Metformin immediate release v Metformin SR

[Robbie64]

Hi

Does anyone know how much longer the prolonged / sustained release version of Metformin takes to get into the blood stream when compared to the ordinary (immediate release) version of Metformin?

I was on ordinary Metformin for 5 years with good results until late last year. My blood sugar levels both before and after a meal, and on a morning were within the recommended range plus my HbA1c levels were fine too. However last year I was under a lot of stress in my personal life and my sugar levels rose to levels that were too high (they went into double figures).

Up to that point I was on 2 x 500mg Metformin each day. My GP increased this to 2 x 500mg Metformin twice a day and I asked my GP if I could have the SR version of Metformin, which he agreed to.

However, no matter what I do my levels struggle to get with the acceptable range. Most of the time they are in the 9s / low teens. It's almost like the SR version just isn't working - my sugar levels and HbA1c levels at times are not much different from what they were before when I was taking just 2 Metformin immediate release. My last HbA1c was 65 (in April), down from 82 in January. Two years ago, before all the stress, they were nearly always 42 and below and my blood sugars were between 5 to 7.

I test myself before breakfast and then before my evening meal and 2 hours afterwards. Does anyone know how long metformin SR takes to work compared to the immediate release version? Would it be worth switching back to the immediate release version?

My GP prescribed Foxiga alongside Metformin a couple of weeks ago. Unfortunately after a week I had swelling in the throat and chest and became dehydrated and ended up in A&E as I was having breathing problems, a very fast heart rate and low blood pressure. I'm pretty fed up to be honest. I had a heart attack in March this year and want to get my sugar levels under control but am struggling badly. I don't want to end up on a concoction of diabetes medication if possible. My GPs surgery doesn't have a specialist diabetic nurse, the nurse you see treats a number of conditions and everything she says seems to have been lifted from a text book. I just want to get my levels down to an acceptable range and don't know where to turn to.

 

[bulkbiker]

What kind of stuff do you eat?

Changing food input is what has worked for many of us.
It has led us to remission unmedicated.

 

[Robbie64]

I must admit I'm not the best of eaters of healthy food though I'm a lot better than I used to be when I was living on microwave food and takeaways a few years ago.

I try to eat basic, simple meals but these invariably involve food types that include things I should be avoiding, such as potatoes, bread and pasta. Even so, until a year ago my readings were good until the latter half of last year (I was looking after my ailing father who died in October) I started to eat food that could be quickly made out of necessity so went back to microwave meals a bit too much. I was also drinking too much due to the stress, something I knocked on the head in January this year.

I'm eating smaller portions again but the metformin just seems to make no difference. Yesterday, for example, my blood sugars before my evening meal were 6.3 then two hours after eating (which was only two slices of toast with beef paste spread and margarine - I know that isn't the best) it had risen to 12.9, over double what it was two hours earlier. I took 2 metformin just before I ate but it's like they didn't work. A couple of years ago my readings would have been fine and I would only have taken 1 immediate release metformin.

 

[HSSS]

I can explain yesterday. It would have been the toast. I suspect you are going to need to ignore what’s healthy for a type 2 according to the nhs historically and to cook a few basic quick meals. It’s all about the carbohydrates that you eat. So the things you identified. Bread potatoes rice pasta to name the biggies. Have a read of these. I know you’re not new to this but things have changed and so too must your response to your diabetes. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ and https://www.diabetes.co.uk/forum/th...ish-i’d-been-told-at-type-2-diagnosis.173817/. I suspect stress, diet and time have all contributed to your higher levels. Diet will do more than metformin to get control.

Metformin doesn’t work instantly regardless of name. The dose builds over a week or two and then works to reduce the amount of glucose dumped into your blood by your liver in the background. It does not counteract the food you eat directly. The slow release versions just breakdown into your body over a longer time so are usually used to be more gentle of the digestive system. Once metformin has reached a therapeutic level in your body it’s effectiveness isn’t really effected by the delivery system.

 

[searley]

My understanding is that metformin builds up in your system and works 24/7. Irrespective of normal or SR

SR just releases slower into your system.. mostly used to prevent the risk of stomach upsets

Diet control if you are not doing it will most probably be the best way to get you bg under control.. avoiding all the high carb foods