Metformin ~ slow release or not?

[sleepylu]

Have been on Metformin now for just 2 weeks, first week 500 once a day & now twice a day, morning & night. Touch wood not too many adverse effects?!

Now, I know it's very early days but i'm finding that i'm still having spells when i'm weak & shaky & dizzy in the afternoon. I'm thinking praps i need a midday dose?

I gather that slow release is a reluctant option for docs to prescribe cos it's obviously much more costly BUT aside from that does anyone know of any reason why standard maetformin is preferable to SR?

Seeing doc again tomorrow & it would be useful to be informed.....

Thank you experts!

 

[hanadr]

I don't know about the SR met, because I've been on the normal one for 5 years. what I can't understand is why you think the shaky feeling would be better on it.
the "Shakes" when caused by hypo, are not improved by Metformin. They are not usually caused by it either.
Now is the time to DEMAND enough strips to test when this happens. You shouldn't get real hypos on Metformin and taking more wouldn't prevent it's happening. A glucose Tab might.
You need to find the cause

 

[sleepylu]

OMG
Who do i ever believe?

Was told to lose weight & increase exercise for 3 months. Nothing else.
2 months on I was having horrid dizzy spells & palpitations.
Doc eliminated my thyroid as a cause.
She did a blood test which was 11.2 an hour after my breakfast. Took my BP which she said was up 148/90 (ish) & told me it was because my bllod glucose was going up & down & suggested Metformin to stabilise this happening.
I HAVE been feeling less woozy since taking it but only for a few hours after the tablet. So i was assuming that i needed a midday one.
My doctor does not want me to do any testing yet. She says it leads to obsession & is unnecessary at the moment. I know you lot don't agree with her.

I just feel like i am wading though treacle (& can't even have a lick of it) cos everyone is telling me different things.

Arrrrggghhhhh!!!!!!

 

[hanadr]

It's so easy to tell the patient to lose weight. It's not that straightforward. I've been trying all my life. I think some of them do it for a way out. If you fail, they can say you didn't take their advice. "Blame the uncompliant patient"
We definitely think testing is essential, especially in the early stages of learning.
The ONLY thing that has ever worked for me is low carb. Try it. You can combine it with Metformin .
It also helps you to lose weight.
If you want to upset your medical team, try Atkins. It's pretty good for T2 diabetes and "THEY" hate it. Also It Works. Will bring yout BG down too. Don't worry about the word Ketosis. Dietary ketosis isn't diabetic ketoacidosis.
It's worth doing just to give them the V sign, if they have just left you in the lurch as they seem to have done.
Surely it's better to get obsessed with BG control, than have constant worry about what's happening.

 

[Trinkwasser]

OMG
Who do i ever believe?

Was told to lose weight & increase exercise for 3 months. Nothing else.
2 months on I was having horrid dizzy spells & palpitations.
Doc eliminated my thyroid as a cause.
She did a blood test which was 11.2 an hour after my breakfast.

Don't EVER eat that breakfast again!

Sorry but your doctor is typically clueless.

Beg borrow or buy your own meter. do this

http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

get your BG down and your BP and lipids will surely follow, plus you'll probably lose weight and become an order of magnitude healthier all round. Exercise makes a good complement to Metformin in reducing your insulin resistance.

Then go back and tell her how you did it. They HATE that!

Alternatively, any chance of getting a competent doctor? They do exist.

 

[SilverAndEbony]

I have Type 2 diabetes, so I am talking from a (reasonably) well-controlled person with Type 2's perspective.
I have to say, not all of us are so absolutely sure that testing our blood glucose levels, especially in the first month or two after diagnosis, is absolutely essential. I test myself a couple of times a week. Just to check there's nothing major going on. If there is - and there never has been - I'm be off to the docs. Initially, as I think most type-2s who don't have really high initial BG test results, I watched what I ate closely and exercised a lot more. Which was good as I take enough pills already ;-)
But, although it improved, I went onto metformin within a couple of months. I can't remember how long, it was probably a month at most. I then tried adding a low dose of metformin, which didn't make enough of a difference so I'm now taking 850mg 3 times a day. I started testing my blood after I'd been using the metformin for a short while - again, I can't remember exactly how long.
My BG has stabalised near the top of the 'good' range. So I test a couple of times a week.

If I'd been told to test my blood 2 times a week when I was first diagnosed I'd have got even more obsessed than I was! It was not health, and I believe would have ended up with me probably eating chocolate, not looking after myself and not seeing my gp and diabetes nurse again. I certainly felt like doing that anyway! I tried my best to control my GB levels, then felt a total failure when I couldn't. The levels were coming down, but by nowhere near enough. If I had been testing my blood at that point, I may well have got so stressed who knows what would have happened :-(
Is stress supposed to raise BG levels? I don't know.

I understand that it's totally different for people with type 1, or who's BG levels were worse on diagnosis than mine.

 

[graham64]

Hi SilverAndEbony,
I can't agree with you over the BG testing, I'm also T2 and on diet and exercise but No Meds, this is only due to a lot of testing in the first few months after diagnosis. I realised that my BG was not improving with the standard NHS diet and asked to see a Dietitian who changed my diet completely, resulting in in much better BG control. Without testing I would probably have been on meds now.

Regards
Graham

 

[Trinkwasser]

Hi SilverAndEbony,
I can't agree with you over the BG testing, I'm also T2 and on diet and exercise but No Meds, this is only due to a lot of testing in the first few months after diagnosis. I realised that my BG was not improving with the standard NHS diet and asked to see a Dietitian who changed my diet completely, resulting in in much better BG control. Without testing I would probably have been on meds now.

Regards
Graham

Couldn't agree more, without testing I'd probably be DEAD by now.

My BG was never that high by comparison, but my blood pressure was ludicrous and my lipids were worse, I was a heart attack on legs made far worse by the diet. Rigorous testing at first helped me to identify the patterns and learn what to do about them (principally reduce carbs and rebalance them through the day) now that I'm on a much more even keel and know what I'm doing I test a lot less.

The speed with which many people gain control by following this

http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

or similar protocols suggests there'd even be an advantage to giving all newly diagnosed diabetics a loaner CGMS for a month.

I can't conceive how some of the cretins who invent these anti-SMBG research protocols could consider four times a week to be "intensive" testing. And NOT using the results as feedback to modify your diet and exercise protocols is ludicrous.

 

[sleepylu]

Why is it that it seems that every post asking a question on this forum unrelated to testing & low carbs always seems to end up back at those 2 issues?

Do I need to make this a rhetorical question? Unless someone perhaps can explain the benefits of Slow Release metformin over the standard type!!

 

[sleepylu]

While i am now on my soapbox .......
I would also like to say that make an observation that many of you use terms & abbreviations that, as a newbie, are of absolutely no meaning or help to me whatsoever!
I appreciate that many of you have been living with diabetes for some time but i beg of you to please bear in mind that sometime you may as well be responding in japanese.

Thank you.

 

[Trinkwasser]

Why is it that it seems that every post asking a question on this forum unrelated to testing & low carbs always seems to end up back at those 2 issues?

Do I need to make this a rhetorical question? Unless someone perhaps can explain the benefits of Slow Release metformin over the standard type!!

OK, people were trying to point out that your shaky symptoms were probably the result of BG swings not metformin.

Many people find the SR gives fewer digestive sound effects. However some do not. Although metformin is not supposed to have any immediate effect, some people find an immediate BG lowering on the meal with which they take their dose with the standard version which the SR doesn't do, obviously since you only take it once a day.

 

[hanadr]

OK Slow Release metformin. You only need to take it once a day, so it's not tagetted at the increased blood sugar from a particular meal.
It's supposed to cause less tummy grumblies
It costs far more, so they give it to you reluctantly.
the maximum allowable dose is different. I don't really know why.
You get used to it quicker, that's the grumblies thing

 

[Dennis]

Sorry to disagree Hana, but you do need to take the SR version of Metformin twice a day. Each dose lasts for up to 12 hours (as opposed to standard Metformin lasting for up to 6 hours). The SR version releases slower than the standard version and is therefore kinder to the stomach and less likely to cause some of the more unfortunate side effects that accompany standard Metformin, particularly indigestion & diarrhea. The main function of Metformin is to reduce insulin resistance, thereby ensuring that insulin works on blood sugar more effectively. The advantage of SR is that it provides this action for a full 24 hours, rather than in the short bursts that standard Metformin provides.

 

[sleepylu]

Thank you!!!

 

[1000nettie]

I disagree about Metformin and hypoglycemia. Although it did not cause it, I had hypoglycemia anyway and found the Metfomin made it much worse.

After following my doctor's advice of 3 healthy, carb laden meals a day, I got a thorough dressing down at my next clinic appoinment for putting on weight, even though I was calorie counting and exercising like a mad thing. I complained that this was because I was having a lot of hypos, but they disregarded this and told me it was not possible for Metformin to cause or contribute to it.

Let me tell you, it can. The only solution I have found is to low carb, and I split my food into 6 small meals a day. I havent had a hypo since.

I only learned how to take control of my diabetes through this forum, I would have just blithely gone on wondering why I was gaining weight and suffering otherwise.

 

[hanadr]

theoretically Metformin cannot cause hypos and it's supposed to cause weight LOSS. In fact anyone can have a hypo. they don't have to be diabetic and in the case of a diabetic who has been running on high sugars for a while. A drop to what might still be quite a high level might feel like a hypo. It wouldn't however be dangerous. It's the drop you feel, not the level and it's the level that determines whether you can continue to function

 

[sleepylu]

i have now been on 500 x 3 metformin for just a week & i really do not feel any benefit.

Have had a horrible "hypo" experience this lunchtime, 5 hours after my breakfast, just sitting in a meeting feeling fine BUT as soon as I moved .....WHOAH, the shakes, feeling so faint, head & heart pounding. I stuffed my face with totally inappropriate things i could find in the car just to feel better.

I'm sure it's not a true hyp as hanadr says, it just is a drop to a lower level but it's scary.

I know i need to be better prepared & have something with me to eat but I was just sitting around feeling fine & not even thinking about it.

I thought metformin was supposed to stop this happening? BUT when will it start to take effect?????????

 

[catherinecherub]

Hello Sleeplu.
I find that eating 4hrly stops those nasty hypo feelings. You do not say what a typical breakfast is for you. Try keping a food diary and then you may be able to pinpoint the problem. I take metformin 500mgs x2 daily. Hope you will soon be able to get things under control.

 

[sleepylu]

Hi catherine

Am low carbing (well low'ish) as i've been told to lose weight (& low carb is the only way i know) & increase excercise, not that i have ever been a couch potato, I have a stenuous walk for an hour every day (some days having to stop & rest co i feel so faint) & am swimming 3 or 4 times a week (half a mile per swim) I am also keeping a food diary & making a note of when "hypo" feelings occur ....... not finding much time for a life yet beyond all this!

It's early days i know after just 3 weeks on metformin but i am just so fed up with feeling so ill.

Doc reckons some of this may be attributed to highish blood pressure but won't do anything about that until the metformin has time to kick in. I would have thought after 3 weeks that would be happening?

 

[catherinecherub]

Hi Sleepylu,
Perhaps you are not eating enough for the amount of exercise you are doing. The metformin will decrease your blood sugar levels anyway and combining with exercise may be why they are going so low. The early weeks of metformin were bad for me but not in the way that you describe. I had stomach cramps and spent ridiculous amounts of time on the loo. Exercise is good for high blood pressure so that should be going down. I think it is trial and error and we all feel hopeless in the beginning. If anyone thinks becoming a diabetic is easy then they are a liar. If you feel you need to see the Dr again then go. You are concerned about your health and have every right to be. Write everything down that you want to ask him as it occurs to you so that you don't come out of the surgery with unanswered questions. Good luck