medication or not...?

[Spiral]

I see my GP on Monday morning in his regular diabetic clinic.

I was diagnosed in Febraury, he wanted to put me on Metformin straight away, but I resisted, wanting to see what I can do with diet and exercise. Saw GP about 6 weeks ago and he was pleased with my initial weight loss and reduction in fasting numbers (from 8.7 at the first blood test to 6.9 last time).

I had another HbA1c last week and the result from that was 7% - I was told this was "satisfactory". I was a bit dissapointed with the number, to be honest, but I have fallen off the wagon several times over the last 3 weeks due to high levels of stress, which isn't about to reduce any time soon.

I have just started testing and my readings vary from 6.3 to 8.7 over the course of the day. I've been on holiday this week and out of my usual routine, so I don't know if this would affect my fasting level - I took it at 10.15 this morning, but I have been testing after meals and keeping a food diary. I have reduced my carbs significantly and am exercising regularly.

I have had some problems with my feet - http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=15&t=8470 - which are worrying me. Don't know if it is due to carrying excess weight or the diabetes or both.

I want normal blood sugars and to be half the woman I was at diagnosis.

I have read around here and have seen how well people have done on Metformin and that the unwanted effects seem fairly tolerable. I am usually very resistant to medication, but when I do take it I prefer to take the minimum dose possible and I am a very compliant patient, which my GP knows. After refusng it at diagnosis, I am considering asking about a Metformin prescription on Monday. The aim of taking it would be to reduce my insulin resistance and get my BS number down to normal levels as soon as I can, I would also like it to curb my appetite so that I can loose the weight quickly in the hope that this will aid my future management of BS levels and see if my foot problems improve once I have lost the extra weight.

Can I use Metformin like this, for a few months, then review and withdraw it? Has anyone done this, how did it work for you?

Thanks

 

[dipsticky]

Spiral. You can do what you want. You don't need permission. Try it and see. Just remember the other benefits of metformin as well.

D

 

[Spiral]

I'm not asking for permission.

I want to know about other people's experiences with Metformin to find out if my expectations are realistic and if there is anything I hadn't considered so that I can make an informed decision. I want to know if I will get what I hope for if I make the decision to use Metformin, and also what might happen if/when I decide to stop using it.

Do you use Metformin, dipsticky? What have your experiences with it been?

 

[Trinkwasser]

In the States it's much commoner for people to be prescribed a bunch of meds at first, and these are reduced or eliminated later as diet has more effect.

Start at a low dose and work up slowly, and initially at least take in the middle of your meal, without many carbs, which should reduce the most likely side effect of squitters. It may take a while before you have ramped up to a working dose. Stopping it usually produces no problems.

 

[Spiral]

I met another T2 on a course today, we talked drugs and diabetes. She said that once you are on the medication you will never come off it, but she also collapsed in a hyperglycaemic episode earlier this week with a BS of over 26 when it was tested at the hopital :shock: I suggested that this (the not coming off the medication issue) was not true and she seemed quite surprised.

I'm seriously considering the medication especially in relation tp the problems I'm having with my feet. I know that the medication won't cure the problems I'm having there but better control of BS and dropping the weight more rapidly may help sort the problems out.

I take my foot care seriously (I've always been a sensible shoe girl), if the feet are not right nothing else will be right above them :? and that affects my ability to exerise and do stuff generally.

I'm concerned about reducing and removing the medication once I get where I want to be (normal blood sugar levels and considerably lighter) - how easy is it to reduce/withdraw? Is there anything you need to watch out for?

 

[Trinkwasser]

I'm concerned about reducing and removing the medication once I get where I want to be (normal blood sugar levels and considerably lighter) - how easy is it to reduce/withdraw? Is there anything you need to watch out for?

For metformin, usually not much, except keep an eye on your BG afterwards in case it starts to increase again. Basically it has much the same benefits as exercise and weight loss only quicker. Diabetes is a bunch of circular arguments, where improving one thing leads to improvements in others, which in turn make improving the first thing easier.

 

[Spiral]

I'm concerned about reducing and removing the medication once I get where I want to be (normal blood sugar levels and considerably lighter) - how easy is it to reduce/withdraw? Is there anything you need to watch out for?

For metformin, usually not much, except keep an eye on your BG afterwards in case it starts to increase again. Basically it has much the same benefits as exercise and weight loss only quicker. Diabetes is a bunch of circular arguments, where improving one thing leads to improvements in others, which in turn make improving the first thing easier.

So I could use Metformin the way I want to, to get down to normal BG levels as quickly as possible and help to shed the weight? Then come off it. Watching the BG is about being vigilant with the meter...

My GP said once I was on it 9metformin) that I would always be on it because diabetes is a long term chronic condition, he couldn't accept that people come off it without a problem.

I'm considering the metformin because of my foot problems.

 

[Trinkwasser]

So I could use Metformin the way I want to, to get down to normal BG levels as quickly as possible and help to shed the weight? Then come off it. Watching the BG is about being vigilant with the meter...

My GP said once I was on it 9metformin) that I would always be on it because diabetes is a long term chronic condition, he couldn't accept that people come off it without a problem.

I'm considering the metformin because of my foot problems.

Your GP has probably never seen anyone not on a Healthy High Carb Low Fat Diet, and if he did he'd probably tell them to stop it immediately!

Elsewhere in newsgroups and forums I've seen scads of people over many years making significant improvements through diet alone, many have dropped sulphs, some have even dropped insulin and not a few have come off metformin. Others have reached the point where they *could* come off it but chose to continue taking it for its other benefits.

IMO I'd go for it!

 

[Doczoc]

I'm considering the metformin because of my foot problems.

Metformin is recognised as a very safe drug. I would use it if I thought it might help out with any problems.

Elsewhere in newsgroups and forums I've seen scads of people over many years making significant improvements through diet alone, many have dropped sulphs, some have even dropped insulin and not a few have come off metformin. Others have reached the point where they *could* come off it but chose to continue taking it for its other benefits.

IMO I'd go for it!

I have come off Metformin for the last 3 months I'm due a HB1Ac, when I can get round to doing the appoinmemnt) and am interested in seeimg what the result is. I have decided that I am going to go back on the Metformin though for two reasons. One I feel that if the Metformin is helping IR then that will keep my pancreas functioning longer. Secondly, Metformin is said to help vascular health so weighted up against the side effects that seems a good trade off...

Also, you mentioned starting on a low dose and ramping it up. My doctor started me on 1 x 500 but wouldn't increase it when the low carb diet kicked in. She said the Metformin was doing it's job and I didn't need any more. I tried to draw her on the cv benefits, IR benefits, prolonging pancreatic function, weight loss etc, but she didn't want to listen.

 

[Spiral]

I have gone off the idea of medication. I can see the results I'm getting from diet alone through my meter. I know that if I drop the BG a lot at the next HbA1c and I'm on metformin that the credit will go to the pill not my work, however, I'm not ruling it out. I go back to my position that if this is a "lifestyle" problem I need to learn to manage the problem with a lifestyle that keeps me well rather than taking tablets if I don't have to.

I want to see what I can do between now and the next HbA1c, unless my trip to the hospital diabetic clinic for my foot problems needs more drastic measures. But these symptoms might have nothing to do with the diabetes :?

 

[Trinkwasser]

I have come off Metformin for the last 3 months I'm due a HB1Ac, when I can get round to doing the appoinmemnt) and am interested in seeimg what the result is. I have decided that I am going to go back on the Metformin though for two reasons. One I feel that if the Metformin is helping IR then that will keep my pancreas functioning longer. Secondly, Metformin is said to help vascular health so weighted up against the side effects that seems a good trade off...

Good plan! Similar I've dropped my simvastatin because I want to see my unmedicated lipids. I'm quite prepared to restart it should I need to and I don't appear to have gained or lost any side effects from it.

Also, you mentioned starting on a low dose and ramping it up. My doctor started me on 1 x 500 but wouldn't increase it when the low carb diet kicked in. She said the Metformin was doing it's job and I didn't need any more. I tried to draw her on the cv benefits, IR benefits, prolonging pancreatic function, weight loss etc, but she didn't want to listen.

Well like all drugs sometimes it actually does have significant effects at minimum dose for some patients. Maybe that was all you needed. Would have been useful to have been given the opportunity to titrate the dose and see what else happened though. A lot of meds have a U curve where too much can be as bad as too little, just in a different way.

 

[hanadr]

Read David Mendosa's web site. David is a long time T2, who went over to a STRICT low carb diet. ( he doesn't even eat tomatoes!! :shock: ) He now uses No medication, having had byetta and got his weight down.
It's David who inspired me to go reduced carb