metformin at diagnosis

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paltry

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Has anyone here been put on metformin straightaway at diagnosis? My reseach shows it to be recommended by many studies and diabetologists, especially for those of us who are overweight(!)

T
 

))Denise((

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1,580
Type of diabetes
Type 2
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Tablets (oral)
I wasn't put on metformin straight away, but think it was less than a month before I was put on it. I don't remember having any extra blood tests to determine whether I was doing any good on diet only, but I may have done.

If I had found this forum back then, then maybe I could have kept off it for longer, but it does have good points.
 

Lynmi

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Messages
139
Type of diabetes
Type 1.5
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Insulin
I was diagnosed last October and put straight on 1 x 500 metformin twice a day upped to 2 x 500 twice a day in november. This was'nt to aid weight loss as my nurse didn't feel my weight was zn issue although I have already dropped from 12st down to 10st
 

daisy1

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I was given three months without medication while noting my levels to take to my next appointment. Then the endo decided to put me on 500mg Metformin. She has now increased it to 1000mg. I don't get any side effects.
 

Unbeliever

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1,551
paltry said:
Has anyone here been put on metformin straightaway at diagnosis? My reseach shows it to be recommended by many studies and diabetologists, especially for those of us who are overweight(!)

T
Yes I was pu on Meformin straight away but was also strictly warned no o lose any weight as I was underweight.
In the event the metformin did not make me lose weight and did nothing at all for my blood sugar levels. I was old at he ime that it was o protect me from stroke and heart attack. I continued o take i for 3 years wih side effects , My GP at the time was thinking of taking me off it but I was forced o move house and GP's practice and the new GP. - new in every sense of the word- disagreed and sated -in ringing ones- that he waned it to be The Cornerstone of my Treatment! I could not help but ask "Instead of being The Bane of my Life?" but he is too young o have developed a sense of humour. I now take the maximum dose ,plus other things , but thankfully after 4 years he side effects have subsided.
 

viviennem

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I went on it at my own request to help with weight loss (which it hasn't yet!) and expect to discuss upping the dose from 1500mg per day next time I see my doctor. I recently found out about the protection from heart disease and stroke, which is a bonus!

I also thought that if it helped with the insulin resistance it might give my pancreas a rest by making its job a bit easier.

I'd dropped my BG from 9.2 to 6.7, my HbA1c from 6.5 to 5.6, and my weight by 30lb, in 3 months by diet only, before I gave in and allowed them to register me as diabetic (Type 2). My only regret is that I hadn't been self-testing before I went on to it, so I can't tell how much effect it's having. After 1 month on it my fasting was 6.0 and my HbA1c 5.4 (3 months from previous tests), which isn't a big difference. Next tests in March may show more.

Does it really help in lowering bg levels? I'm tempted to stop it for 3 months to see what happens, but then I'd have all the side effects when starting again! :lol: :lol:

Viv :)
 

kellieb

Member
Messages
9
i was given 3 months 'grace' before i was put on metformin. been on it since last saturday and havent had any side effect yet. doseage is 1 x 500mg for 1 week then 2 x 500g for 1 week then 3 x 500mg from then on. the only effect that i have noticed is that i seem to be hungry more since taking the metformin, i dont recall reading that this was a side effect, i was kind of hoping it would help with some weight loss as well as the obvious reasons. my blood glucose readings are a bit all over the place at the moment, does anyone know how long it takes before the metformin start working?
 

Unbeliever

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1,551
I was given to understand that everyone was put on metformin as a matter of course,when I was diagnosed. Of course they were also automatically given test meters and strips then.
I wonder if this is another change/costcutting measure?
 

bowell

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Depends on your glucose levels at diagnosis and or BMI
If your only just in range your more than likely be on diet only to start with


Refer to the T2 map of medicine for info see below


http://healthguides.mapofmedicine.com/choices/map/diabetes2.html

From above:

Blood glucose lowering therapy

Initial therapy guided by body mass index (BMI) [6]:

* if patient with BMI above 25kg/m2 - start metformin
* if patient with BMI 25kg/m2 or less - consider starting metformin or prescribe an insulin secretagogue (sulphonylurea)

Consider the following when starting metformin [6,7]:

* step up metformin over several weeks to minimise risk of gastrointestinal (GI) side effects
* consider trial of extended-absorption metformin if GI tolerability prevents the person continuing with metformin
* review metformin dose if serum creatinine is greater than 130micromol/L or estimated glomerular filtration rate (eGFR) is less than 45mL/minute/1.73m2
* stop metformin if serum creatinine is more than 150micromol/L or the eGFR is less than 30mL/minute/1.73m2
* prescribe metformin with caution for those at risk of a sudden deterioration in kidney function, and those at risk of eGFR falling to less than 45mL/minute/1.73m2
* if the patient has mild to moderate liver dysfunction or cardiac impairment, discuss benefits of metformin so due consideration can be given to its cardiovascular-protective effects before any decision is made to reduce the dose

Consider sulphonylurea if [6,7]:

* patient is not overweight (tailor the assessment of body-weight-associated risk according to ethnic group); or
* metformin is not tolerated or is contraindicated; or
* a rapid therapeutic response is required due to hyperglycaemic symptoms

References:

[6] National Institute for Health and Clinical Excellence (NICE). Type 2 diabetes: newer agents. Clinical Guideline 87. London: NICE; 2009.

[7] Srinivasan B, Lawrence I, Davies M. Diabetes: glycaemic control in type 2. Clin Evid 2008; 07: 607.
 

Malc.

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Messages
114
Type of diabetes
Type 2
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Hi,
I was diagnosed 4 weeks ago and was given Metformin, even though I mentioned that I wasn't keen on taking tablets of any kind...
She said that she would just try me on ONE 500g tablet per day, (as though she was doing me a favour). My Bg reading at the surgery was 7.8 ( I'm not overweight)
I was not given any opportunity to try a period of 'diet only' treatment initially and wasn't offered a monitor.
I have since bought my own and I'm currently testing about three /four times per week, with the option of increasing to a more frequent check as I progress.
Oh, those Metformin are still in their box, untouched!
My fasting Bg this morning was 6.6 I'll check it again tomorrow, just in case...

Malc.
 

ShyGirl

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Messages
467
I was put on insulin as I was diganosed after ending up in hospital and given my age it probbaly looked like T1.
I was put on metformin six months later after some tests.
 

bowell

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those Metformin are still in their box, untouched!

Your body your choice

Metformin has other benefits eg with Cholesterol
Have good read up on Metformin

You can lead a horse to water: but you cant make him drink :eek:
 

Malc.

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Messages
114
Type of diabetes
Type 2
Treatment type
Tablets (oral)
bowell said:
those Metformin are still in their box, untouched!

Your body your choice

Metformin has other benefits eg with Cholesterol
Have good read up on Metformin

You can lead a horse to water: but you cant make him drink :eek:

I take your point, however, I'm not saying that I'll never take them...
I believe that as:

1/my initial readings weren't too high,
2/I'm not overweight.
3/I don't have any of the symptoms, such as tiredness, excessive thirst,frequent toilet visits.etc.
4/ I have never smoked.
5/I hardly drink any alcohol

Then I should have the opportunity to reduce my Bg with careful diet control.

Regards, Malc.
 

bowell

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Just for interest have you tested 2hr+from a meal ?
 

Malc.

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Messages
114
Type of diabetes
Type 2
Treatment type
Tablets (oral)
bowell said:
Just for interest have you tested 2hr+from a meal ?

Hi,
Only on a couple of occasions, I've mostly tested early morning, (fasting), however I did a test late last night which was 8.1
The reading this morning, as stated in an earlier post 6.6
Yesterday, I managed to get more testing strips (50) for my meter, so I am now able to test more frequently, which will include those 2hr+ situations.

Malc.
 

bowell

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Malc
Try a few tests 2hrs+ from a meal may surprise you :shock:
if your going to try diet alone ,you will need to test more
before you eat then 2hrs+ as a minimum
just to find the foods suits you

keep us all tuned in
Bob
 
P

paltry

Guest
[q
bowell said:
Depends on your glucose levels at diagnosis and or BMI
If your only just in range your more than likely be on diet only to start with


Refer to the T2 map of medicine for info see below


http://healthguides.mapofmedicine.com/choices/map/diabetes2.html

From above:

Blood glucose lowering therapy

Initial therapy guided by body mass index (BMI) [6]:

* if patient with BMI above 25kg/m2 - start metformin
* if patient with BMI 25kg/m2 or less - consider starting metformin or prescribe an insulin secretagogue (sulphonylurea)

Consider the following when starting metformin [6,7]:

* step up metformin over several weeks to minimise risk of gastrointestinal (GI) side effects
* consider trial of extended-absorption metformin if GI tolerability prevents the person continuing with metformin
* review metformin dose if serum creatinine is greater than 130micromol/L or estimated glomerular filtration rate (eGFR) is less than 45mL/minute/1.73m2
* stop metformin if serum creatinine is more than 150micromol/L or the eGFR is less than 30mL/minute/1.73m2
* prescribe metformin with caution for those at risk of a sudden deterioration in kidney function, and those at risk of eGFR falling to less than 45mL/minute/1.73m2
* if the patient has mild to moderate liver dysfunction or cardiac impairment, discuss benefits of metformin so due consideration can be given to its cardiovascular-protective effects before any decision is made to reduce the dose

Consider sulphonylurea if [6,7]:

* patient is not overweight (tailor the assessment of body-weight-associated risk according to ethnic group); or
* metformin is not tolerated or is contraindicated; or
* a rapid therapeutic response is required due to hyperglycaemic symptoms

References:

[6] National Institute for Health and Clinical Excellence (NICE). Type 2 diabetes: newer agents. Clinical Guideline 87. London: NICE; 2009.

[7] Srinivasan B, Lawrence I, Davies M. Diabetes: glycaemic control in type 2. Clin Evid 2008; 07: 607.
uote][/quote]


I actually asked the question as the American Diabetes Association recommends metformin from diagnosis;

Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy
A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes

1. David M. Nathan, MD1,
2. John B. Buse, MD, PHD2,
3. Mayer B. Davidson, MD3,
4. Robert J. Heine, MD4,
5. Rury R. Holman, FRCP5,
6. Robert Sherwin, MD6 and
7. Bernard Zinman, MD7
http://care.diabetesjournals.org/content/29/8/1963.full

I was directed there when studying online as part of my Continuing Professional Development (I'm in the NHS).
 

Malc.

Well-Known Member
Messages
114
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Following on from my previous post, I tested more frequently today...
Results below.

9.15 am fasting test result...6.9
Breakfast, 1x weetabix + a handful of spoon-size shredded wheat + milk, no sugar.cup of tea, no sugar.

11.50 am (2+hours) test result 6.1

1x slice of toast, white bread + cup of coffee, no sugar...
followed by ( later)
Lunch, 1x white bread roll with phillidelphia cheese + salad & a few potato crisps.Cup of tea, no sugar.

3.55 pm (2+hours) test result 5.6


These are the best results for me so far. It's really encouraging (to me, anyway) to have these lower readings at this early stage and without any medication, so far.
I wonder if those two small (and I mean small)glasses of red wine helped? (last night and the previous night) :)

We plan to have a 'bar meal' again this evening and that may interupt the flow of the lower readings above, but I won't make the same mistake(s) as last week,(as I reported on a different thread).
There'll be no chips, no regular coke and no 'sticky toffee pud'... :cry:

O.K. We went out for our Bar meal and I had:
Steak & Mushroom pie (puff pastry top) with new potatoes, garden peas & salad.+ half pint of bitter.
My final reading tonight 2+hours after the meal, was.....8.4

Malc.