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Metformin

Discussion in 'Ask A Question' started by witsum, Mar 21, 2009.

  1. Dennis

    Dennis Type 2 · Well-Known Member

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    Hi Hairlessone,

    I think you may be expecting too much of metformin. It is designed to reduce insulin resistance which will make your body's insulin work more effectively, but metformin on it's own will not make a huge reduction in your BS. The maximum reduction that metformin is capable of (at maximum dose) is 1.5mmol. If you need to reduce by more than that then you will need to look to your diet and additional exercise to achieve a greater reduction.
     
  2. markd

    markd · Well-Known Member

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    This review of Metformin is quite interesting:

    http://adipocyte.co.uk/metformin.htm

    In particular, this section:

    >>>
    Should patients with impaired glucose tolerance be started on Metformin?

    Yes! Currently metformin is not approved for this indication, but logic suggests that it should be used early on in insulin resistance. While genetic factors are at work in producing progressive beta cell failure, the contribution of insulin resistance to this inexorable decline could be alleviated with metformin use early on. The diabetes prevention programme has proved this concept to be true. Diabetes Care. 1999 Apr;22(4):623-34. In addition, IGT has been shown to pose a cardiovascular risk in its own right, even before overt diabetes is diagnosed. Diabetes Care. 2003 Oct;26(10):2910-4 If one would consider metformin in IGT, then there is nothing to stop one from initiating metformin at diagnosis of type 2 diabetes. My own view is that the term diet-controlled diabetic should be abolished, as diet control merely improves glucose values without improving the underlying insulin resistance and hence the pancreatic work load remains at a higher level than ideal. Arguing for diet and lifestyle changes based on results of the DPP is all fair, but everyone is acutely aware that in the real world any degree of adherence to weight maintaining maneuvers is poorly sustained.



    MarkD
     
  3. witsum

    witsum · Active Member

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    Markd
    Thanks for posting that link-it made interesting reading and I'm now starting to see that, as stated by Katherine, that the endocrinologist is right to recommend that I start on metformin whilst still only pre-diabetic.
    What is swaying me more is the cardiovascular risks as both my parents died from heart related problems. Although I am active, eat healthily and have good blood pressure readings averaging 115/70, the fact that I have got IGT means I am more susceptile to the 'hidden' cardiovascular risks as my pancreas is having to work harder.
    My GP has not yet received the letter from the endo recommending starting Metformin but at least I feel more informed now and when the letter arrives I can discuss with the GP that despite his reluctance that this is the way forward for me.
     
  4. markd

    markd · Well-Known Member

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  5. samcogle

    samcogle · Well-Known Member

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    This is just personal opinion, but my endo knows a lot more than my GP. Don't get me wrong my GP has been great but they are not the specialists in diabetes like the endo.
    I am following a low carb diet. I was diagnosed beginning of january. My BS is down from 18 to between 5 & 8. I take 3 metformin a day and the side effects have gone [it is definitely metfartin], I feel great and the wright is dropping off slowly and steadily.
    Good luck and welcome to a great place :D
     
  6. cugila

    cugila · Master

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  7. samcogle

    samcogle · Well-Known Member

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    An endocrinologist is fab and mine is also very handsome :)
     
  8. cugila

    cugila · Master

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    My DSN isn't bad either (female) :)
     
  9. hanadr

    hanadr · Expert

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    Hi ?Witsum
    I have been taking Metformin 500 for nearly 6 years. I started on 3X, one with each meal, then dropped back to 2X now I am at liberty to use up to 4 per day as I see the need. Today will be a 3 day. My family came for lunch and I ate a tablespoonful of bread sauce and a piece of potato with my chicken. Followed by jelly and cream. trhat's enough carbs for me to take the extra Met. I never had any rouble wiht it, because I only ever had the 500s. Almost all the people I know using it, have the 850s. Perhaps they are harder on the digestion?
     
  10. Pickwick

    Pickwick Type 2 · Member

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    How do you get to see an endocrinologist in the first place?

    My only experience with my GP (about diabetes, anyway) was a 10 minute session 3 years ago when I was first diagnosed with T2. Passed straight on to a practice nurse and that was that. I asked at the outset when I'd get to see an endo - the question wasn't even taken seriously. I asked again later, but no luck. It even took 2 years of desk banging to have a diabetic eye test done, though they've promised them yearly from now on - we'll see. Other than that, it's 2x500 metfartin per day and diet, without too many problems other than social embarrassment. I've rarely had a meter reading lower than 5.5 so little chance of hypos I think.

    But the last month or two I've started putting on weight again for no apparent reason - nothing changed in my lifestyle afaik. And just this last week, my meter readings have been all over the place - 7.2 when I awoke this morning. Tried to phone the practice nurse but she's on holiday until next week. I could see my GP I suppose, but I'm not that keen on his "serves you right, fatty" approach.
     
  11. cugila

    cugila · Master

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    Hi pickwick.

    To see an Endocrinologist you have to ask for a second opinion or a referral from your GP. It is not a criticism of your GP. You can also see one privately if you can afford it.
    If your usual one won't oblige, then go to another Dr in the practice. It is your right to ask for this.
    If you are not satisfied, complain to the Practice Manager. Make sure you know the reasons behind your request before you go, i.e. treatment not effective and you want to see a specialist. Be polite but firm.

    Let us know how you get on ?

    Ken. :D
     
  12. bernie.freeman

    bernie.freeman Type 2 · Well-Known Member

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    Hi everyone,
    Has anyone encountered the terrible side effects of Metformin? The one in particular is running to the loo? how long does it last ?
    Has anyone any tips to avoid these side effects? I have started taking 500mg a day , my GP said in the morning.

    Thanks

    Bernie
     
  13. HLW

    HLW Type 1 · Well-Known Member

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    Taking them with food helps, and it might settle down on its own in a while anyway. If it doesn't, the slow release version might help, it helped a lot with me.
     
  14. JohnTheGorilla

    JohnTheGorilla Type 2 · Member

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    There's a slow release version? Don't wish to appear thick but how would I know which version I am on (just called "Metformin" on the box).

    I also suffer the stomach cramps and occasional embarrassing social gaffe. I want to be sure of my facts before I question the nurse!

    Cheers
     
  15. cugila

    cugila · Master

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    Hi John. It would normally be called Metformin SR or MR if a slow release version. Do you have the Patient Information Leaflet with it. It should be clearly marked. If not ask your pharmacist about it.

    Here are some possible side effects of ordinary Metformin, not compulsory. :)
    Side-effects anorexia, nausea, vomiting, diarrhoea (usually transient), abdominal pain, taste disturbance, rarely lactic acidosis (withdraw treatment), decreased vitamin-B12 absorption, erythema, pruritus and urticaria; hepatitis also reported


    ken.
     
  16. samcogle

    samcogle · Well-Known Member

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    As someone who is overweight I find the side effect of anorexia slightly disturbing :?
     
  17. JohnTheGorilla

    JohnTheGorilla Type 2 · Member

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    Thanks Ken - checked and seems I am on the standard 'metfartin' - I will discuss this with the powers that be at my next appointment.

    Can't say that I've noticed signs of anorexia, but have always noticed my diarrhoea to be extremely transient :wink:

    Cheers
    John
     
  18. sugarless sue

    sugarless sue · Master

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    Oh I don't know ,Sam I wouldn't mind a short burst of anorexia,just to lose a few more pounds .
     
  19. samcogle

    samcogle · Well-Known Member

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    Well there is that :D
    Isn't it the case that if you go to the doctor having lost a cerain percentage of your body weight, even if this is high you can be classed as anorexic?
    One of my students said it happened to her. She is quite overweight and got a really bad stomach bug, even though she was still overweight the doc told her mum she was anorexic as she had lost so many percent fat. I thought she was pulling my leg at the time but I suppose it makes sense sort of...well it does in my world :lol:
     
  20. peppiB

    peppiB · Well-Known Member

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    Must admit that since I started using Metformin (just 10 days ago) I have noticed a great fall off in appetite but no reduction in post meal BG levels. Will persevere til I am back with medics in another 11 days. I could do with losing a few more pounds anyway!!
     
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