Metformin & Me: FBGs etc

[AloeSvea]

Just some feedback on my metformin experiment, just in case it is interesting or helpful to others.

I began taking it seven months ago and I’ve been keeping records on my Fasting Blood Glucose (FBG), and my general bodily response to metformin. 2x 500 mg, morning and evening, always with food. (Wouldn't dare not to, re the tummy pain and nausea.)

I have written elsewhere, in the fasting sub-forum, on the combo of metformin and an intermittent fasting (IF)/window of eating regimen, and intend to on the weight loss and dieting sub-forum on the effect of the pill and the IFing on my waist measurement, waist height ratio, and weight for the BMI.

Here I will share the changes in my FBGs in particular.

Metformin affects me personally by lowering my appetite, and making me feel intermittently nauseous, which also lowers my appetite. In the first month or two, I was also actually physically (and violently) sick a few times over two months, although that stopped by month three. The intermittent nausea has greatly lessened, at the six month mark. I still get it from time to time. Funnily enough – less as I forget to take a pill at least three times a week, and when that happens, so lessens the intermittent nausea.

Anyway – FBGs. I began the month prior to a full month on metformin, with an average FBG of 9.2. After a month on metformin it dropped 12% to an average of 8.1. After two months, I saw a very big drop – 28% - in my average FBG – down to 6.6. (Awfully, I put this down to the nausea and vomiting, which peaked in that month.) The following five months they were all in the low to mid 7s, an average of 7.2. So a reduction from the baseline/month-preceeding pill popping - of 22%.

Or a nice easy way of expressing it – I dropped two numbers, from 9.2 to 7.2 in seven months.

In five months of metformin-ing (and three months of sunrise to sunset IFing) my HBA1c went from 57, to 52, to 47, so a drop in 10 numbers or a drop of 18%.

This is significant as it indicates the lowering of the amount of extra glucose my liver makes and spurts out for the get-up-and-go dawn phenomenon, I am supposing. If this is particularly dysregulated it keeps my Blood Glucose readings (BGs) high all day, with relatively few dips during the day, over the last three years when my BG went to hell in a handbasket. Cheers from Aloe!

 

[jjraak]

Just some feedback on my metformin experiment, just in case it is interesting or helpful to others.

I began taking it seven months ago and I’ve been keeping records on my Fasting Blood Glucose (FBG), and my general bodily response to metformin. 2x 500 mg, morning and evening, always with food. (Wouldn't dare not to, re the tummy pain and nausea.)

I have written elsewhere, in the fasting sub-forum, on the combo of metformin and an intermittent fasting (IF)/window of eating regimen, and intend to on the weight loss and dieting sub-forum on the effect of the pill and the IFing on my waist measurement, waist height ratio, and weight for the BMI.

Here I will share the changes in my FBGs in particular.

Metformin affects me personally by lowering my appetite, and making me feel intermittently nauseous, which also lowers my appetite. In the first month or two, I was also actually physically (and violently) sick a few times over two months, although that stopped by month three. The intermittent nausea has greatly lessened, at the six month mark. I still get it from time to time. Funnily enough – less as I forget to take a pill at least three times a week, and when that happens, so lessens the intermittent nausea.

Anyway – FBGs. I began the month prior to a full month on metformin, with an average FBG of 9.2. After a month on metformin it dropped 12% to an average of 8.1. After two months, I saw a very big drop – 28% - in my average FBG – down to 6.6. (Awfully, I put this down to the nausea and vomiting, which peaked in that month.) The following five months they were all in the low to mid 7s, an average of 7.2. So a reduction from the baseline/month-preceeding pill popping - of 22%.

Or a nice easy way of expressing it – I dropped two numbers, from 9.2 to 7.2 in seven months.

In five months of metformin-ing (and three months of sunrise to sunset IFing) my HBA1c went from 57, to 52, to 47, so a drop in 10 numbers or a drop of 18%.

This is significant as it indicates the lowering of the amount of extra glucose my liver makes and spurts out for the get-up-and-go dawn phenomenon, I am supposing. If this is particularly dysregulated it keeps my Blood Glucose readings (BGs) high all day, with relatively few dips during the day, over the last three years when my BG went to hell in a handbasket. Cheers from Aloe!

Not sure if it's the METFORMIN or the INTERMITTENT FASTING.
But certainly a drop of 2 points on your average fbg is a worthy result indeed.

Not to mention the significant reduction in HBA1c..bravo @AloeSvea

 

[AloeSvea]

Yes - I agree. I'm sorry not to do a pure tidy experiment - ie on one variable only. But with a FBG averaging 9.2 - well - you understand I am sure. I pull out all the guns I can when this kind of thing happens, and this hadn't happened in the 5-6 years previously. So. Metformin - bienvenue. The fasting - been a constant one way or another throughout post diagnosis. (The other time I pulled out all the guns I could was just post diagnosis, of course. No tidy experiments there either, alas.)

The big time increase in my BGs I put down to stress, and the pfizer vacces. (And of course - one never knows how much of what is what.) Pleased not to die from covid! But I clearly had a bad BG response, metabolically speaking, to the dead rna, or whatever it is, of that vile virus.

 

[AloeSvea]

Just a wee addition to the info from my ol' bod, re metformin and lowering the amount of glucose my liver spurts out (fancy word 'gluconeogenesis'), of a morning.

I was not able to get a c-peptide test (grrr to new doc in the countryside where I live), to get an actual number on lowering natural insulin production (remember - this is a good thing when you have persistent insulin resistance like I have, where my body has been producing tons of insulin to counter the high blood glucose and in relation to fats for three to four decades off and on).

But, I do have my Fasting Blood Glucose marker, which pretty much does the same thing (but hey - I like the c-peptide number for easy comparison).

Anyway. For the first time since diagnosis and BG testing, I can and do go without eating breakfast if I feel like it, and my BG will actually stay the same ish - this morning - 7.1 on waking, 7.0 now, with just coffee with cream for a few hours.

Thank you French Lilac! (Or chemical reproduction of.) But now I am hungry and will eat some late breakfast.

 

[AloeSvea]

Pulling together what I have been writing in other threads on metformin, here on my own one.

My FBGs have gone back to bad (as in way too high - between 8 and 9) in the last two to three months, so is a new pattern, unfortunately. Got my bloods done yesterday, for the first HBA1c since just before Xmas, so will see the damage soon. So I see it that whatever help the french lilac (compound remade in a lab I suppose) gave me it has stopped giving me.

Also, re the kind of blood glucose reduction that one can expect on metformin - been having lively discussions about that here in the Forum. I have also researched for a writing project which includes this subject, so it was with great fascination I have seen that the information on that differs hugely, and is hugely confusing. Three different pieces of information - first there is the standard 1-2% reduction, pitched most online. As a mathematical formula it should be quite straight forward. Especially with our IFCC mode of measuring - a two to three digit number easy enough to calculate a percentage figure from. Most simply - a hypothetical HBA1c of 100 would mean a predicted reduction of 1-2, being an HBA!C reduction to 98 or 99. But, if trying to calculate 1-2% of a figure in the DCCT mode, which is already a percentage, say, the percentage reading of the 100 being 11%, then 1-2% of 11% is ... is it even possible to calculate a percentage reducation from a percentage? Anyway, looking at a blood glucose chart - this has been estimated to be a 11 mmol/L drop, so to an HBA1c of 89, or to 10 to 11 (%). This is the modest reduction often reported.

Then I found a diabetes doc/endocrinologist here in Aotearoa/NZ, Dr Paul Ryan the editor of the journal where I got this, saying one could expect a reduction of 16mmol/L with metformin. Wow! I thought. Well, there is absolutely no way metformin has affected my HBA1c so profoundly. If it did, I would be out of the diabetes zone altogether and woulod be still celebrating with my friends and family for doing so. But of course that doesn't mean that that isn't the data the researchers have and reported on.

I spoke to a clinic nurse yesterday about this, as she was taking my blood for my latest lipid test and HBA1c, and she had not heard of such a wonderfully large drop in blood glucose due to metformin alone either. But hey - I need to find out more about this. Because, as I said previously elsewhere in the Forum, in NZ, and in the UK - metformin is standardly prescribed to those presenting with T2D, and enormous amounts of this drug are sold and dispensed to 98-99% of those with T2D in both of our countries (where I have seen the stats). We ought to have clear information about what kind of reduction in blood glucose from metformin we can expect, or is predicted, or however you want to talk about this.

If I have misunderstood what I am reading, or the maths in a crucial way - do sing out! This issue has been bugging me for years, and any contribution to the subject is enormously appreciated.

 

[Antje77]

If I have misunderstood what I am reading, or the maths in a crucial way - do sing out!

Only to clarify here:

looking at a blood glucose chart - this has been estimated to be a 11 mmol/L drop

saying one could expect a reduction of 16mmol/L with metformin.

I suppose this should be mmol/mol (hba1c units) and not mmol/l (BG units)?

As for the maths, I'm of no help here!

 

[AloeSvea]

ah! Quite right @Antje77. Pesky keys . Ahem. Yes. HBA1c units.

And we are all not alone in getting with the maths. But it shouldn't be like this. I have a 'go to' STEM expert that I consult for such. But he has made mistakes with this ghastly calculation, due to the formula, and the two HBA1c measuring modes. And really - a percentage of a percentage????!!!! - those Americans and their differing measuring units.

 

[AloeSvea]

Just an update - I had already decided to keep the metformin taking as a metabolic shake up, and not intended it to be longterm. Especially as I am one of the ones that metformin, even with an upped dosage (I went from 1000 mg a day to 1500, ie an extra pill) did not affect my fasting blood glucose in a obvious way, or not that I could see. (I've had to stop that check, sadly.)

So I stopped taking it a couple of weeks ago, and keeping an eye on my waist line. The reason being - metformin mainly acts on me as an appetite suppressant.

I wondered about the affect metformin has on my emotions as well, as normally I am pretty resiliant to feeling down. I did not know if it was life circumstances that just happened to coincide with me taking metformin that I wasn't conscious of, or, the metformin affected my usual bounce back nature, by not bouncing in the same way.

Almost instantly, as in a day or two, I noticed I had my old mood range back. ie life's usual downs didn't send me into a blue funk as has been the case. And, my evening appetite returned! As pronto smart. But I am just dealing with that, as I do a sunrise to sunset five days a week eating window. I wondered how much metformin was making it easier, well - now I know. But hey! I may be hungier at night, and must practice self control more than before, but, I'm sure happier.

hmmm.

I will make an appointment with my country GP to give her feedback on the metformin and the mood range thing. Ditto also the appetite, but not my fasting blood glucose. Interesting if she actually does what she is supposed to do and make it part of the stats on negativve side effects! (I have had experience of docs who do not do this, even though they are of course supposed to, especially if patients make an appointment deliberately for this reason.)

I cannot feedback on my own insulin production and metformin, because this doc said no to a c-peptide, which is a real shame. She is the only doctor who has. And she did that awful thing of sneering at me for suggesting it, called a diabetes nurse specialist then and there at the regional hospital whilst I was in her office - no discussion with me, but continuing to make eye contact with me, and no discussion with the diabetes nurse on the phone about my particular type two (and I have severe insulin resistance), said thank you, hung up, and triumphantly told me no to the c-peptide.

No wonder I like the 'Equalizer' films so much! I would love that office appointment to end like a scene with the lovely Denzel in the Equalizer movies.

Oh dear. I told you all my usual mood range has returned. Including feeling a murderous response to ghastly behaviours by medical professionals

 

[EllieM]

Hi @AloeSvea

Hmm, the lack of cpeptide from your country doctor is a real shame. (I got the impression from my GP's DN that cpeptides were quite commonly done in Aotearoa, she was telling me about young children with T2). Not that I've ever to my knowledge had a cpeptide, as I was diagnosed in 1970 and am not sure if they did them then.

No other doctor in the practice I suppose?

Last time I saw an endo was over 2 years ago (I guess I'm not urgent) but I do have a phone number for the hospital DN so I can hassle her if I need to). The public health second class treatment for T2s seems to be a common issue worldwide, though, so I'm guessing you don't get to have a hospital referral?

As regards the metformin, all I know about it is that you should get B12 checked occasionally if you are on it? Am guessing you already know this though. And the B12 test is something that GPs can order with ease (or at least mine did when I asked).

And the 1% thing is saying it can improve hba1cs by around 11mmol/mol. A 1% reduction is not 1 in 100 of the hba1c figure but a reduction of 1 in the hba1c when measured as a %. eg an hba1c if 8% might go down to 7%.

Hopefully you are still getting things like eye checks though?

Good luck.

 

[AloeSvea]

Hi @EllieM. Yeah - I have had no problem dealing with a couple of my former GPs with getting c-peptides. Just a new country GP who turned me down on it. And no, in a small country practice ones choice is to change practice.

And yes indeedy, thanks to you and Anje I realised the error of my way in the earlier computation re metformin. Thanks for that.

I checked it out with an endo expert here in Aotearoa, on the phone, and he confirmed what we all know here - the individual differences are vast! Regarding any metabolic response to the whole kit and caboodle metabolically speaking, including meds. (The price I paid for asking him was him telling me how I could go to a public library and access data and records there with the help of a librarian. Good grief. To give credit where credit is due, apart from the old-fashioned library research thing, I did bring this condescension up with him, and he did apologise very nicely. So.)

After a year and a half I know what my own personal response to metformin is, and it isn't, after an initial period of response, much of a muchness on the liver spurting out glucose of its own accord. I am not alone on that one. Not worth the probs with B12, that I also know is my personal response.

The power in keeping excellent records, and checking on health/T2D markers. So says I.

EllieM - I will not be able to see an endo even if I wanted to (which I do not), as my blood glucose regulation is too good! I am very happy to keep right away from so-called 'diabetes teams' here. (Or anywhere!) Type 2 really is very different to Type 1 in this way. I believe.

 

[AloeSvea]

This must be my fault in how I expressed myself - please know no longer having a depressive effect (which I suspected, now I know) from metformin is a really GOOD thing! Lol. I realise it must look like the opposite as I got a couple of hugs. I am sooooo happy now to have my old range of emotions back, with my basic jolly nature taking precedent. Feeling angry at bad docs is part of my normal range of emotions .

 

[AloeSvea]

HBA1c stable, ie the same as on metformin. (I'm not surprised.) Dealing with having very strong hunger signals again, keeping up the eating window IF regime. Enjoying having my old mood range back and feeling more upbeat generally. Still stunned how swift a return that was on ceasing metformin. Pleased not to have the drug mugging effects to counter with CQ10 and B12 - both expensive supplements.

 

[peter-c]

Hi. Been on metformin SR 1000 mg since June. It seems to have no effect. FBG 8 to 9. Feel cloudy headed (I’m a writer so not good)?? And am not overweight - even thin! Did you stop suddenly ir decrease metformin??