efelstead

Newbie
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3
Greeting from West Lancashire where it is VERY cold and foggy.
I was diagnosed with with Type 2 some four years ago but was
not offered any treatment for the diabetes but was offered Statins and Fibrates
for my high Cholesterol which is caused by a Gene defect.
Just recently a phone call from my doctor (yes a personal call) set alarm bells
ringing when he said I was in great danger of developing pancreatitis
due to a Triglycerides reading of > 20!!!.
Now I am being treated with METFORMIN ,SIMVASTATIN and FENOFIBRATE.
I am finding it very difficult to tolerate these three together especially the METFORMIN
which is causing me considerable stomach pain and great quantities of gas and Diarrhea.
Comments on this combination of drugs most welcome.
Best wishes
Edward
 
Welcome to the forum Edward :) I think you will soon get some of the information you are asking for on the combination of your medications. I'm sorry you are having such trouble with them. I know you are not newly diagnosed but you still might like to read this document put together by the Forum Monitors for the newly diagnosed. It is interesting and you may find it useful:

viewtopic.php?f=20&t=17088

You could also try doing a search on the medications you are taking - there is a lot of information out there.
 
Hi,
I was on the EXACT same treatment regime! I did NOT get on well at all with it! Metformin (referred to around here as MetFARTin :wink: ) absolutely HAD to go. I was put on the modified release Met (Glucophage SR) and that had the same effects.

I ended up stopping taking met without discussing it with my GP - the side effects were unbearable.

Simvastatin was also not a good drug for me. I ended up getting terrible pains in my legs, and feeling like I'd ben zapped of all energy. This crept up on me (gradually) and got to a point where I could hardly drag myself out of bed of a morning).

Fenofibrate had no adverse effects - BUT - I found the initial dose (160mg?) ineffective. (ie - did not lower my chol or Trigs).

Good news, though. There are alternatives to metformin, and there are alternatives to Simvastatin. They will almost certainly replace Simvastatin (if you're not getting on with it) with another statin, but even if you don't get on with the replacement statin, there are other alternatives (the drug I take for my chol now is Ezetimibe).

Fenofibrate can be administered in a higher dose, and in micronised capsules. I've found these to be much more effective at lowering my total chol and trigs.

If you have trouble with metformin, I'd ask at once to try the Modified Release (Glucophage SR/XR). Again, if you don't get on with that there are alternatives (Metformin is an Insulin Sensitiser - alternatives are available).
Be wary of Simvastatin, and consider the effects (muscle pains/cramps, etc...) I'd advise getting off them at the first sign of any pain/discomfort. In my case, it got REALLY bad and I didn't realise it was the statin for a long time.

Good luck - I hope it all works out for you.
 
Oh Patch - Thank you so much!!
I was trawling to see if it is my meds that have done me in!!
I was diagnosed as Pre-Diabetic about 18 months ago and sent away to lose weight - the reason I went to them in the first place was because I could not lose weight :evil: Anyway, they finally capitulated and put me on Metformin, with Simvastatin (I was already taking Ramipril and Benflouro something or other).
Well I've had Metformin before for Polycystic ovaries and I get constipated - I told them this and they laughed at me - NOT POSSIBLE they said - Metformin makes you go - you'll get Diorrhea before you get constipated, but start off gently and see how you go.
So I did - and I got nausea and constipation - so I went back and they changed me to Glucophage and gave me Amlodopine for good measure - and guess what - yep! More nausea and more constipation. So I've halved my Glucophage and now my bloods are hovering at 10 - so I clearly need more meds but nothing is touching the constipation - and to add to my misery, I'm exercising 4 times a week and it has cut from 1hr per session to 45 mins to now 20 mins and then I have sit down and rest. I can't even go food shopping without feeling exhausted - I'm 42 for god's sake - not 82!!
I have an extremely hectic job which often takes me away from home for 10hrs a day and a team of staff who need strong direction - I'm just whacked out.
So now I can go back to the doctor/nurse and at least discuss a change to medication
Thank you so much for the information :D
 
Hi Ambersam and welcome to the forum.

If it's any consolulation I too have Polycystic ovaries and kept asking the Dr's at various times why I was putting on so much weight {I'm 54} and was told that while the cysts are active I would struggle to lose weight.I developed Pre Diabetes two years ago and then went on to develope Type2 Diabetes a year ago.

I never ever suffered with constipation until I developed the disease and now struggle to go to the loo most days.I was put on 1x500mg Metformin to be taken twice a day and for the first four days had terrible stomache pains and Diarrohea before it settled down.I asked the Diabetic nurse about the problem and she said to pesevere until five days and see what happened.By day five the problem dissapeared and i haven't had a problem since.

Over the last year I have lost three stone in weight and my last HbA1c last October was 5.7 down from 9.3 when first diagnosed and 6.3 by April last year.After the visit to see the daibetic nurse in October,I have been able to drop off one of the tablets so only take one a day.

I have been following a low fat GI diet pluse done even more exercise than before including work on a trampette that i bought within a week of Diagnosis.

Please don't give up with the exercise and try to build some into your busy life every day.I have also been where you are with work and running a home so know about the exhaustion.

One thing I find that helps with the constipation is peanuts but I try not to eat them every day just when the problem gets too much,oh and i also suffer with Fartformin but that is a small price to pay for keeping in contol of this disease. :)
 
Hi All. I was diagnosed Type 2 about 4 months ago, a big surprise since the only symptoms I had were going to pee a lot at night. Still, better T2 than the alternatives.... I have been on a gluten-free diet for over 20 years, and recently have read that gluten sensitivity (coeliac disease, CD) and diabetes are on the same gene - anybody know anything about that? There seems to be an acknowledged link between CD and T1, but not T2. Now the bad news. I have had problems with chronic constipation for 30 years - really due to the CD, and getting progressively worse. I have had all the scans and cameras where I didn't really want them. Of course some people do find T2 links to constipation, maybe 60% if you believe some web sites. I also have diverticular disease, which is caused by constipation, and causes it ( get out of that one!) I have also had an anal fissure, a real pain in the a***. It seems to me that they are all linked somehow, probably started by the CD. When I started on Metformin, I was told it would give me diarhoea; that would have been a real treat! It didn't; it may even have made the constipation worse, though I'm not sure I could really tell.
I started on the blood pressure treatment 4 years ago, but couldn't find a tablet I could accept. Eventually, with the docs agreement, I stopped. When diagnosed T2, they wanted me to start again, Amlodipine. Within days I felt really ill, always tired, no energy, just "felt old" (I'm 62) and with quite severe chest pain, what I now know to be palpitations, the commonest side effect, 4.5%. I quit again. I am just about getting over the side effects, after nearly 2 months, but still very constipated (Amlodipine does that too), I must be Senokot's best customer, nothing else works. I also find that "fibre" in any form usually bungs me up even more. Apparently a new treatment is available on the NHS, but for women only, as it hasn't been tested on enough men. I certainly find that male doctors don't seem to believe that men can be constipated, while some female doctors are at least more sympathetic. Best Wishes, Peter
 
Hi Peter and welcome to the forum :) A member is sure to know the answer to your question - in the meantime have a good read around any ask any more questions you like. For general information here is a guide for newly diagnosed diabetics written by the Forum Monitors which you might find helpful:

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.
Click to expand...
 
Hi Efelstead

Just to say that simvastatin snuck up on me to the extent that I could barely walk 100m this time last year. I stopped taking them last February and am gradually getting better. I now refuse to take anything for cholesterol, but have dropped from 5.8 to 5 by low carbing (Atkins), and my total/HDL ratio is fine, as are my triglycerides. I think losing weight is helping both.

Peter, you have my sympathy! Dare I suggest rhubarb? sweetened with Splenda and served with organic live yoghurt and some flax seeds? But I bet you'll have tried that already. Fresh figs? not too high in carbs to eat occasionally. One thing that really keeps things 'easy' with me is red wine, but I'm not drinking at the moment except in extremis (any excuse!). :lol: I also used to find a cigarette helped, but that's been out for more than 10 years now. My system has settled to the Metformin now, and it doesn't seem to make much difference.

V
 
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