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Metformin

LucySW

Well-Known Member
Messages
1,959
Location
Denmark
Type of diabetes
LADA
Treatment type
Insulin
Does anyone know whether Metformin is primarily prescribed for insulin resistance? The hospital doc I saw this week said so. Is it true?

She thought I shd drop the Metformin bec (as a LADA) I'm less likely to be insulin resistant. So she tht it probably wasn't helping. But my BS responds to exercise, so isn't that because I am IR?

Any experience with this? Lucy


LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. On LCHF and Metformin plus a bit of ex. HbA1c currently down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.6.
 
Hi. Yes, Metformin is at it's most useful for IR. When I asked my DN to stop mine she didn't want to saying it helps protect the kidneys etc; true to some extent so I still take them really to keep her happy. The HCPs dish Metformin out to anyone with diabetes regardless; a bit of a bad habit and another cost hit to the NHS. BS responds to exercise as the higher energy use draws on available carbs
 
I was on metformin and gliclazide until diagnosed LADA, my consultant said to stop gliclazide straight away as it would do more harm than good and advised me to stop metformin as it would not really not do any good, but likely no harm.




Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings as low as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
Sent from the Diabetes Forum App
 
Well, I'll see if it was helping BS control when I stop, if you see what I mean.

Asking the consultant next week abt low doses of insulin to preserve my beta cells. The docs were recommending an all-day insulin (don't know if these are the same in the UK, I'm in Denmark where it's called Insulatard). That seems attractive if it's less likely to cause a hypo. But if as LADAs we lack phase-1 insulin, is an all-day sort the best thing?


LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. On LCHF and Metformin plus a bit of ex. HbA1c currently down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.6.
 
I don't know about insulin. Hopefully someone here can give you an answer.


Diagnosed T2 in sept 2013, BS levels 20+. BMI 22, age 58. Requested a GAD test in November, came back very high 2,000+, doc said I would be T1 within weeks, but presently still LADA. On a LcHf diet taking no insulin or medication, and striving to keep my BS readings as low as possible in order to keep as many insulin making pancreas beta cells as possible for as long as I can.
Sent from the Diabetes Forum App
 
Anyone with LADA may be able to stay on tablets for a while before insulin. The length of time varies greatly as deterioration in the pancreas varies. I stayed on tablets too long (my GP refused to move me to insulin until very late). If all the tablets at max dose are failing then it's time for insulin and perhaps a bit earlier to avoid starving yourself as I did.
 
Well, I came off Metformin ten days ago and my BS levels have not risen but have stayed steady at about 6.2. So the hypothesis that M. treats insulin resistance seems to be true.

What I can't do is keep my meals steady in levels of carbs and protein. I can partly blame having to cook family meals, but that isn't really the issue.

But until I can do that, I can't try out the insulin low doses I want to.

Oh, organisation ...

Lucy

LADA, 55, BMI 23, moderately active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.

Now on LCHF plus exercise, no meds.
 
Last edited by a moderator:
According the a write up in the paper today Metformin is a cheap drug so probably not costing the NHS too much but unsure healthy ppl would take the tab I certainly would not unless I had to
 
I have been led to understand that Metformin is primarily an appetite suppressant, helping with weight loss. It also reduces insulin resistance and the production of glucose from the liver, but all to a limited extent.
 
There are definitely different policies as to the way varying countries treat LADA.
There is a European research project which included in their investigations how long it took from diagnosis to starting insulin. .
Those countries that do automatic testing of people who are not 'typical' T2 for GADA tend to put people with LADA onto insulin earlier
if a definition of LADA stated that a person should be independent of insulin for 6 months ,estimates of prevalence would be low in Denmark, Austria, France, and Spain but high in Belfast and London
Click to expand...
Odense, n = 32;the median time was 4.8 months (interquartile range 0–12.8),
Barcelona, n = 67;the median time was 9.4 months (1.1–17.8),
Vienna, n = 35 the median time was 31 months (3.5–59
and Lyon, n = 68 the median time was 29.4 months (17.6–41
But in
Belfast n = 66; the median time was 38.1 months (20.5–55.6)
London, n = 50) the median time was 47 months (29.5–64.8) months (P < 0.0001).
http://care.diabetesjournals.org/content/31/3/439.full
The widespread clinical use of GADA testing on the continent but not in the U.K. means that the presence of a diabetes-associated autoantibody is no longer latent in many European centers.
Click to expand...

Personally, I have never taken metformin, it's never been mentioned. I certainly find exercise lowers my levels. I'm only on here because I have been rushing around doing lots of housework before the family arrives and I 'suddenly' found my glucose at 45mg/dl
 
I was prescribed it for Type 2, Phoenix, before the antibody test result came. Then told to drop it.

In my case Metformin did help to suppress appetite (which was nice). I'm now a lot hungrier.

Thank you for that ref and those extracts. At my Danish hospital they did the GADA test automatically 'just to make absolutely sure' I wasn't Type 1, which I in fact was. But that may well vary regionally. I'm in Aarhus. *Very* interesting figures.

They gave me the go-ahead to try out 1 or 2 units of long-acting NPH to see if my honeymoon could be extended that way. No evidence, but worth trying.

LADA, 55, BMI 23, active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now in honeymoon phase on LCHF plus exercise, no meds. Except once I've stabilised daily levels of carb and protein, as rec by Dr Bernstein, will try a very tiny daily dose of Insulatard/NPH basal insulin every morning.
 
phoenix said:
I'm only on here because I have been rushing around doing lots of housework before the family arrives and I 'suddenly' found my glucose at 45mg/dl
Click to expand...

Ow! Hope you fixed that Phoenix!


LADA, 55, BMI 23, active. Diagnosed Type 1 in July 2014 after GAD antibody test. HbA1c down from 117 /12.9% to 78 / 9.3% and dropping. Average fasting a.m. BS currently 6.3.
Now in honeymoon phase on LCHF plus exercise, no meds. Except once I've stabilised daily levels of carb and protein, as rec by Dr Bernstein, will try a very tiny daily dose of Insulatard/NPH basal insulin every morning.
 
[I've reposted this from elsewhere because relevant to Metformin, so please forgive.]

While reading up abt the dawn phenomenon, which I've never understood before, I find that Metformin is said to stop the DP because it switches off the liver's glucose-releasing hormone.

I came off Metformin two weeks ago. So a good poss explanation ...

Found Brunneria's very interesting thread: http://www.diabetes.co.uk/forum/threads/pesky-dawn-phenomenon.57672/
 
Dr B gives Metformin to most of his T1 patients on the basis that it will reduce their insulin needs, and on the basis this is a Good Thing because 1. More insulin = bigger swings, bigger errors 2. Excess blood insulin is more predictive of cardiovascular and microvascular complications than hyperglycemia.

I think he's right but I have struggled for years to persuade my GPs and hospital clinic to give me Metformin, to no avail.
 
My first consultant review since starting insulin will be in a month. My sitagliptin was stopped but the Metformin SR 2G daily was retained.

I was happy to continue the Metformin as it does not upset me and I think, despite my lacking obvious markers of Insulin Resistance, that it is probably beneficial. It probably depresses hunger a bit, suppresses unwanted glucagon and might have cardioprotective and anti-cancer activity.

As regards NHS cost, generic Metformin SR costs the NHS £5.54 for 56 x 1G tabs. Non-SR Metformin at the same dosage costs £5.28 per month and at 3 x 850mg dosage the cost would come down to £2.86. These standard release tablets are not likely to be as well tolerated as the SR and so there is a case for nudging your NHS GP to provide the SR form.
 
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