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METFORMIN QUESTIONS and ANSWERS

Re: Another Metformin question.

Hi IanD, thanks for your quick reply.

You said; Single figures BG are still rather high for good control & prevention of complications.?

I'm rather confused by this, where should my BG be?

I'm on about 100-120 carbohydrates a day and due to my diet I have lost about 2 stones and have gained my optimal weight and still losing but very slowly now.
 
Re: Another Metformin question.

Hi Ka Mon and welcome. :)

I have extracted part of the information from the "Advice to newly diagnosed T2s" which should help you:

As a Type 2 the latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.
2 hrs after meals......no more than 8.5 mmol/l.
If you are able to keep the post meal numbers lower, so much the better.
Click to expand...
 
Re: metaformin .......here goes

It's comments like 'some people can't cope with low carb so have to resort to medication' etc that are not helpful I think.

Low or reduced carbs would benefit most people I think, not sure of the point of lots and lots carbs - for energy, but how much energy do I need to sit at a desk? But in combination with medication for many is needed. Please be careful everyone to imply that this is to be avoided at all costs.

Sorry for the poor English not easy to type and go back and modify things.
 
Re: Another Metformin question.

SR metformin lasts something like 16 hours ? So I wouldn't think changing when you take it would change much. Taking it with helps with the side effects iirc.
 
Re: Another Metformin question.

I have tried all time slots and combinations for my 4 metformin SR but still find they basically remain slightly enviromentally unfriendly (carbon-dibackside). The best times and doasge for me is 2 @ breakfast (07:30) 1 with lunch (13:00) and the last 1 with the evening meal 19:00.
 
Re: Another Metformin question.

Synonym said:
Hi Ka Mon and welcome. :)

I have extracted part of the information from the "Advice to newly diagnosed T2s" which should help you:

As a Type 2 the latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.
2 hrs after meals......no more than 8.5 mmol/l.
If you are able to keep the post meal numbers lower, so much the better.
Click to expand...
Click to expand...

Hi, thanks for posting the NICE guidelines, seems that my figures are mostly within the recomended range. As my levels are usually withing NICE guide lines I could not undestand why IanD said that my single figures were rather high.

Looks like I might as well stick to the way I have been taking my Metformin.

Thanks to all who have replied.
 
Re: Another Metformin question.

Ka-Mon said:
Hi, thanks for posting the NICE guidelines, seems that my figures are mostly within the recomended range. As my levels are usually withing NICE guide lines I could not undestand why IanD said that my single figures were rather high.
Click to expand...

Hello again Ka-Mon,

I have recently read that there is concern that these figures as recommended are really higher than are safe but am unable to find it at present - perhaps someone else may be able to point us in the right direction.

Personally I am aiming and trying hard to keep my numbers in the 5s as long as possible - whatever it takes :!:
 
Re: metaformin .......here goes

endure said:
They say that starchy foods should make up 30% of what you eat.
Click to expand...

Carbs probably do make up around 30% of my meals, but I eat a third of what I used to. The dietitian on the course I attended did use the eatwell plate but only as a visual aid to show what a balanced diet looks like.

Example, a portion of basmatti rice for me is two tablespoons, others may well eat more or less depending on their tolerances. If I add that to the carbs in the veg I eat and to that of the orange I may have for afters I would be surprised if it doesn't come to 30% of most meals.

I actually had a cold meat salad last night, but I did have a scoop of Cornish ice cream with some strawberry's for afters :D So it does vary but 30% overall sounds about right for me, but as has been said on here a million times "we are all different".

The dietitian told us that the amount of carbs we all need will be different due to our sex, weight, physical activity etc but a good starting point would be around:

breakfast 10 to 30g
Lunch 40 to 50g
Diner 40 to 50g
Plus snacks.

Now I wouldnt call 130g per day loads and loads of carbs would you? And we were encouraged to look out for low GI carbs wherever possible and to avoid the less complex (starchy) carbs.

Like I said, don't write off a course before you attend it, you may be in for a pleasant surprise, I can't believe it is just my PCT who have changed their dietary opinions :D
 
Re: metaformin .......here goes

I often wonder if "plenty" actually mean "a variety of" complex carbs as opposed to lots :?:
I think you have hit the nail on the head Sid.
30% of a smaller amount is doable. I actually try and guage mine so that I use 25% of carbs on my plate. 25% of pasta, rice, etc. is a much smaller portion than what I was eating prior to diagnosis. I can always supplement this with a side salad or up my veggie intake. This is the good advice I got from my DSN/GP when diagnosed. I rarely count carbs but when I do they are in the 90 - 120 range.
Low carb, medium carb, high carb, is very subjective and there are no official guidelines. People have ideas about this but they are only opinions. You only have to read research papers where subjects are put on a low carb diet by professionals and this can vary from 25% - 40% of their meal and ideas of what constitutes low carb do vary. Some of us can tolerate more than others. Eat to your meter and you won't go far wrong.
 
Re: Another Metformin question.

Hi again Synonym, I remember reading something about NICE rasing the hba1c from 7% to 7.5% but can't remember where I read it. If I remember correctly they said that their current recomended figures were too tight and increased fatalities.

If you do find t he article you read I'd be very interested in reading it.

Thank you
 
Re: Another Metformin question.

Im also on the SR met as well and when i picked up my scipt today she asked how i had been taking them, I take 2 in the morning and 2 in the evening with my meal. The pharmacist said that the SR version should really be tajen all at the same time SO she was saying that i had to take 4 at once...this sounds mad to me, what do you all think?

Brian
 
Re: metaformin .......here goes

catherinecherub said:
I often wonder if "plenty" actually mean "a variety of" complex carbs as opposed to lots :?:
I think you have hit the nail on the head Sid.
I would agree with that and think it is the terninology that is at fault.

I rarely count carbs but when I do they are in the 90 - 120 range.
I also rarely count them because I know pretty much what I can have now but unfortunately still can't touch any of the starchy carbs like bread, potatoes, rice, pasta etc.......Yet!
Low carb, medium carb, high carb, is very subjective and there are no official guidelines. People have ideas about this but they are only opinions. You only have to read research papers where subjects are put on a low carb diet by professionals and this can vary from 25% - 40% of their meal and ideas of what constitutes low carb do vary. Some of us can tolerate more than others. Eat to your meter and you won't go far wrong.
Click to expand...
There is probably little likelihood of there being any official guidelines to low, medium or high carb as we are all so very different and tolerate such varied amounts which can also change. The meter is the great enabler and eating to your meter makes everything much simpler. This makes it difficult to understand why a meter is denied to so many people and why the strips are not prescribed for them either. :? :roll: :shock:
 
Re: Another Metformin question.

I spoke to 3 doctors over the last few years about when to take them, they all said split the dose.
 
Re: Another Metformin question.

On the information leaflet for Metformin it states "Normally, you should take the tablets once a day, with your evening meal".

But the next sentence says "In some cases, your Doctor may recommend that you take the tablets twice a day."

I don't think taking all 4 at the same time is a good idea though, especially for the people living with you. :wink:
 
Re: metaformin .......here goes

25-30% sounds about right to me too but doesn't that also depend on the size of the plate a person uses?

30% on a large plate of about 12 inches is a lot more than a plate of about 8-9 inches.
 
Re: How long for metformin to kick in?

Just a quick reply to your last post your BG are quite low for morning readings at 4.5. I could not function at all this level. The lowest I let mine get to is about 5 but I always want my am test to be about 5.6. This shows just how different we type 2's are?

The average on my meter is 6.3 and my last HBA1C was 6.3. My BP is under control, my cholesterol is 4.9, all are within NICE guidelines, but a specialist doctor who I recently saw after my spine surgery told me that guideline cholesterol levels for Diabetics is pretty irrelevant it should be as low as possible not below 5, if you want the best chance of decent life span. My GP and DN has confirmed this, so sadly it looks like statins for me.

Hope you are well and good luck on 9th July
 
Re: Another Metformin question.

Ka-Mon said:
Synonym said:
Hi Ka Mon and welcome. :)

I have extracted part of the information from the "Advice to newly diagnosed T2s" which should help you:

As a Type 2 the latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.
2 hrs after meals......no more than 8.5 mmol/l.
If you are able to keep the post meal numbers lower, so much the better.
Click to expand...
Click to expand...

Hi, thanks for posting the NICE guidelines, seems that my figures are mostly within the recomended range. As my levels are usually withing NICE guide lines I could not undestand why IanD said that my single figures were rather high.

Looks like I might as well stick to the way I have been taking my Metformin.

Thanks to all who have replied.
Click to expand...
My advice is based on my experience - & I followed the advice from the experience of others. The closer we can get to non-diabetic BG the better for long term health.

We are told by the professionals that diabetes is progressive - diet--tablets--more tablets--insulin--complications---

I followed the DUK advice for 8 years, maintaining a fasting BG around 6.8. I was up to 3 mf daily. I had crippling leg muscle pains & the beginning of retina damage after being good & obedient. I then came on this forum & began a reduced carb diet. Immediately my fasting BG dropped below 6. Within 3 months the pains had gone, & now after 2 years, the retinopathy has gone.

The Dr was happy with my control - HbA1c=6.7 but my body was not.
 
Re: Another Metformin question.

brianb said:
Im also on the SR met as well and when i picked up my scipt today she asked how i had been taking them, I take 2 in the morning and 2 in the evening with my meal. The pharmacist said that the SR version should really be tajen all at the same time SO she was saying that i had to take 4 at once...this sounds mad to me, what do you all think?

Brian
Click to expand...


Metformin, as with any other drug should be taken as prescribed by your GP. NOT, as directed by the Pharmacist in this case.

You should NEVER take more than two tabs at one time unless specifically told to do so by your GP/Consultant. To do that is way out of line with the current 2010 BNF59 prescribing guidelines.

The way you are presently taking them is the correct way, even if they are the SR/MR versions. They are designed to cover a 24 hr period and will not be as effective pharmacologically but will probably be very effective in other ways !! Don't stray too far from a loo ! :shock:

If you are confused check again with the GP.......

Ken
 
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