Metformin - understanding more

Goonergal said:

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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Metformin is prescribed so often as it is an old & therefore cheap medication. I was diagnosed type 2 with an Hba1c initially of 119. My experience of trying Metformin is that it did not help my fasting glucose levels which averaged 7.6 in the morning but it did help curtail glucose levels after breakfast. I can only think that before breakfast I was not producing enough insulin for the Metformin to be able to do anything. The improvement after eating when some insulin was produced, for me was similar to the effect of exercise & so in my opinion, of limited value & in fact I now use insulin. As regards side effects, the day after taking Metformin for the first time I developed Raynaud's syndrome, painfully cold hands & feet. This is something I never had before & it was 6 months after I stopped taking Metformin before things went back to normal. I took Metformin for 6 months in the end but for me insulin gives better control & without all the side effects. The problem is to find somone prepared to prescribe insulin & test strips too. Type 1 means insulin is a given plus testing strips but Type 2 means trying various medications that all have side effects & no test strips prescribed, so you aren't able to judge what is working & what isn't unless you buy your own.

Debzz_ said:

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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By diet only I reduced my Hba1c from 119 to 49; diet is far more potent than the effect of Metformin which comes with side effects, including in my case, Raynaud's syndrome [painfully cold hands & feet]. I tried diet first & achieved fasting average around 7.6, which was not helped at all by Metformin. Metformin had more effect after eating, when some insulin would have been generated for it to assist.

According to Dr. DeFronzo, metformin does not reduce insulin resistance, it's effect is on the liver. My fasting BG is usually in the low 100's/5.6 with out it, but in the 80's/4.6 with it. I am prediabetic.

Sid Bonkers said:

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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Actually 500mg is not the maximum dose. I take Metformin in the Glucophage format and the tablets are 750mg X two a day.

I am on Glucophage which is the more expensive Metformin formulation that has very few side effects. The ordinary Metformin gave me terrible indigestion. Doctors are obliged to start you off on the basic Metformin for cost reasons, if you are not happy you can and shuold be prescribed the dearer alternative.
I was told by my consultant that Metformin also helps prevent fatty deposits around the liver.

I have had diabetes for 21 years, supposedly Type 2 but I wasn't overweight as I weighed about 8 stone when diagnosed and my father who also had it wasn't overweight and neither is my twin sister, in fact she weighs less than I do. Immediately on diagnosis I was put onto tablets and one of those was Metformin. After 8 years I was put onto Lantus and then Novorapid as well as still taking the Metformin. I slowly put on weight and got to 9 stone so still not huge but my appetite wasn't huge either and I think the weight increase was due to the insulin. About a year ago I started to feel extremely tired and found out that my B12 was low, this is a side effect of Metformin. I had to have a course of injections which has worked and I no longer feel tired. A few months ago when my appetite had decreased to such an extent that I was eating very small "toddler" size meals I decided to experiment and stopped taking the Metformin. It was miraculous! The day after I actually had hunger pains, something I hadn't had for years. I was eating much better but after a week I thought that I had better start taking the Metformin again. About three months ago I went for my annual checkup and told the nurse that I had been naughty and had stopped the Metformin for a week and she asked how I felt and what my sugar levels were like. I told her that I was eating better and my sugar levels were fine so she told me to stop taking them. I check my sugar levels four times a day and have to say that they are better than they were when I was taking the tablets. I give myself slightly more insulin, my normal dose of Novorapid usually being 4 units and have increased it by one unit and this usually covers most meals. My weight has gone up very slightly but I am still within a healthy weight and don't think I will get very big as I have never been able to put on weight all my life. If anyone is hesitant about taking Metformin they should certainly be aware about the B12 deficiency and if anyone is thinking of stopping it they may find that their sugar levels might actually go down.

Kirktown said:

I am on Glucophage which is the more expensive Metformin formulation that has very few side effects. The ordinary Metformin gave me terrible indigestion. Doctors are obliged to start you off on the basic Metformin for cost reasons, if you are not happy you can and shuold be prescribed the dearer alternative.
I was told by my consultant that Metformin also helps prevent fatty deposits around the liver.

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This is very helpful. I suffer from terrible indigestion on Metabet SR which was not the case on Glucophage SR. I'll switch back to this brand to see if it makes a difference.

Kirktown said:

Actually 500mg is not the maximum dose. I take Metformin in the Glucophage format and the tablets are 750mg X two a day.

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I think you must have misread my post ill quote what I said again so that you may re-read exactly what I wrote:

"The maximum dose, currently 2 X 500 mg tablets twice daily (2000 mg a day)"

Ive highlighted the max dose, hope that clears things up.

Hi @Goonergal

I take 2 x 500mg Metformin each morning. I used to also inject insulin and take sitagliptin - I managed to stop both the insulin and the sitagliptin without any problems but when it came to the Metformin it was a different story. When I tried stopping it I was in a settled period for my BG - usually around the late 4s / early 5s - so I cut my Metformin back by one tablet and by the following week my BG had increased to late 5s early 6s. And that was just stopping one tablet. So I started taking the full dose of 2 tablets again but have never really regained the firm control that I had before my experiment.