Newly Diagnosed - Metformin Question

Zosema

Newbie
Messages
4
Hi everyone, I've just been diagnosed with Type 2 last week and my doctor has put me on Metformin 500 mg, one tablet twice a day.

For the first couple of days I was fine, but now I'm experiencing gastric pain and gas and have had several bouts of painful diarrhoea over the last 24 hours.

Can anyone advise me how long these side effects are likely to last and if there is anything I can do to minimise them? It says on the information leaflet that came with the tablets that these effects should pass, but I'm wondering how long I should expect it to take.

Feeling very confused at the moment with this diagnosis, I feel like the rug has really been pulled from under me. I think I'm in a state of denial, is this normal?

Thanks for listening/reading!
 

daisy1

Legend
Messages
26,457
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Cruelty towards animals.
Hi Zosema and welcome to the forum :) Metformin can often cause stomach upsets. It is very important to make sure that you take them during a meal - not before or after. They can cause damage to your stomach lining if they are not taken with food. The stomach upsets may not go and if they don't you should ask your GP or DN if they will prescribe you the SR or ER (slow or extended release) version as they are much less likely to cause stomach problems. They are more expensive so that's why they tried you on the standard version to start with.

Since you are newly diagnosed, here is some information that we give to new members. I hope it is interesting and helpful to you.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 

Zosema

Newbie
Messages
4
Hi Daisy, thanks for the information, that's very helpful. I'll make sure I take this evening's tablet half way through my meal, I have been taking them afterwards so that is probably why I'm experiencing issues.

Zosema
 

chocoholicnomore

Well-Known Member
Messages
638
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi Zosema

I have had exact same problems! I started metformin 850g x 2 on Tuesday (was diagnosed last Friday)and have had the runs all week. I was taking them during the meal as advised. Phoned diabetic nurse on Friday and was advised to stop over the weekend and collect new prescription for 500g on Monday. No problems since Friday night.

Please keep us informed how you get on as I am worried it will all start again when I begin taking the new dose.

I don't know about you but I wasn't told very much by diabetic nurse and have been left to muddle through. I have, therefore, found this website and forum extremely helpful and no question is too trivial. Everybody is really nice and welcoming and friendly. Hope you find it as useful as I do.
Good luck with it all!
 

IanD

Well-Known Member
Messages
2,429
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Carbohydrates
I am surprised that you have been prescribed metf immediately on diagnosis.

My Dr referred me for advice on all aspects of diabetes - diet, foot care, exercise, medication, self testing, etc, but did not prescribe metf for several years. He wanted to see how my blood glucose responded to lifestyle changes. The local hospital (West Middlesex) did a 1 day course every week for newly diagnosed.

I would suggest not taking metf until after your next blood test in 3 months. [Obviously I cannot go against your Dr's prescription - I don't know your general health, symptoms, blood levels, etc.]

Was was your HbA1c on diagnosis? (mine was 8.6)
What symptoms caused you to be diagnosed?
What is your general health?
 

Daibell

Master
Messages
12,652
Type of diabetes
LADA
Treatment type
Insulin
Iand, I had the opposite experience when my GP didn't prescribe anything for 3 months whilst I adjusted my already good diet and continued my regular visits to the gym. My BS was thru the roof. Surprise, surprise I needed the Met so I think it's safer to start early if the GP is organised enought to prescribe it.
 

chocoholicnomore

Well-Known Member
Messages
638
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi IanD

In answer to your questions my hb1a was 9.5 and my BG was 13.something.
My symptoms were mostly feeling very tired all the time with no energy for anything. I put this down to depression as my husband left after 21 years of marriage (that's another story)
I was also hot all the time and was beginning to think it was menopause. Didn't know whether to be relieved or not when told it was diabetes!
It all kicked off 2weeks ago after flu and other infections and feeling really run down. Thought I had urine infection and that's when nurse found "loads of sugar".
Have just collected new prescription for 500g metformin but am wary of taking it in case diarrhoea and stomach pains return!
Have been referrd to dietician, podiatrist, eye specialist, and X-pert education course. Have no idea when I will be seen so just have to muddle through in the meantime as best I can.
Am so grateful to everyone in this forum. They have all been such a great help with loads of advice and information.

Thanks everyone
Chocoholicnomore (just sometimes!)
 

viviennem

Well-Known Member
Messages
3,140
Type of diabetes
Treatment type
Other
Dislikes
Football. Bad manners.
chocoholicnomore said:
Hi Zosema

I have had exact same problems! I started metformin 850g x 2 on Tuesday (was diagnosed last Friday)and have had the runs all week. I was taking them during the meal as advised. Phoned diabetic nurse on Friday and was advised to stop over the weekend and collect new prescription for 500g on Monday. No problems since Friday night.

Please keep us informed how you get on as I am worried it will all start again when I begin taking the new dose.

I don't know about you but I wasn't told very much by diabetic nurse and have been left to muddle through. I have, therefore, found this website and forum extremely helpful and no question is too trivial. Everybody is really nice and welcoming and friendly. Hope you find it as useful as I do.
Good luck with it all!

I'm surprised your nurse put you straight on to 850g of metformin twice a day immediately. It's more usual to start on 500g, take one a day for a week, then two a day for a week, then (in my case) 3 a day from then on. This lets your system get accustomed to the drug. It won't stop you having some gastric upsets, but it should make life easier!

I settled on to them quite easily in a couple of weeks, but I am well-known for my cast-iron digestion! :wink: :lol: I still gt the occasional bout of the runs, but weeks apart now and may not be anything to do with the Metformin.

If you really have problems with them, ask your GP for the Slow Release version. More expensive, but easier on the system!

Viv 8)
 

sharonsw

Member
Messages
10
Our surgery don't do the diet thing either. Straight to metformin. And also, straight to a lot of metformin. I'm supposed to ramp it up so I'm taking 1000mg per dose twice a day.

I'm going to stick with 500mg twice a day and see how that affects me. My HBA1C is 5.6 so good. It's my GTT that is absolutely abysmal.

Oh and I'm taking statins as my cholesterol is a mystery to them and not at all what it should be.

So, I've had my feet looked at, my eyes tested. No dietician at all and looks like there won't be. Really need to get organised with diet as I have 2 children and a vegetarian husband so not loving the fact I may need to cook 3 different meals a day.

Having upped to metformin in the morning I'm currently spending most of the day feeling sick which is no fun whatsoever.
 

Daibell

Master
Messages
12,652
Type of diabetes
LADA
Treatment type
Insulin
Don't forget to ask your GP for Metformin SR (Slow Release) if you continue to have stomach problems. They don't prescribe it at the start (well, my GP did) as it costs more than standard Met.
 

Grazer

Well-Known Member
Messages
3,115
I'm not convinced about all this "straight to Metformin". I think it might be the safe option for some practices who don't think we're bright enough or dedicated enough to manage without. My HbA1c wasn't terrible on diagnosis, 8.2, and on diet only I got down to 5.9 in 4 months. I remain on diet only with HbA1c about 5.5 My friend was much worse, 11.2 on diagnosis, with a fasting BG of 16. He too went on diet only nonetheless, and after 4 months is on an HbA1c of 6.0, with very few peaks over 8. He's currently probably sub-6 with his HbA1c looking at his BG testing results. I'm not eating silly, I'm on 150 to 180 grams low GI carbs a day and, of course, no complications because no meds.
Sharonsw - if you're HbA1c is 5.6, why do they want to ramp up the met?
I'm sure more of us could manage perfectly well on diet only if given the right advice about carb consumption. Obviously, if you're happy on metformin then fine, but from the sound of it, some of you aren't!
Hope it all works out O.k
 

sharonsw

Member
Messages
10
Grazer - I have had the prescription since June and just got it a few weeks ago. I have been trying to diet but it's not an easy thing to do when you have no idea what works and what doesn't. I found when I was pregnant sometimes the usual things that are meant to be good weren't - porridge for instance gave me an awful result. I think my main problem is breakfast. Just seems my body reacts to this one meal and once it gets going for the day it's fine. The reason I started the metformin and statin was that I've been feeling a lot more tired and just a few other body type niggles that I didn't like. T2 is hereditary so my time bomb was ticking louder.

The latest doctor I saw said go with 500mg morning and night and see what HBA1C in December says. See that's the other thing they tested in June and weren't going to test for 6 months. If they'd just done that and fasting sugars no-one would have been any the wiser.

how often a day do you test? I'll get some more strips and see what my results are like. When pregnant I managed to diet control through the whole of my first pregnancy with testing regularly and up to 36 weeks with the second (was older see lol)
 

Grazer

Well-Known Member
Messages
3,115
sharonsw said:
I think my main problem is breakfast.
Lots of people are like this, and have things like omelettes or scrambled eggs (no carbs) for breakfast. I have shredded wheat (high carbs but very low sugar content compared to even cornflakes) and get on well. Some that can't have ANY carbs at breakfast handle them well later - I am hopeless with carbs in the evening. We're all different.
sharonsw said:
how often a day do you test?
I used to test very regularly, sometimes 6 times in a day, working out how different foods at different times of the day affected me. Finding out things like my reaction to breakfast (as above) Now I've got it pretty sussed, so don't test for ages, then have a splurge if I'm trying something new. I also test now and again anyway just to ensure things aren't changing. The key I think is that when you do test, you test before you eat and then again 2 hours after to see the DIFFERENCE in blood sugar. If you just see that it's, for example, 9.5 two hours after dinner with meat, new potatos and veg, it doesn't mean much if it was already 8.0 BEFORE dinner. If however it was 6.0 before dinner, then it's a substantial rise and something in the meal needs to change next time. Also, WHY was it 8.0 before dinner? Was it something you had at the previous meal? So then I'd go and investigate that.
The other reason I didn't rush to Metformin is that on diet only it takes a while for blood sugars to settle down. You don't get an instant fix, even though you do get some instant improvements.Once I found a good meal mix, my sugars dropped steadily over many weeks. So that's why I don't think we should rush to Met as soon as we see some readings we don't like.
It takes time, but in the end you get to understand just how your body deals with all the different things it encounters with different mixes of food. The you're REALLY in control. In some ways it was easier for me, testing with no medication at all to cloud the issue. I knew that a good result came from a good food choice, not disguised by the fact that the medication helped to give the good result.
Ultimately, I'll probably need to go on meds, but in the meantime I'm happy to have found a diet that gives me excellent control with no meds. Although my last HbA1c was good at 5.9, it's now even better, and probably low to mid 5's.
Good luck, hope this helps.
 

viviennem

Well-Known Member
Messages
3,140
Type of diabetes
Treatment type
Other
Dislikes
Football. Bad manners.
I asked for Metformin and was actually prescribed it before I let them register me as Type 2 (in denial, of course!), because I'd heard it helps with weight loss. I weighed almost 300lb at the time :shock:

I was finding weight loss, even when I got back on to low carb, quite difficult because I take NSAIDs evey day and they can slow the loss. The Metformin may or may not be helping (I've lost 4 stone in the last 18 months) but it helps protect against coronary heart disease and strokes, too.

Apart from the odd unexpected bout of the runs - always heralded by cramps so with any luck I can find a loo, even when out :shock: - I'm happy with Metformin. I may ask if I can go down to 500g twice a day instead of 3 times, to see if that removes the unexpected events :lol:

Viv 8)