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Metformin

J

jonesd

Member
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13
Hi everyone ? Is ther anybody on the forum that has an HBa1c over 9.2 that is non medicating ? This is my first and only reading and I am trying to control my T2 with diet and exercise . Difficult to know what is going on with my blood as I've said before my Dr does not issue monitors. Also wondering if they routinely call you in for foot and eye checks, I should ring and ask. Had my last checks one year ago and my hba1c check in february.
Dr did prescribe metformin and was angry I wasn't taking them, said 'had I got a death wish ?' which upset me . Haven't really slept that well since that Dr's appointment. Says I have a 1 in 3 chance of a stroke or heart attack. I lie awake in the middle of the night wondering how long I've got !!! Dr says he's referring me to a pyschologist because I am not taking the tablets or taking this seriously ! I am !
Trying hard to take responsibility for my T2, read a few books , some of which give conflicting advice - all quite confusing. Added to them hospital dietician recommended a diet of carbs which conflicts with low GI dietary advice. She recommends bananas - I challenged this and said I though they were high in carbs and she said it depends how much of the banana you eat ? I'm trying to retain my sense of humour.
Feel quite down.
Any advice as to whether I should take the metformin or not ? Any advice at all will help. You all sound on the whole so positive. I think I've mislaid my fighting spirit somewhere. Haven't even told my partner how i feel . Thanks for reading.
 
hi jonesd

Firslty, could you share with your partner how you're feeling - a worry shared and all that.

Secondly, not even gonna suggest whether you should or shouldn't be taking the met. I believe it is a very good, safe drug but like you I wanted to get my numbers down on diet alone. I have managed it, not easy but very very do-able. My HBA1c was 7.1%, so not as high as yours.

Can you get yourself a meter cos you'll find it very hard to know what carbs you can and can't eat without one. In fact impossible.

Doctor doesn't sound your most positive specimen but perhaps he wanted to make the point of how serious it is and didn't realise how much you would worry.

If you get a meter, keep diet and testing records you will have firm data to go back with to prove you are in control of this. Rather than just saying you are.

Good luck and keep us updated

Mary x
 
Hi Mary,

Thanks for your reply.

My partners wife died eight years ago from a heart attack. She had been ill for a number of years and he had cared for her. Don't want to cause him any worry as you 'll probably understand.

How long have you had T2 ? And do you have any symptoms ?
I don't seem to have symptoms such as excess thirst, loss of weight, needing the loo etc, so probably in denial to a certain extent. Have a few aches and pains in joints , and very dry eyes which DR says was nothing to do with diabetes as that affects the back of the eyes , not the front.

What monitor would you recommend Mary ?
 
Hi Jonesd and welcome.
I understand why you want to stay off medication, but I think metformin is different. It is not only a very safe drug, well proven over many years, but it also has really good long-term protection against cardio vascular disease. I'd strongly recommend taking it. It won't do a great deal for your blood sugar levels; you'll need to do that with exercise and diet. But it will protect you. There is no downside. Some get bad tummies for a while, but if you do you can go on the SR (slow release) version which doesn't have those side effects.
Regarding symptoms; you often have no symptoms at all until it's too late. i had no symptoms. But you ARE diabetic, and you can't hide from it. you need to deal with it.
His some info that might be useful in sorting it out.
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!
 
As mentioned Metformin is a safe drug and has protective properties that are important.

Your doctor knows this and he was, understandably, a bit upset that you were not following his.her advice.

Your HbA1c of 9.2% is well above the point at which most doctors would prescribe medication.

On diagnosis mine was way above yours, and I did manage to progressively get it much lower, I managed less than 5% on diet and excercise. It was not easy and when my DSN offered a low dose of Metformin I gladly accepted, it has allowed me a bit more variation in my diet whilst giving the protection I previously mentioned.

So, my advice would be to go and see the doctor again, and offer to try the Metformin for a while whilst you try and reduce your HbA1c to a lower figure, you can always come off it if you do very well.

In my opinion you should have an HbA1c every six months at least, your eyes, feet etc., are usually done every 12 months.

So why not ask for an HbA1c when you see the doc? They are usually OK about doing this, and it would help you by having some more up to date information.

H
 
Hi. Please do take the Metformin. It's the most common diabetes drug and well proven and safe. If you should have stomcch troubles with it, ask for the Slow Release (SR) version. If Metformin still doesn't help your Hba1c come down then there are further drugs that can be prescribed but Met is the best start point for most. AS you are aware though, the right diet is so important and bananas are not a good idea even though I occasionally have one!
 
Hi,
i tried the SR metformin and it gave me a terrible hangover if i had just the one pint of beer with my evening meal which lasted well into late afternoon of the next day so i said enough of that.

Went onto a low carb diet, lost 36 lb in 4 months. Had a blood test Monday, awaiting results Friday so fingers crossed.

Andy
 
Let us know how you get on friday, that's some weight loss.Well done ! What sort of diet did you go on and did you exercise ?
 
Hello - I managed to control T2 diabetes for 7 years with only diet and little exercise as I have had several spinal operations. Get Dr Bernsteins guide to controlling diabetes - it's a bit expensive but very good. If you can control by diet alone - which is quite hard sometimes especially when everyone around you is noshing cakes and chocolate - you will of course benefit by not getting any side effects of the diabetic drugs - however as diabetes is a disease that is progressive it's likely over time you will need the drugs but ... My philosophy was to try my hardest to control my diabetes by diet and it worked for seven years. I agree you also really need a BGL monitor as it's really the only way you will know if the diet is working and what foods affect your numbers. Good Luck
 
Angiebabe said:
My philosophy was to try my hardest to control my diabetes by diet
Click to expand...

Understand completely, and that's the way I viewed things for some time. However, I modified my view recently. Metformin is a harmless drug (apart from potential tummy issues which are easily dealt with) whereas other more powerful diabetic drugs are not so harmless. Some of the next drugs in line after Metformin work by encouraging the Pancreas to produce more insulin. This is effective, but also causes the failing Pancreas to fail more quickly, so we move onto the next line of drugs etc.
I therefore decided my way forward was to stay off these hardline drugs as long as possible. As Metformin can help to postpone the need for these other drugs, and protect against cardiovascular disease, I felt that taking Metformin actually helped me in my goals. So I've just started taking it, even though my BGs are low on diet and exercise alone, with HbA1c's in the 5's. (last test 5.9, I think lower now)
Metformin doesn't do much for Bg lowering, just a little, but it makes our insulin more effective and reduces the amount of glucose our liver releases. Both these things mean our Pancreas doesn't have to work so hard, so we preserve it for longer, so the stronger drugs are put off for longer. And if you DO get upset tummy, just go on the Slow release version and it should be fine for most people.
Each to their own of course, and if you want to stay totally drug free in the short term, then that's the right thing for you.
 
Mod Edit (Pneu): Quote from deleted post removed

I disagree. The urine sticks are almost useless, they only record BG levels above 10mmol/l, which is almost useless when you are trying to keep your BG levels below 7mmol/l 2 hours after you eat.

You probably need to accept that your Doctor is not going to give you a meter, so you need to make the investment and buy one yourself. Choose the one with the cheapest strips (the cost of the meter is trivial by comparison) and test yourself before you eat every meal and 2 hours afterwards.

Also ignore the NHS dietery advice. You need to somehow reduce your carbohydrate intake. By how much depends on your metabolism (and also on how much sacrifice you are prepared to make). Some of us eat as much as 150g a day, I eat less than 30g (although you probably don't need to go that low). I think the GI stuff is useful but, in my opinion, it's easier to reduce the amount and worry about the quality later.

I'd also suggest using this as the basis for your diet:
xyzzy said:
The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals potatoes, root vegetables and rice than a traditional diabetes diet.
Click to expand...

And take the metformin, it's good for you. My Doc won't give me any more, and I'd love to still be taking it.
 
Mod Edit (Pneu): Quote from deleted post removed

Sorry, can't see how this is useful. The key to testing is finding out what foods you can eat, and in what quantities, so the newly diagnosed knows WHAT lifestyle changes in dietary terms they need to make. To do this you need to test 2 hours after eating various foods at various different meals to see what takes you over BG targets and what doesn't. You can't do that simply by testing once or twice a day. NICE and the NHS set a target of less than 8.5, although most on here believe it should be lower, but how do you tell without testing very regularly in the early days of testing?
This forum has an e-petition on this subject, prepared by the site administrator in consultation with a number of members of this forum. Here's a link. I hope you'll sign it.
http://www.diabetes.co.uk/petition/
 
Mod Edit (Pneu) Quote from deleted post removed

It had a committee; or at least, a representation from a number of experienced members. Not sure if you read it right; it does require the GP to provide strips to ALL diabetics on an on-going basis; it simply accepts pragmatically that after a while, a patient may not require so many as when forst diagnosed. This was inserted for two reasons;
1) After an initial period of intense testing, a patient gets to know what foods affect him/her and how. They therefore need to monitor slightly less, mainly to check that things aren't changing, or when they try somthing different. So they really shouldn't need so many.
2) Being pragmatic, cost is why the NHS steers away from providing them; so by demonstrating that our demand isn't completely open-ended, or open to abuse, there is a better chance of getting some agreement. By abuse, I mean that If they thought that anyone of 3 million type 2's people could say "I'll have 300 a month please" on a regime of diet only, i.e completely in patients control, they would never agree. So it's a matter of winning the major prize of making sure we all get them, and that newly-diagnosed get as many as they want within reason.

Remember also, it's supposed to be part of an "education program", so it does rely on people being told how to use them properly and sensibly.
 
I was put on Metformin in the early days of diagnosis with an A1c of 5.9. I was plenty peeved and soon discovered low carbing and took charge of my life. Within 5 months and using my meter lots to see what didn't work I was getting very low figures in the morning, like 4.2. So I decided to reduce my tablets until I had stopped them all.
I haven't taken meds for about 3 years, I think and my last A1c was 5.2.
While I was unhappy to think that I needed meds knowing what I now do about the damage that can occur while having high readings, I am happy that I took the meds until my meter and blood pressure machine showed me that I was more healthy than I have been for a long time due to massively cutting carbs.
So just because you take meds doesn't mean that you will always have to. Get a meter, find out what food makes you worse and avoid that food.
Alison
 
Thats a wonderful achievement Alison. Do you have any advice on low carb diets or recommend any books ? i notice you grow veg ? I'd love to - have a very small garden though. Did grow tomatoes and runner beans the last 2 yrs , not enough to live on though LOL. Do grow quite a few herbs which I enjoy doing. How long since your diagnosis ?
 
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