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Now down to pre-diabetes

wozey

Well-Known Member
Messages
94
Type of diabetes
Type 2
Treatment type
Tablets (oral)
So Friday I went for my review and was told that in 3 months I’ve completely turned it around and I’m no longer in the range for diabetes however she believes that’s because of the medication and has said I need to continue taking the Metformin at the highest dose, I’m not entirely happy with that because she’s completely ignored my low carb diet. Just wanted to know what people think, is she right as I’m still in the pre-diabetes range or am I right in at least wanting a lower dosage? I don’t want to be that person but it’s my health after all and the fewer medications the better as far as I’m concerned
 
can you give us more information? what was your hba1c before and what is it now? Maybe continue on the metformin until your next blood test? Have you got a blood glucose monitor? It might be worth asking if you can have one so you can keep track of your daily readings.
 
Congratulations @wozey sounds like you achieved a lot by eating low carb. I remember my diabetes nurse saying the same but I did need to stop my metformin because I was having major digestive discomfort. Doubt very much that metformin will have been more powerful than your low carb way of eating and for me it was my LC way of eating that brought me down to normal levels. If metformin suits you may wish to carry on with it as an extra to help improve lowering your insulin resistance. It's whatever suits you best but it's you and the changes you made that lowered your hbac1 - well done you.
 
Really well done. Metformin doesn't affect eaten carbohydrate - it reduces the ability of your liver to top up your BG with glucose it manufactures itself. In other words it won't produce the sort of drop you've had.

I'm not surprised she doesn't want to consider that low carbing has anything to do with it: the training they get is still that diabetes is progressive etc etc and there's nothing that can be done, medication is inevitable, plus encourage people to eat plenty of starchy carbohydrate.

You don't have to take the pills, it's your choice. I have zero experience with diabetic medication so I can't give you a user's view, but so many of us have achieved big BG reductions without it.
 
Well Done. As others have said the effect of Metformin is pretty minimal for lowering blood glucose, but it is prescribed even to T1D to provide some protection for the heart and arteries. It does help a little with lowering Insulin resistance in T2D but your success is due mainly from your diet changes. If your GP will not reduce the dose, then it becomes a secret between you and that round receptacle on the floor. You control what goes into your mouth I trust?
 
HI @wozey I am on a half dose of Metformin, having taken the full 2000mg for a couple of months, my endocrinologist said to reduce and see what happened, he suspected not a lot would change - and basically nothing did, but I am happy to continue taking the half for all the protective qualities and benefits alongside my low carb and exercise routine, even though I'm in non-diabetic range.

I believe Metformin stays in your system for while (days/weeks), so missing the odd dose would not give you a true picture of how you would be without it.
 
Hi @wozey - and yes - well done you.

If I was you, I would read up about metformin - there is masses out there online. And, on the website that this very Forum is a part of! There are some truly interesting youtubes on the subject by experts out there, that the internet age has marvellously provided us access to.

Like much to do with metablic disease - everyone has their own response to all treatments out there available to us, and that absolutely includes medications. Perhaps - particularly medications?

I have yet to read in here, or hear of irl, and absolutely not in my own experience - of a person with diabetes being given the full explanation of how metformin works and doesn't work, maybe given a wee pile of studies and so on, and being sent away to think about it, and come back for a fullsome discussion about the pros and cons with their medical professional/s so the doc and you could make a really good decision on whether or not you should be taking it. Even with the fabulous doctors, and diabetes specialist nurses. (And I have been lucky enough to have a few of those, OK - one doc and one specialist diabetes nurse.... but they were truly fabulous.) Love to hear about positive fullsome experiences in any case!

But what that means - in the context of the 15 minute medical appointment - if you really want this question answered for you - it is you who are going to have to do the reading and thinking about it. And, I would suggest - experimenting with it! Which means keeping good records, tracking your diabetes health markers, being tested every three months just to keep on top of it - and seeing how you body responds, or doesn't respond to metformin. And make a really educated decision based on your health markers. (Being monitored by your doc/diabetes team, naturally.)
 
Bilous and Donnelly's "Handbook of Diabetes" is what the NHS goes by. It says, about metformin,

"Metformin increases insulin action (the exact mechanism is unclear) lowering glucose mainly by decreasing hepatic glucose output."

So they know what it does (since mediaeval times - metformin was derived from chemicals identified in a plant called goat's rue) but don't know how it does it.
 
Hi @KennyA - just to say upfront how much I get from your excellent posts! Many thanks.

But, re metformin, and from doing a read on this actual website in the research section - it's a lot more complicated than that - isn't it always?! (Yes!) A big in depth study in this website talks about the gut action, and, of course - the effect on the mitochondria - ie the very essence of the energy giving part of our cells.

I have to say, I have a little sigh every time, and it is many times, I read somewhere it being said metformin works by increasing insulin sensitivity full stop - it can even backfire for some of us with - dare I say it - severe insulin resistance - re the amount of glucose in the blood, as in increasing or staying much the same, and in that research paper referred to... where, but in the research subforum on this website, explains all too well.

Anyhow. It's not surprising that medications effects and affect turns out to be way complex, considering the complex nature of the blood glucose regulatiion system. And also why the side effects of medications can be - terrible also! As in 'heart failure' (not metformin obviously, but a drug was initially interested in...). Digestive issues, which metformin is infamous for, is explained in that study....


and an easy/easier to read summary in nitter (link posted in the subforum)

stephen o'rahilly (its pronounced O-RA-hill-EEE) (@StephenORahilly)

After decades of confusion and many thousands of papers some real clarity is emerging as to how metformin actually works. Its key sire of action is the intestinal epithelial cell, into which it is selectively very concentrated. There, it impairs mitochondrial oxphos and
nitter.net
 
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