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Metformin question

M

Maggie75

Well-Known Member
Messages
147
Hello again everyone,

I have a question about metformin, I'm a T2 diabetic diagnosed last November, been on 1 metformin per day since then. Last HBA1C in May was 36 and DN wanted to take me off metformin at that time which I did for a week or so but because my diet wasn't great due to depression and anxiety I spoke to GP who agreed I should go back on it. I'm almost out of it now and phoned dr's for new prescription, I've now had 2 calls back from GP surgery advising dr won't prescribe any more metformin until I have another HBA1C done. I'm very confused with this, surely it's my choice if I want to stay on metformin, my diabetes is certainly not in remission and is metformin not a fairly benign drug if you're not having side effects with it? Am I totally wrong here or has anyone else experienced this from GP? Next HBA1C wasn't due until later in August but I guess I'll need to arrange it for next week now to try and get my medication! Been told GP wants it done asap, again I don't know why, very confusing.

Maggie
 
It might be worth speaking to a doctor on the phone so you can discuss this and ask for their reasoning rather than having to wait to find out/everything being funnelled through a receptionist. Our surgery has specific times when doctors return calls or you can book telephone appointments; hopefully yours will do something similar.
 
I guess it's because your last numbers were not high enough to justify any diabetes meds. If you are still below 40'ish then you really don't need any Metformin. Yes it's a pretty harmless drug but why take something you don't need?
 
Metformin has many benefits however it may not be the best medication for you. Your Dr knows more than us about your health.
I'm guessing you aren't over-weight or you need a more important med for a more serious condition/disease that is more hazardous to you than this level of type2 diabetes. Some medication benefits clash.
Recently our family had a very bad reaction with citalopram and naproxen, for example.
 
I am always for getting off medication and if my GP says I don't need it I stop taking it.
 
Why would you want to take a drug you don't need to take?

Why would you not want to get an HBA1c test whenever offered the opportunity?

How are your Depression & Anxiety now? Are you in a place where you could look at your diet instead?

I don't think any of us gets to choose which medication we get prescribed on the NHS, no. It's on a 'need' basis, and I guess your GO has to justify the cost/reason of prescribing it to someone with such a good HBA1c result!!

if mine was 36 I'd be dancing in the street!
 
Hi everyone and thank you for your replies, I've spoken to GP today, it was about another matter but I asked about the Metformin and he explained because they now considered me non-diabetic that's why they would be reluctant to prescribe me more but if I felt my diet wasn't great he'll happily give me a short supply until I know what's happening with my HBA1C, I'll book the HBA1C test for next week to get it as close to the 3 months as possible and I suppose I'll know then what damage has been done by my 2+ months of unhealthy eating.

I don't take any contraindicated medication, the only thing I take in thyroxine for under active thyroid and I still have over 2 stone to lose to get to a healthy weight (had lost 40 pounds in 6 months through low carb which was how I reduced HBA1C to 36). The reason I wanted to stay on Metformin was that my DN told me initially it would help with weight loss, and I really want to shift this 2 stone but I know I need to change my eating and drinking habits really in order to do that. GP I spoke to today was delighted with last HBA1C and told me effectively I had reversed my diabetes and that the Metformin in the quantity I was taking it would have contributed very little so that cheered me up a lot! Although I don't consider myself to have reversed my diabetes with one good HBA1C result, here's hoping the next one won't be too bad and I can get back to healthy low carb eating. Thanks again.

Maggie
 
Hi @Maggie75 Your doctor is correct that metformin will have done little if anything to reduce your HbA1C - you did that with your diet and you can do it again if you have fallen off the waggon.
One area where it might have helped is in a slight appetite suppression, but if you eat Low Carb and prioritise Protein and fill in with Fat then Calorie reduction isn't critical in order to lose weight.
Once fat adapted you don't get so hungry and just 'burn' your stored fat to make up your daily energy requirement.
 
Ah, glad you were able to chat to the doctor and are feeling more positive!
 
I'm newly diagnosed too on 1000mg sr a day. I thought that was to help the hab1c but reading this you say metformin will make little difference so wondering the benefits of if I should be on anything else, would like to lose about 35 kgs. Thank you
 
babyflowers said:
I'm newly diagnosed too on 1000mg sr a day. I thought that was to help the hab1c but reading this you say metformin will make little difference so wondering the benefits of if I should be on anything else, would like to lose about 35 kgs. Thank you
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If you are a type two diabetic with nothing exotic, then a low carb diet should put you back into normal numbers quite quickly. An ordinary type two can't cope with the carbohydrates in the modern diet, so reducing them is very effective.
 
Hi Maggie

You mention you are on Levothyroxine for under active thyroid. Has your TSH been checked recently? This could be why you are struggling to lose that last 2 stone. If you are having a blood test soon could they add on TSH to make sure your Levothyroxine dose is correct?
 
Resurgam said:
If you are a type two diabetic with nothing exotic, then a low carb diet should put you back into normal numbers quite quickly. An ordinary type two can't cope with the carbohydrates in the modern diet, so reducing them is very effective.
Click to expand...
Thank you, but still confused about the main role of metformin if it is said that it doesn't make much difference to the hba1c level?! Sorry if I'm being thick here....!
 
babyflowers said:
Thank you, but still confused about the main role of metformin if it is said that it doesn't make much difference to the hba1c level?! Sorry if I'm being thick here....!
Click to expand...
Metformin does make a difference. It generally is one of the best tolerated with minimal side effects. It also does decrease levels. Perhaps not in as huge an amount as some doctors (not yours it sounds like) seem to describe but does have an impact as well as potentially other beneficial properties. Hate to say it but it’s also really cheap, which in the NHS is important

https://www.nhs.uk/medicines/metformin/

it can have some side effects especially gastric that are, for some intolerable but not for all. I had over a decade with no side effects on the slow release

it is in the order of around 1–2% (11– 22 mmol/mol) drop in hba1c which alongside dietary changes can be very helpful for some and in my opinion is not, not making much difference

The % drop could sound confusing, took me a while to realise that it is a dcct drop, not a percentage of current levels

https://care.diabetesjournals.org/content/diacare/35/2/446.full.pdf

It’s not always going to have the same impact on all and I totally understand for some the side effects are bad, but it has its place and can be just enough to keep diabetes at bay. But what I found was sone doctors don’t understand it isn’t a way to stop it by itself, diet and other control is needed to curtail the progression

I am drug free now because I had a decade on diabetic drugs and wanted to see if I could. But I considered keeping a low dose of metformin to help, I still think I may ask the nurse if I can as there are T2 who keep this low dosage to help. We shall see when my next hba1c comes around
 
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Resurgam said:
If you are a type two diabetic with nothing exotic, then a low carb diet should put you back into normal numbers quite quickly. An ordinary type two can't cope with the carbohydrates in the modern diet, so reducing them is very effective.
Click to expand...
I think that may be a bit of a sweeping statement. Yes, many T2s can go into remission by low carbing but metformin also has its place. And there's nothing wrong with doing both (low carb and metformin) and then dropping the metformin if you get the levels as low as @Maggie75 's excellent result.

If I could take it and get my A1C to go down by 10-20 mmol/mol I'd be battering my doctor's door down for it, but as a T1 it unfortunately doesn't have quite the same effect.
 
Sone T1s I think are prescribed to help with insulin resistance?

it won’t have as huge an impactful all of course, diet and weight loss etc had much bigger impact for me and taking metformin vs stopping hasn’t, seemingly, made my blood reading change much so I do know it’s impact isn’t always so good. I’m not an evangelist for it and I know it’s drawbacks but I do know it can work well for many
 
I’m four years from my type 2 diagnosis. I started Metformin on diagnosis when my HbA1c was 70 and (apart from the first week or so) I don’t get any unwanted side effects. My HbA1cs have been in the 30s since four months after diagnosis. Metformin has helped me control my blood sugars along side a low carb diet and it curbs my appetite so helped with losing a shed load of weight. I did reduce the dose once but my average blood sugars rose by a little bit and my weight loss stalled. I like to keep my HbA1c well down into the non diabetic range as this gives me a margin for error should something occur to raise my blood sugars, like Covid, which I’m just recovering from or a few surgeries over the past couple of years. It also mean I don’t have to compromise my diet further than I already have.
 
So taking Metformin I might have lowered my Hba1c from 91 to 70.
I tried Metformin for a few weeks - one tablet taken after I had done any errands outside the house.
Explosive incontinence, gut wrenching pain, and sleeping wrapped in two towels plus changing the bed each morning and buying a high quality carpet cleaner.

Low carb diet - Hba1c down to the top end of normal at 6 months from diagnosis and no problems with diarrhoea.
I have not felt so well for a long time. Bit of a no contest really.
 
Maybe, and maybe not. In many/most cases diet, including low carb is a better approach. in your case clearly the side effects were beyond tolerable and no one should put up with that

many do not have that level of effect luckily. For many people it may well be that metformin is a well tolerated drug that helps their blood levels. Unfortunately in some cases no matter how much people try, diet/low carb just doesn’t quite get the effects needed. Uniqueness of humans I guess
 
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