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Metformin - understanding more

Discussion in 'Type 2 Diabetes' started by Goonergal, Mar 27, 2017.

  1. Goonergal

    Goonergal Type 2 · Moderator
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    Hi

    I'm not taking Metformin - have been managing mainly through diet, with a bit of exercise. However my doctor has mentioned Metformin a few times and I would like to understand more.

    Putting the side effects to one side, I've read a number of times on here that Metformin has a minimal impact on blood sugar levels. If that's the case, what are its benefits and why is it prescribed so often?

    Thanks.
     
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  2. Squire Fulwood

    Squire Fulwood Type 2 · Expert

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    Compared to diet Metformin had no discernible impact on my blood sugars. I believe it is prescribed because a flow chart on my DN's computer says it should be. I have heard that it slows the production of sugar in the liver but am not too clear about that.

    There have been many other vague claims for it but most that I have heard of say that the benefits won't be obvious until I am 110 years old.

    I am not a fan but then I had side effects and they are not the topic.
     
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  3. Art Of Flowers

    Art Of Flowers I reversed my Type 2 · Well-Known Member

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    Metformin does have a small effect, maybe reducing blood sugars by 1 or 2 points. However, it won't reduce your fasting blood sugars down to normal levels (4-7). For that you need to change your diet to be low carb. A lot of people have stopped taking Metformin because of side effects and still managed to get their blood sugars down to normal levels.

    Doctors and diabetic nurses currently don't advocate LCHF diet, so rely more on drugs to lower blood sugars, often using increasing amounts and resorting to insulin for type 2 when they are found to be ineffective.
     
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  4. Goonergal

    Goonergal Type 2 · Moderator
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    Thanks @Squire Fulwood and @Art Of Flowers

    Interesting. I am using low carb diet and brought HbA1c down from 108 to 57 between December and February - trying to understand if there would be benefits to using Metformin to supplement this. Particularly keen to know if it would help with the pre-breakfast rises that I have. Outside of those (this morning went from 6.6 fasting level to 8.7 before breakfast a couple of hours later). Outside of those numbers I'm pretty much in normal ranges.
     
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    #4 Goonergal, Mar 27, 2017 at 9:11 AM
    Last edited: Mar 27, 2017
  5. Freema

    Freema Type 2 · Expert

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    In my case the metformin I take seems to keep the my blood glucose average down with around 1 mmol. But as I am Then in a normal level almost all the time and Then also able to eat around 110 grams of carbs a day it makes my life easier concerning eating and bearable , it is as I have understood it mostly the liver it affects by lowering the speed the liver transform proteins into glucose. And theories also says that it in a little extent do better insuline resistance , I Think no more than a few percent
     
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  6. walnut_face

    walnut_face Type 2 · Well-Known Member

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    Metformin has two outcomes
    1. It increases insulin sensitivity
    2. It slows the release of glucose from the liver

    Of the side effects, it will reduce you appetite among other things
     
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  7. Goonergal

    Goonergal Type 2 · Moderator
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  8. Sid Bonkers

    Sid Bonkers Type 2 · Well-Known Member

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    Metformin works in three ways firstly it help you to respond better to your own insulin, then it will lower the amount of sugar released into your blood stream by the liver, and lastly it decreasing the amount of glucose absorbed by the intestines.

    It also as a 'good' side effect as it seems to help decrease your appetite which in turn can help those who are overweight to diet without feeling hungry.

    More recently it has been found to help guard against certain cancers too.

    The maximum dose, currently 2 X 500 mg tablets twice daily (2000 mg a day) generally helps to reduce bg levels by between 1 & 2 mmol/L so not a startling difference but it definitely can help with diabetic control along with a reduced carb diet.
     
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    #8 Sid Bonkers, Mar 27, 2017 at 10:12 AM
    Last edited: Mar 27, 2017
  9. Ann1982

    Ann1982 Type 2 · Well-Known Member

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    I have just stopped taking metformin after reducing it by half for a few weeks. It never curbed my appetite, still bothered occasionally by higher fasting blood sugar but the LCHF diet has sorted out my sugars. HbA1c was 60 in January down to 45 this week, but the side effects were awful. Very "explosive" too often which made me exhausted. I feel much better now. I believe the side effects do not affect everyone but neither the ordinary or slow release seem to have helped me at all. Had my usual breakfast this morning and sugar now 5.9. Hope this sheds some light for you.
     
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  10. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    You may find this discussion on Metformin interesting
     
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  11. Goonergal

    Goonergal Type 2 · Moderator
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  12. Freema

    Freema Type 2 · Expert

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    I can eat metformin on an empty stomach which most say is not doable But it doesn't bother my stomach. It seems to anoy my kidneys the most , which is why I take the whole dose in the morning on an empty stomach together with my levothyroxine pills . Wonderful to have ones medicine in only one "meal"
     
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  13. debpre

    debpre Type 2 · Member

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    Metformin causing me problems even though SR. So is the arguement that it only brings BS down 1 or 2 points worth taking it?
     
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  14. Freema

    Freema Type 2 · Expert

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    I Think only you can Judge that
     
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  15. Ann1982

    Ann1982 Type 2 · Well-Known Member

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    @debpre i have only been without the metformin for a few days and no noticeable difference in BS. I will see after a few weeks
     
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  16. Incarnation77

    Incarnation77 Type 2 · Member

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    Been on the stuff a week, not really seeing the difference yet. Only on 500mg a day though.
     
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  17. Debzz_

    Debzz_ Type 2 · Well-Known Member

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    My 4th week on Metformin my glucose levels have gone down from around 16 in the mornings to mostly 7's this last few days . A good result along with the low carbs .
     
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  18. rmurphy195

    rmurphy195 · Member

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    This thread has some useful information, including a section about metformin. It's easy to forget that high blood sugar has other effects - such as causing eye problems.

    For myself, my annual HBA1c readings since diagnosis with T2 have been (earliest first) 7%,51,53,48,44,42,40,41

    The reading of 53 is about the time I switched from 2x500mg/day to 3 per day - at which point my HBA1c kept decreasing year on year. Dietary changes - just minor ones - have been reviewed each year. The reading of 40 was at my last annual review in Nov 2016 at which point I discussed with my GP a reduction back to 2/day, with a review after a few months. The reading of 41 was as of 3 weeks ago - my GP is as pleased with this as I am, so the reduced tablets will continue until my next review in November.

    The period where it went down from 44 to 40 coincides with the time period when my wife retired. The difference - 4-5 times a week we go for a walk and have coffee and cake half-way through, something I didn't do in the time period up until then.

    There has been a change of diet between November and now - that is slightly higher sugar intake (Christmas/new year!) and more carbs during the Winter and some cancelled exercise opportunities (shorter walks/bike rides in the cold/wet weather!). Because of this the November result (which will be preceded by longer walks/bike rides) should prove interesting.

    From my viewpoint I would say the MF works. At first I did get the (warned-of) side effects -upset tummy, sweating etc - but these passed after the first few weeks.

    How do you define minimal impact? - well, the impact of having one less slice of bread at teatime for a few months resulted in a weight reduction over that time of 1 kg. A tiny change, a minimal impact day-to-day - but a nice cumulative effect thank you. A bit like compound interest! Maybe "minimal" is all you need to make a difference over time.

    Basically, do it and measure to see the effect.
     
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  19. BarbaraG

    BarbaraG Type 2 · Well-Known Member

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    Bear in mind that, given metformin's mode of action, it will reduce your level of circulating insulin without necessarily reducing your BG very much. High insulin levels are damaging independently of high BG's.

    If you are taking metformin and your BG's are not completely normal, there are two possibilities:

    1) you are insulin resistant - this means your insulin levels will be high, and if you stop taking metformin they will go higher, even if your BG doesn't.

    2) your ability to produce insulin is reduced - your pancreas is already going going flat out and it's not enough. If you stop taking metformin, your insulin levels can't rise - but your BG can.

    Either result would increase your risk of diabetic complications.
     
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  20. Freema

    Freema Type 2 · Expert

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    metformin is only to be considered a stick to lean at where what really helps the broken leg is to eat low carb as few carbs as possible preferably under 100 grams a day untill blood glucose is again under control
     
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