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Reducing dosage of metformin

Pipp - I'm assuming you still have HBa1c tests? If so, what was your latest, and how have they trended over your time in remission?

Thanks.
 
HbA1c tests every 3 months. Prior to Total food replacement had been averaging at 58. Last two years have been between 37 and 39. Apart from one just after Christmas, when I had been inactive due to illness and overindulged feeling sorry for myself, when the HbA1c was 41. Wake up call , I am working on it.
 
Very well done.

I'm interested that you still have tests quarterly. At my last (also my first) review, I was told that if I had one further good test (it was 37), in August, I would move onto annual testing. I have mixed feelings about that, to be honest.
 
I have HbA1c readings in the normal range and still have 6 monthly tests The test coinciding with my annual diabetic check also has lipids, kidney and liver functions tests. The mid 6 month test is only HbA1c.

Doug
 
To AndBreathe

Quarterly tests were because I have been waiting for two major surgical operations needing time in intensive care after each, and so have not been able to exercise. I do have several other medical conditions. GP was being very cautious. Now I have had second operation, and recovering slowly. I think GP had never before had someone with t2diabetes follow the total food replacement programme, so I was sort of a pioneer.

I think My circumstances differ to yours, as I had been diabetic for over 5 years, and nothing had helped before I did the total food replacement. I guess the rapid weight loss triggered the physiological response that was not happening with a slower weight loss.

In your circumstances, (t2 since October 2013?) i think I would be alarmed having being newly diagnosed, then at review having such a good reading. I would want to know how accurate was the original diagnosis, and the review. Also, query the future testing being annually. I would want more reassurance, rather than feeling that I was being parked by medical professionals.

You must have done something right to have such a good HbA1c reading though, so be proud of that.
 
Apologies Maryc117 for side-tracking your thread.

Pipp, my initial diagnosis was right out of the blue, and the readings were way off anything I might have expected. My cholesterol was also very high, at the point of diagnosis (same sample, obviously).

I was extremely confused and questioning at the time, but honestly didn't have time to demand a recount, so to speak, as I was within 3 weeks of leaving UK for 9 months, and just had to get my act together. To be fair, a follow up A1c test came in elevated (8.5), and I did have abnormal numbers on self-testing, but nothing even approaching the 15.6 of the fastin test I was diagnosed on. So, I accept the diagnosis now.

I returned to UK for February to have follow up tests and a review, and my cholesterol levels were in the normal range, with no discussion of statins, thankfully. My BP was excellent. It had been elevate at diagnosis, but that's a different story in itself, with sub-optimal testing coupled with white coat syndrome, and my HBa1c, as I say, at 37. I've also become quite skinny, as I didn't have too much to lose, so working on not losing any more.

I am away again until August, when I will have a further HBa1c, and take it from there. My current 90 day average, from my meter is 4.9, and my 7, 14 and 30 days are 4.3, 4.3 and 4.6 respectively. I have reduced my carbs; averaging 90gr a day, so I still eat a varied and interesting diet. I do miss fruit, but will be trying to re-add some additional fruits very shortly - particularly as the mango season is almost upon us!

Tonight's meal was a beef and bean curry, with rice. My bloods were 4.3 before and 4.7 after eating, so I'm really pretty comfy, as I sit here at 20:25, having a small glass of red before bed.

It's been an interesting time, and I hope I can maintain the good numbers.
 
Yes, apologies for going off topic.

To get back to it, I would like to make the following points:

Metformin can be reduced safely, but only in cooperation with doctor or nurse monitoring you.

If weight loss and or lower blood glucose has been achieved discuss with doctor or nurse.

I believe individuals should 'own' their health, i.e find out as much as possible about their condition and work out an individual and a manageable strategy to deal with it, with support as necessary.

For some of us, t2 diabetes can be reversed with assistance and determination.

Best wishes

Pipp
 
Hi Pipp
Thanks for the response, it was really great to hear your success story this morning, I am definitely inspired. Yes I am referring to the same diet you mentioned and the work by prof Taylor. I am at least following the principle, 3 x 200 cal packet meals supplemented with veg for another 200 cals. The packet meals I have gone for are the Exante diet. It seems to be reasonably comparable to the Optifast compositions (as in the Newcastle diet) for nutrients and vitamins.
A bit early to comment but my sugars have not yet dropped, 9.3 this evening after rowing for 30 mins and before eating my final meal today. Still early days, I am really looking forward to dropping the metformin and quite a few pounds.
I am a bit disappointed in my GP who had not heard of the Newcastle diet or the work of Taylor. His idea of support was, you can try it but don't go silly, eat if you feel ill, make an appointment for 8 weeks and we'll see how you got on. Interestingly he also has the view that you cannot cure diabetes only delay the inevitable, but you delay it long enough with good management, something else will get you in the end! very encouraging. I had no idea until I read it in several posts that your doctor can and will take you off the diabetic register, that is now my new goal.

thanks again for the support

regards
Kim
 
Hi

I was diagnosed T2 18 months ago with HbA1c of 55 and cholesterol of 4.5. BMI was 28.5 and I was put on 2 x Metformin plus stains + thyroxine (for low thyroid).

After 1 year my BMI was 23 and Hb1Ac was down to 38. I was taken off Metformin (so T2 is diet and exercise) but thyroxine was increased from 50 to 75 mcg. I'd had problems with muscle pains on simvastatin (20) and have been switched to pravastatin (20). This is slightly less effective as it is water soluble not lipid (fat) soluble apparently.

Awaiting the next round of 6 monthly blood tests but I'm hoping to be around 40 for Hb1Ac from my own (personal meter) blood glucose tests.

So you can get off metformin with the right figures and a GP that is encouraging you to diet and exercise. In my case the increase in thyroid has probably made me more active. Good luck and I hope you manage to do the same.
 
kimyeomans said:
Hi Pipp
Thanks for the response, it was really great to hear your success story this morning, I am definitely inspired. Yes I am referring to the same diet you mentioned and the work by prof Taylor. I am at least following the principle, 3 x 200 cal packet meals supplemented with veg for another 200 cals. The packet meals I have gone for are the Exante diet. It seems to be reasonably comparable to the Optifast compositions (as in the Newcastle diet) for nutrients and vitamins.
A bit early to comment but my sugars have not yet dropped, 9.3 this evening after rowing for 30 mins and before eating my final meal today. Still early days, I am really looking forward to dropping the metformin and quite a few pounds.
I am a bit disappointed in my GP who had not heard of the Newcastle diet or the work of Taylor. His idea of support was, you can try it but don't go silly, eat if you feel ill, make an appointment for 8 weeks and we'll see how you got on. Interestingly he also has the view that you cannot cure diabetes only delay the inevitable, but you delay it long enough with good management, something else will get you in the end! very encouraging. I had no idea until I read it in several posts that your doctor can and will take you off the diabetic register, that is now my new goal.

thanks again for the support

regards
Kim
Click to expand...

I think with GPs the emphasis is on the "general" i.e. they have such a wide remit that they cannot possibly have in depth knowledge of all of the conditions their patients present with. Although, diabetes being fairly common some GPs will have special interest. They tend to follow the current NHS guidelines, so if a patient asks for something out of the ordinary they are sometimes at a loss as to what to do. I think many are also afraid of patients putting in a legal claim against them if they do anything not in NHS protocols. Not meaning to underestimate the GPs here. They have a heavy workload, and are having to follow NHS guidelines. If GP is not supportive, get a different one.

In my case, I researched diabetes in academic journals and when I found the Prof Taylor Newcastle article I printed it off, took a copy to the GP, asked for a long appointment and explained the reasons why I wanted to follow the programme. It took a while to persuade him, and he did go to the trouble of reading more of the research himself, bless him. Then he had to discuss it with the senior doctor in the practice, but when they realised how determined I was agreed to monitor me carefully during the 10 week Total Food Replacement diet.

It all comes back to what I said in an earlier post. We need to be proactive in finding out as much as possible about our condition then work out a way of getting as well as we can. Prior to finding out about the Newcastle research, I also believed that I would have diabetes forever, and that debilitating symptoms would increase as I got older.

For anyone considering the Newcastle programme, I would say, get your GP educated about it, get GP support, and go for it. It is a few weeks, out of your life on a strict diet regime, but the prize is well worth it.

Be well folks

Pipp
 
I would like to reduce my dosage and hopefully stop altogether. I am still quite new to this diagnosed end Feb, managed to lose 12lbs so far, cycling every day, on low carb which I am comfy with, my Friday night treat is a finger of fudge! Worked out my average levels for the month mornings averaging 4.7 and after evening meal 5.7. I am on 3 metaformin a day and a statin at night, due for next apt beginning of June so will let you know the outcome fingers crossed once I have my results back I will ask about reducing the dose
 
Hi Pipp (anyone)
1 week in and mixed experiences
BS down from 10.4 to 7.8 but in the week all over the place, some higher then I had for some time, up to 11+. And lots of the symptoms from original diagnosis, 'cold eyes' blurry vision, crinkly tingly fingers and frequent urination?
Weight down 8lb to 14st13lb, lowest since diagnosis.
BP down 145/90 to 119/88
So far so good. Not hungry at all, fancied some meat or a beer from time to time but easy to resist. Mind set ok.

regards
Kim
 
kimyeomans said:
Hi Pipp (anyone)
1 week in and mixed experiences
BS down from 10.4 to 7.8 but in the week all over the place, some higher then I had for some time, up to 11+. And lots of the symptoms from original diagnosis, 'cold eyes' blurry vision, crinkly tingly fingers and frequent urination?
Weight down 8lb to 14st13lb, lowest since diagnosis.
BP down 145/90 to 119/88
So far so good. Not hungry at all, fancied some meat or a beer from time to time but easy to resist. Mind set ok.

regards
Kim
Click to expand...

Hello Kim

Sorry I am not able to get online much.

Not sure I can comment on the symptoms, really. All I have to offer is my own experience. I was not testing my blood glucose at the time I was following the Newcastle programme. Just having the pharmacy measure ketones in urine, and BP and blood tests every 3 months at GP surgery. Oh and, yes I did pee a lot, but on the diet programme I was drinking 2 or 3 litres of water a day.

Are you checking Blood sugar too often, and worrying about the variation? Well done for the improved BP and weight loss, but if you are not already doing so, I would urge you to get monitored regularly by medical professionals while you do this.
 
Hi Pipp
I have also been away a lot and not logged in, just saw your post.
End of wk 2 and
BS 6.8 fasted, settled down, less variation.
wt 14st 8lb (13lb lost)
BP 119 / 80
As my doctor did not really support the trial I bought my own test strips and I will make an appt for Hba1c etc at the 6 wk mark. What were you looking for in the ketone tests from the chemist?
I have stepped up the exercise. Throughout golf on Saturday I kept having light headed spells and in the gym last night I just felt i could not do what I was doing routinely 2 months ago! I am guessing it is just a lack of calories. I plan to adjust the diet with a bit of extra protein, some meat or fish with the soup every couple of days. Might even substitute a packet with areal salad with prawns in!

regards
Kim
 
Kim,

I am no expert, but your numbers are looking good. Looks as though you regime is succeeding. Though I would be cautious with exercise if you are finding it too strenuous.

The diet I used was Lipotrim. On this you have no other food at all, and only drink water, or tea or coffee without milk. Around 600 calories a day. Strictly monitored either by GP practice or, as in my case, pharmacy. They test urine, weekly, for ketones. The science behind it is that the lack of calories puts the body into a state of ketosis, whereby energy is obtained from fat stores. This shows up in urine. It is a way to monitor dieter, as if you have eaten anything other than the diet products there are less ketones in urine.

I exercised in water, either swimming or aquafit, and would make sure i had one of the meal replacement drinks or 'flapjacks' with me to have if I was feeling tired or lightheaded.

I think that the Newcastle diet, using meal replacement products, and 3servings of vegetables a day is probably a better , less drastic and more manageable way of doing it. I think this gives about 800 calories a day, and I would probably choose this method in the future.

Be kind to yourself. Don't overdo things. Take notice of what your body is telling you, and see your doctor or nurse for any concerns. Make them support you. Also don't forget that it takes a long time for for a body to develop T2 diabetes, so we should not punish our bodies by expecting a quick fix. However, a medical professional told me that a weight loss of approx 15kg is usually enough to put diabetes into remission. We do, of course, need to make sure that we continue to eat sensibly and exercise regularly.

Best of luck

Pipp
 
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