Should I ask for Metformin?

[spendercat]

Con- I have been diagnosed Type2 for nine months and I am perfectly comfortable on a low carb diet of around 50 gr of carb a day. During the day my BS control is good - by mid morning it is below 6 and after lunch it returns within an hour and a half to the same level.

Pro- I have recently followed advice to test more extensively and discovered that my evening meal causes my BS to climb for about two hours to around 8 to 9. and it returns to a lower level of between 6 and 7 about four hours after eating. It then stays at that level all night, and it is only after breakfast that my BS falls to a level I consider good - below 6.

I had not realised that this was happening, that for fourteen hours every day my BS is above normal - and since I want my BS as close to normal as I can get it I wonder if I should ask my Nurse to prescribe Metformin, to help drop these evening highs?

Or am I being obsessive about this? Should I avoid drugs as far as possible? Metformin certainly seems to have powerful protective qualities for diabetics, and experts say the sooner it is given after diagnosis, the more effective those protections are. On the other hand - drugs, you know.... I hate them.

 

[viviennem]

Do you spread your carbs over the day or do you eat most of them at your evening meal?

Between 6 and 7 is on target for Type 2 readings (NICE guidelines) though I can understand you wanting them to be lower.

When you say - stay at that all night - have you tested between bed-time and getting up, that you can say that with certainty? If you are getting up to test, they could be going higher because of stress and because you're worrying about them?

Those are just a few random thoughts - it's not easy, is it?

I'm on Metformin mainly because it may help with weight loss, and I've had few problems with it. It may be worth discussing with your GP whether one x 500mg with your evening meal would help.

Viv 8)

 

[LittleGreyCat]

Good point spendercat.

I am currently within NICE guidelines and averse to taking any more drugs, but I do wonder from time to time if Metformin would improve my general diabetes control without a significant downside.

Cheers

LGC

 

[Daibell]

Hi Spendercat

Have you had an annual HBa1C test yet to check you average BS level? Your GP will use that to help decide whether to prescribe a medication such as Metformin. As you seem to be spiking I would be inclined to ask your GP for Metformin to try to reduce the spikes. As I found many years back diet alone is not always enough to control Type 2 BS. I've had no trouble whatsoever with Metformin SR over 7 years now; can't speak about standard Met as I started with the SR version. Met is a very well proven and safe drug.

 

[spendercat]

Thanks for the replies. My evening meal is actually the lowest for carbs, because I usually serve chicken or red meat with veggies for me, and starchy veggies for everyone else. About 10gm iin total. I am glad someone else thinks this is spiking, despite the NICE guidelines.
Now I just have to convince the practise nurse - she thought levels of 8/9 were really good! Low expectations.

 

[Daibell]

Hi Spendercat

I set myself a level of 10 two hours after a meal above which I start to get worried and which resulted in me moving on to add Sitagliptin to my meds based on my high HbA1C of 7.7. I now consider 9 or below sort of OK for a tested reading. A level of 8/9 two hours after after a meal for you could be worse, but I don't think your nurse should say it's really good.

 

[Grazer]

Con- I have been diagnosed Type2 for nine months and I am perfectly comfortable on a low carb diet of around 50 gr of carb a day. During the day my BS control is good - by mid morning it is below 6 and after lunch it returns within an hour and a half to the same level.

Pro- I have recently followed advice to test more extensively and discovered that my evening meal causes my BS to climb for about two hours to around 8 to 9. and it returns to a lower level of between 6 and 7 about four hours after eating. It then stays at that level all night, and it is only after breakfast that my BS falls to a level I consider good - below 6.

I had not realised that this was happening, that for fourteen hours every day my BS is above normal - and since I want my BS as close to normal as I can get it I wonder if I should ask my Nurse to prescribe Metformin, to help drop these evening highs?

Or am I being obsessive about this? Should I avoid drugs as far as possible? Metformin certainly seems to have powerful protective qualities for diabetics, and experts say the sooner it is given after diagnosis, the more effective those protections are. On the other hand - drugs, you know.... I hate them.

Really interesting Spendercat, because I am on diet only like you, and I have exactly the same sort of pattern with my BGs. Good after breakfast (can have a massive carb breakfast) at about 4.5 to 5 2 hrs after, good all day, then poor in the evening even after a salad! I also seem to have a problem with my fasting sugars being the same as my "Before bed" ones, and too high for my liking. Like you, I was concerned that I've therefore got a great slug of the day with higher than desirable BGs. One thing I did which helped was to do an exercise regime about an hour after eating in the evening when I know my BG will be reaching it's highest. I have a strider type machine (walking machine?) and just do ten minutes of hard work on it, enough to make me a bit breathless and bring out a sweat. This seems to work in bringing my BGs down much quicker (done lots of tests with and without this brief workout, after similar meals) and I go to bed with lower BGs. As a result, my fasting BGs are also lower. I've done some calcs (bit of a geek I'm afraid) and I've worked out that this has brought my HbA1c down by about 0.3 in the long term - and it all counts!
By the way, I asked a professor of Endocrinology that I saw privately if my bed readings and fasting readings being consistently similar meant my BG was an average of the two overnight - he said that in my case, as a type 2 with no meds, it probably was. That they would go down a bit and then come up again before waking, but no significant change. He did stress that this was "probable" though as you can't be sure without night testing as Viv says, and I can't be bothered with that!

 

[spendercat]

Thanks Grazer, I have one of those machines too, I keep it in the shed. no room in the house.
My physiology says - exercise in daylight, not in the dark - but I will give this post prandial exercise a go!
About an hour after eating, for ten minutes, will do it for a week and see if it helps the spikes.

 

[Unbeliever]

I have a very low carb meal in the evenings too. I used to have spikes of up to 18 in he evenings after having 4s and 5s all day. I now take sitaglypin [Januvia} which helps constderablt but wihout some sort of eercise in the evenings I will still ,sometimes , be up in the 7s several hours after eating.

If this happens I will wake up with similar figures. I find that about 10 mins exercise works very well
and my fasing readings revert o their normal 4-5. It makes me very happy to think that I have beeen at this level all night so I hope that is the case.