Metformin newbie - progress log

* For context - my BG control is reasonable (last 3 half yearly HbA1c: 7.1 (for winter period) 6.4 (for summer period) 7.0 (for winter period). I have managed since March 2008 on diet and exercise but have now decided to add Metformin to my regime to see how much lower this will take my BG levels. HCPs are happy with my control but also happy for me to take Metformin. 1 * 500mg per day, HbA1c and review in 3 months

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Having asked the questions after not finding all the answers I thought I would chart my progress over the next week or so, via edits to the topic or quick replies.
On 1 * 500mg once per day; taking it with large breakfast as my morning BGs seem consistently higher than my afternoon/evening BGs from previous testing.

Friday 27th April - first pill with a late breakfast. Spent the next few hours wondering if and when side effects might kick in. Gradually went from "am I talking myself into something?" to mildly queasy :sick:
Stayed with me all day and through the night. Now easing off just in time for the next pill.
Not debilitating, just a bit uncomfortable - a background nagging.
Wonder if this means the pill is working immediately; also, sugggests that one pill lasts for 24 hours.

Saturday 28th April - second pill with brunch at about 11:30; really need to eat early on and have pill then but it is Saturday
Queasiness less than yesterday.
18:00 No loss of appetite - possibly slightly more hungry. Mild grumbling feeling in guts but nothing untoward happening so far. Will start testing Monday when the pills have had a chance to kick in.

Sunday 29th and Monday 30th April - both days took pill as early as possible with a small portion of rhubarb crumble and natural yoghurt to buffer it. Queasiness has turned to indigestion which is unsettling but not a major problem. Slightly more windy than usual (but so is the weather).
Main problem is that the indigestion makes me wonder if I am hungry - it gets worse about 2 hours after I have eaten - and I have found that a snack and a drink ease the symptoms for another hour or so.
The regime of regular snacks does NOT fit in with the expected benefit of loss of appetite and therefore some weight loss!
Just as well my weight is O.K. at the moment.
I've started BG testing Monday and so far I haven't had any high readings.
This despite snacks of low GI cake and small cheese and wholemeal bread portions.
It will take me a few days to check if my figures are better, but there are hopeful signs.

viviennem said:

Are you staying on one a day for a while? I'm on 3 a day, but was eased on to them - 1 first week, 2 second week, 3 a day third week onwards.

I don't recall any queasiness etc, tho' I did have the runs to start with in the third week. Mind you, I have a digestive system like cast iron - very little upsets it! I try to take one at about meal times, but sometimes the last one is at bed-time - and the others, whenever I remember!

Our diabetese "expert" said I must take it with food for it to have any effect :!: :?: ; my favourite GP said, 'space them out evenly'. I have no idea who is right. The timing seems to make no difference to my innards. :wink:

Viv 8)

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I've updated my progress log with a bit more detail.

I am one one a day for 3 months then a review.

I would have said that I have a pretty cast iron digestive system but I am noticing some effects - fortunately no major ones so far.

Tuesday 1st May and Wednesday 2nd May - unsettled gut seems to be settling down for the most part. Appetite now seems to be reducing once the indigestion has reduced, which is good. Morning BG levels still are in the 7 -> 9 area so I haven't eliminated the overnight boost yet. More scientific testing to follow when I am not so busy doing stuff. Now wondering if (should my guts adjust more to the Metformin) I should check with my HCPs and then up the dose to one tablet in the morning and one in the evening. Then again I may just be an impatient patient.

Thursday 3rd May and Friday 4th May, Saturday 5th May morning.
Unsettled guts still not settled, infact a bit worse. On Friday I strayed twice Firstly we were out so I had a pub lunch; ham egg & chips and I ate the chips. Secondly my lady wife bought some sourdough break from an artisan baker and I succumbed to a cheese and salami sandwich for tea. I think that upping the carbs also ups the reaction to Metformin. I feel best when on almost pure protein. I have also been completely knackered all week - I don't know if I have a lingering bug (tickle on the chest) or if this is a side effect of the Met.
Testing has shown that my fasting readings in the morning are not really coming down as I hoped.
7.1, 8.5/8.6, 7.7, 6.1, 7.1, 8.4
I am now wondering if I should be taking a Metformin tablet last thing at night.
When I get a clear run I will do a full day of testing and see if my morning to early afternoon readings are improving.
Edit: Sunday 6th May 8.2 this morning. So the Metformin is really not reducing my morning numbers. Nearing the end of a two week pack so I now have to decide if I switch to a single pill in the evening or increase the dose to two pills a day spilt between morning and evening. Think I'll probably try an evening dose.

Monday, Tuesday, Wednesday morning 7-9 May

Well, an eventful few days.
Firstly, when I came to take my Sunday evening Pravastatin it was missing but my Sunday morning Metformin was still there.
Deducing a Senior Moment I took the Met and effectively switched to taking the pill in the evening.
This seems to cause me less nausea/indigestion - uncomfortable after the evening meal but fine by next day instead of uncomfortable all through the day.
Further bad news for my personal life style - I avoided all alchohol yesterday and didn't seem to suffer as much from side effects. Further testing required but I really don't want to find that having a beer whilst on Metformin makes me queasy!

Side note - is it just me or are Metformin tables salty? :?:

Further alarums - Tuesday morning, drying my legs after my shower, I noticed that my right leg was swollen and that there was bruising/bleeding signs around the inside of my foot and my heel. Perfectly fine the day before.
Burst of paranoia while I read and re-read the common and rare side effects of Metformin. No mention of this.
Arranged to see the doctor a.s.a.p. because something was obviously not right. He saw me at mid-day, and rang the hospital immediately to book me in for an Ultrasound scan of the leg.
I had twanged my calf whilst running just over a week previously so this was probably just a late release of fluid from the damaged area but the symptoms were also consistent with Deep Vein Thrombosis and if I had that I would need blood thinning injections but they aren't something you give unless really, really necessary. Doc confirmed that he didn't need to inject me immediately, and filled out a form on his computer and faxed it off to the hospital who should ring me back to give me a time to come in.
Still nothing by 16:00 so I checked back with the surgery who rang me back in a bit to say that the hospital had cocked up collecting the fax so my appointment was now tomorrow. Call from hospital this morning, in for 10:45 and all processed and out the doors by 11:40. No DVT, signs of fluid at join between muscle and tendon suggesting a minor tear. absolutely NOTHING to do with Metformin :thumbup:
Still finding KY Jelly in unusual places :shock:

So I can confirm that your leg swelling up is not a common side effect of Metformin - just of taking insufficient care to stretch out before and after running.

Morning BG 8.5, 7.2, 8.2 (the 7.2 was at 06:30 and the others between 07:30 and 09:00 so I am now wondering if my BG climbs first thing in the morning not overnight). Whatever, the single 500mg dose doesn't seem to be having a massive effect on my numbers.

Cheers

LGC

Thursday 10th - Tuesday 15th May

Morning readings 7.7, 7.5, 6.8, 7.7, 7.6, 7.4
Looking a little better, but need to see this for several weeks to be sure.

Nausea has almost gone

Extensive, intensive, rigorous and far reaching dedicated testing has established that alchohol does not cause nausea in conjunction with Metformin. 8)

I think I have been lucky in that it has only taken a couple of weeks for the side effects to have settled down although I am only on the minimum dose.

Next question is when/if to up the dose to 500mg in the morning and evening.
Doctor has said to have another HbA1c three months after starting the pills.
I am wondering if I should contact the surgery and discuss upping the dose as I would like to see my fasting reading coming down closer to 7.0.

Cheers

LGC

xyzzy - thanks; really useful information and something to go in the Metformin 101 (if it ever gets sorted).

Sounds like I should try the second tablet.

Oh, hang on, your tablets are half a Kilogram each.
Not quite sure how you swallow them but maximum respect! :shock:

Quick update.
Taking my single dose each evening with my meal, along with my statin.

All side effects seem to have disappeared thankfully, although I haven't seen any major change in my fasting readings.

Advice gleaned sugggests:
(1) A single 500mg dose may reduce peaks, the second cut back fasting BG. So I may need another dose per day.
(2) It can take up to 3 months for the effects to show.

So I will know more when I have my 3 month HbA1c; still to decide if I ask the doctor if I can up my dosage before that.

No longer a Metformin newbie so I'll update again when I have more information.

Cheers

LGC