Metformin v Exercise ?

I've been on only a single Metformin for a few weeks now and still doing ok - as per my doc's instructions, I take the 500mg Met with the biggest mmeal of the day.

It doesn't seem to matter if I take it lunchtime or evening, my morning fasting is about the same, so I'm a bit confused over how Met actually works, or rather, how long it works for.

Rather than Met acting for a long time, then, is it closer to think that Met acts to reduce spikes immediately after a meal and overall diet/exercise does more to control fasting levels? Or have Igot it wrong?

I'm not on SR, just ordinary and my fasting is almost always between 4.4 and 4.8 with really no change if I;ve had my Met 10 hours earlier or more like 16 hours earlier at lunchtime.

Mark

Dennis said:

Hi Mark,

Metformin doesn't itself reduce your blood sugar. It works by reducing insulin resistance so that the insulin that your body produces can work more effectively in dealing with your blood sugar. It remains effective in your system for up to 6 hours. This is why doctors often suggest that you take it with breakfast so that the dose will cover two meals.

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OK, so the 6 hours tells the story; since I'd always be measuring fasting glucose at least 12 hours after my last dose and meal (sometimes 18hours after a dose) I'm guessing that the body's usual metabolic activity masks what the Metformin may have done for me that long ago.

Since I dropped from two to one 500mg Metformin daily a few weeks ago, my average fasting level has gone up by only a very small amount - 0.1 to 0.2 - so there's probably a half-life decay perhaps?

I was still hoping that my GP would let me drop Met completely in a few months, but now that I take it mid/late-meal and the gastric upsets are fewer, I'm not so sure.

If taking it helps to preserve whatever beta-cell function I have left, perhaps I'd be better served staying on it, since weightloss and exercise seems to keep my fasting levels OK.

Maybe when I hit my final weightloss target, another 20 pounds, (and the ****** weather improves so I exercise more) I'll try an 'informal' glucose tolerance test again - from the six hour figure, I guess it doesn't matter if I've taken a Met the previous day, so long as I don't take one with the drink(!)?

The more information I present to my GP, the better he is able to help me, right?

Mark

mikomikimika said:

My doctor told me that metformin has a half-life of 12 hours, which is why I have to take it twice daily.

If your diabetes could be controlled by exercise alone, your doctor wouldn't have perscribed metformin. Neither one is more effective than the other, since you need both the be healthy.

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As Dennis states, only the SR version has a 12 hour half-life, I'm on the standard version.

When diagnosed, I was just on the margins of prediabetic/diabetic and my GP felt that going on Met immediately, rather than only diet/weightloss/exercise/wait-and-see first might be a better course in order to preserve what beta cells I have left.

As it is, I've lost a lot of weight and my GP has already dropped me to only one Met per day with the potential option of a reduction to zero if things go well.

He says he always treats marginal patients with Met immediately, in conjunction with the usual diet/fitness advice - it seems that there are indications that this preserves more beta cell function in the longer term, thus putting off the spectre of needing insulin in a decade or so in the future.

I'm happy with that for a plan!!!