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Metformin for type 1

J

Jess1D

Well-Known Member
Messages
137
Good morning

I have been struggling with high numbers in the mornings, I carb count & five more insulin than needed but numbers still go very high
Have expressed concern about this to my nurse
Had a call yesterday & she just said that being diabetic so long (24 years) that my sites are over used & insulin takes longer to absorb
She has suggested metformin?!!
Will this help?
Is it suitable?
Many thanks
 
Jess1D said:
She has suggested metformin?!!
Will this help?
Is it suitable?
Many thanks
Click to expand...

My understanding is that metformin may reduce the sugar dump from your liver in the morning, so it might help. Have they offered you a pump (the suggestion from my clinic because of my issues with dawn phnomena)? Or a cgm (so you can see what is actually happening overnight)?

Not totally convinced that it is because your sites are overused, though that might be a factor.

Metformin can also help with insulin resistance so might be worth a try. You can always stop taking it if it doesn't work.

My GP has offered it to me but more exercise and/or slightly lower carb has reduced my insulin resistance and dawn phenomena so that though my bg is higher than I like in the morning, I can live with it.

Good luck.
 
Jess1D said:
She has suggested metformin?!!
Will this help?
Is it suitable?
Click to expand...
It might help, for some T1 it helps a lot, for others it doesn't seem to do anything. It is suitable, there is no reason why metformin would be a problem for T1's.
Jess1D said:
I have been struggling with high numbers in the mornings, I carb count & five more insulin than needed
Click to expand...
Do you go high in the morning after breakfast or do you wake up with high numbers? Or do you rise as soon as you get up?

You say you take more insulin than you need but still go high. So you don't take more insulin than you need.
Your insulin to carb ratio can be very different over the day, do you generally use the same ratio for all meals?
Many of us have found we need more insulin for the same carbs at breakfast than for dinner.
 
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Hi
My insulin to carb ratio is 1-10
So for breakfast I tend to give 5/6 units for 20 grams of carbs
I was on an insulin pump but had accident (licence revoked for a year) got taken off the pump (meant to be pump holiday) that was in August- still not back on it
 
As suggested maybe your ratio at breakfast is just not 1:10, whilst 1:10 is a good starting point when diagnosed, it does not mean its what you need, everyone is different and ratios through the day/month/season may also differ, can change over the years as well

I know I need slightly more than double in the morning as I do in the evening for the same amount of carbs for instance
 
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Hi @Jess1D

Being told that your sites could be a problem from a phone call it's an assumptive guess, I would ask that they check your sites physically before suggesting this, if you have good rotation then sites shouldn't be an issue but they can feel for lumps.

That said your insulin needs do change over time and I am definitely more insulin resistant in the morning so my am ratio is a third more than my usual daytime requirements.
 
What happens if you don't eat breakfast? Do you still get high numbers? Like others, I need a higher insulin to carb ratio in the morning, and personally have found it easier not to eat till lunch time.
 
Hopeful34 said:
What happens if you don't eat breakfast? Do you still get high numbers? Like others, I need a higher insulin to carb ratio in the morning, and personally have found it easier not to eat till lunch time.
Click to expand...

It also depends what you eat, personally I find a low carb breakfast keeps me in range till lunch and I even take a little bolus with this to manage the protein, but when I eat carbs like bread or cereals I can easily go high numbers, however later in the day I can tolerate carbs much easier when more active so I don't spike so much then.
 

I've been offered metformin and it is a safe drug though can have gastric side effects.
I find though that a lower carb approach keeps me on an even keel.
Btw if your insulin: carb ratio is 1 unit for 10g but you are taking 5 or 6 units then that suggests you are getting a little resistant to the stuff if having taken the same dose you are now finding yourself higher after same carbs etc. Your ration would suggest you needed 2 units not 5 unless I've misunderstood that?
Type 1 insulin resistance is a thing and the metformin would help your liver be inhibited from chucking out glucose to some extent but you may well get an even better effect by reducing carbs or eating more protein with less carbs perhaps at least at breakfast. Or even skip breakfast. It isn't obligatory even for type 1s.
 
Hi. You don't say what sort of diet or BMI you have; if some excess weight then reducing that with low-carb would help. What Basal are you on? If Levemir it should probably be split and the overnight shot can be adjusted to be at the right point in the morning. I change my nigh-time Levemir most days to get the morning right.
 

Yes like you said I should only need 2 units but this is what I have to give
I keep saying this to my nurse- that I’m having to give so much more than I should
She just says it’s my sites
 
So this am woke at 5am - Libre reading 13.1-gave 3 units as correction
6.30am - 15.3 - corrected with 4 units- took the dog for a 20 minute walk
Had only had water during this time
7.45am - 15.3
Given 4 units as had small banana for breakfast
This is often the case - give a fair dose of insulin & it still goes higher
 
Did you check any of those readings with a finger prick test, as Libre can be inaccurate especially at higher numbers?
 
Yes I did & they were reading 14s
I’m just wondering to I try low carb
If I do this - should I still try the metformin?
 
Jess I dont think you need to go low carb. What are you typically eating at night? It took me long 30 years before I could figure out why I was having high blood sugars. Everybody processes food differently. So you will have to try a lot of different styles of food.
 
For tea we mainly eat chicken/fish & salad:vegetable
We don’t tend to eat high carb foods
 
I saw one of your post where you in the morning you go walk your dog without eating any thing and you are giving your self insulin dose for high reading. Same thing used to happen to me. What you have to try is even if you are high in the morning, eat something with carb..doesnt have to be high carb. Like have your breakfast with little bit of carbs and take your regular insulin dose and the correction dose for your high together. And then go for a walk and daily activities. In the.morning there is too much hormones and staying hungry signals liver to keep dumping sugar to prepare you for the day. Eating and taking insulin should/will stop that from happening. Try it and let me know.
 

Thank you - that’s interesting
I have done that sometimes but it just seems to stick high
Had a right mare on Thursday it just stayed at 16 for nearly 5 hours despite lots of insulin
At the moment my numbers are normal
5.6
 

Morning
So still going high
Had 3 mornings now when I have given my bonus & had breakfast - still going up after
That’s also trying low carb too
This am had Greek yoghurt/raspberries & Brazil nuts- no more than 12g carbs- had to give 4 units - now sugars are 13.9 & rising!!
Should I maybe try the metformin

This is doing my head in tbh
 
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