Should I ditch my metformin tonight?

[briped]

Would you do it if your BG were 3.8? I normally take one with my meal, and I'm not used to my BG being this low, so am somewhat hesitant.

 

[steveis36]

Would you do it if your BG were 3.8? I normally take one with my meal, and I'm not used to my BG being this low, so am somewhat hesitant.

When my bgs were 4.8 and still due 1 more pill i didnt take it..no way.
Yours is low..
Which what we are all aiming for i guess lol
I try to keep mine 5-7mmol

 

[Guzzler]

Metformin has very little effect on blood glucose levels. It has cumulative effectsso won't have any immediate affect on your meal time readings whether you choose to take it this evening or not.

 

[Resurgam]

Metformin doesn't lower BG but it does interfere with the liver's ability to release glucose, so that could be why you are so low - I'd be asking my GP why Metformin was necessary if that is a typical reading.

 

[briped]

When my bgs were 4.8 and still due 1 more pill i didnt take it..no way.
Yours is low..
Which what we are all aiming for i guess lol
I try to keep mine 5-7mmol

Thanks Is your 5-7 with or without meds? ATM I'm probably having way too much. 1,8 mg victoza, 10mg Jardiance and 2 x 500 mg metformin + for the last 3 days I've been eating very low carb, so I'm not surprised.

 

[briped]

Metformin doesn't lower BG but it does interfere with the liver's ability to release glucose, so that could be why you are so low - I'd be asking my GP why Metformin was necessary if that is a typical reading.

It's not a typical reading, but it may become typical, especially if I continue with my present meds + very low carb. When I last saw my endo Dr at the end of March my A1C was 13.4, you see, so things have changed since then, and the endos don't know that - yet. I just wonder if it's early days to have my meds adjusted.

 

[briped]

Metformin has very little effect on blood glucose levels. It has cumulative effectsso won't have any immediate affect on your meal time readings whether you choose to take it this evening or not.

Thanks I chose not to take it, and if my readings are low tomorrow too, I'll probably chose to not take it over the weekend. Just the evening pill, mind you. On monday I better see if it's possible to get in touch with the endo doc. I'm on Jardiance and Victoza too.

 

[Resurgam]

Thanks I chose not to take it, and if my readings are low tomorrow too, I'll probably chose to not take it over the weekend. Just the evening pill, mind you. On monday I better see if it's possible to get in touch with the endo doc. I'm on Jardiance and Victoza too.

Ah that explains it - it is the other medication pushing your BG low - I thought it was a bit odd, - you do need to let your HCPs know you are going low and they might then say up the carbs - which is not unusual I'm afraid - but do watch your levels as with BG lowering medication it is possible to hypo - the Metformin is not the problem.

 

[Guzzler]

Thanks I chose not to take it, and if my readings are low tomorrow too, I'll probably chose to not take it over the weekend. Just the evening pill, mind you. On monday I better see if it's possible to get in touch with the endo doc. I'm on Jardiance and Victoza too.

Quite agree about the endo appt. The Jardiance and Victoza do impact on blood glucose levels just bear that in mind but get advice before you even think about changing or missing dosages on those two medications. Take it steady.

 

[first14808]

I'd say.. keep an eye on it, ie check your BG a bit more regularly and beware hypos. Then it's figuring out why your BG's dropped. I was usually in the 5-6 range with Metformin, but today got a low and hypo. I'm thinking that may be due to having increased exercise a bit, dropped body fat down to aound 18% and might need to adjust my food intake to include some more carbs or fat. As I understand it, fat's slower to convert as an energy source & might be why my BG dropped.

(and it's times like this I wish I had a CGM so I could look more closely at what was going on.. )

 

[MrsGruffy]

Metformin has very little effect on blood glucose levels. It has cumulative effectsso won't have any immediate affect on your meal time readings whether you choose to take it this evening or not.

When you say it has a cumulative effect, how long would you suggest it takes to be doing it's job?

 

[Guzzler]

When you say it has a cumulative effect, how long would you suggest it takes to be doing it's job?

That depends very much on a couple of things, the amount of fat in the liver and the insulin resistance levels of the individual esp. in liver cells.

 

[DavidGrahamJones]

1,8 mg victoza, 10mg Jardiance and 2 x 500 mg metformin + for the last 3 days I've been eating very low carb

If you've recently lowered your carbs then you would expect your BG to drop, however, you should be looking at the Victoza and Jardiance rather than the Metformin.
When I stopped eating bread/potato/rice/pasta my BG dropped and I stopped taking Gliclazide and Januvia, both drugs which encourage the pancreas to produce more insulin. That was five years ago and I am still on Metformin.

 

[Mbaker]

I would stop the metformin and maintain a low carb liefstyle. I would also look to over time remove the other medication, perhaps reducing by 25% a week and diligent testing.

 

[briped]

If you've recently lowered your carbs then you would expect your BG to drop, however, you should be looking at the Victoza and Jardiance rather than the Metformin.
When I stopped eating bread/potato/rice/pasta my BG dropped and I stopped taking Gliclazide and Januvia, both drugs which encourage the pancreas to produce more insulin. That was five years ago and I am still on Metformin.

I agree with you, and I did expect my BG to drop, but not by quite that much. I take my other meds in the morning, and this reading was at 8:20pm, before my last metformin (I eat very late), so it was the only knob to turn. I'll see what happens over the week-end, and get in touch with a professional on Monday to discuss reducing Jardiance and Victoza. Before the 2 year "blip", which ended in late March, I managed well on smaller dosis.

 

[briped]

I would stop the metformin and maintain a low carb liefstyle. I would also look to over time remove the other medication, perhaps reducing by 25% a week and diligent testing.

Won't it make more sense to remove first what was added last? Actually, I already reduced the Jardiance from 2 x 10mg to just 10mg without consulting anybody about a week ago, naughty girl, but I better let the endo people know what's going on on Monday.
Anyway, I'm finding it increasingly difficult to stick to less than 20g of carbs per day, and this is only the beginning of day 4! I must be doing something wrong, because I'm hungry non-stop and kind of miss my very carb-expensive veggies. Perhaps too little fat?
I better find out what to do in the long run, because very low carb combined with quite copious doses of meds won't do. That much I do know.

 

[briped]

Quite agree about the endo appt. The Jardiance and Victoza do impact on blood glucose levels just bear that in mind but get advice before you even think about changing or missing dosages on those two medications. Take it steady.

I have to admit that I cut the Jardiance from 20mg to 10mg about a week ago. I felt it was safe to do so as it was only increased in late March as an alternative to putting me on Insulin, and I could see she wasn't too happy about doing it. My A1C was 13.4, but going further than that without asking the endoes ...? Not a good idea.

 

[Guzzler]

I have to admit that I cut the Jardiance from 20mg to 10mg about a week ago. I felt it was safe to do so as it was only increased in late March as an alternative to putting me on Insulin, and I could see she wasn't too happy about doing it. My A1C was 13.4, but going further than that without asking the endoes ...? Not a good idea.

May I ask how long it took you to get down to 20g carbs per day? I ask this because I made the mistake of going too low too quickly and got 'Carb Flu' and I almost gave up the whole idea of Low carbing. Carb flu made me feel as though life just wasn't worth living if that was how healthy living was supposed to make you feel. Other mistakes I made were the thought that my fat intake was high enough (it wasn't ) and failing to hydrate enough.

As to changes in dosages of medication, this must always be done with extreme care and detailed testing and recordings so as to avoid going into hypo territory.

 

[DavidGrahamJones]

so it was the only knob to turn.

Don't forget Metformin doesn't work the same way as the other two and as it's effect is accumulative so not taking one tablet isn't going to make any difference at all.
Metformin lowers the amount of sugar produced in the liver, and also increases the sensitivity of muscle cells to insulin.
Jardiance helps the kidneys remove glucose from the bloodstream through the urine.
Victoza is taken by injection, similar to insulin, but they're not insulin. These medications are in a class of drugs called incretin mimetics, which improve blood sugar control by mimicking the action of a hormone called glucagon-like peptide 1 (GLP-1).

Three different drugs, three different actions.

Also, perhaps less than 20gms carb a day is too low to aim for. I just gave up bread/pasta/rice/potato to get down to 40gms a day and I eat a lot of vegetables (only the ones that grow above ground, so less carbs).

get in touch with a professional on Monday to discuss reducing Jardiance and Victoza

The best idea!

 

[briped]

I'd say.. keep an eye on it, ie check your BG a bit more regularly and beware hypos. Then it's figuring out why your BG's dropped.

Oh I know why it dropped. It's because I went from low'ish carb to very low carb (below 20). I should have mentioned that, but I just needed a quick opinion as it was right before supper and pill-time, and yes, I do keep a very close eye on the BG
Trust people in here to give me much better answers than the question warranted, but I'm so grateful for that!

I was usually in the 5-6 range with Metformin, but today got a low and hypo. I'm thinking that may be due to having increased exercise a bit, dropped body fat down to aound 18% and might need to adjust my food intake to include some more carbs or fat. As I understand it, fat's slower to convert as an energy source & might be why my BG dropped.

I had a similar experience in 2005/6, when I was first diagnosed and lost 35kg. Back then I didn't have a glucose meter, but my GP lokked happier and happier for every time I'd had my blood tested, which I think I did once a month. After about 8-9 months she told me that I didn't need metformin anymore. I don't expect that to happen again because surprisingly enough I'm older

(and it's times like this I wish I had a CGM so I could look more closely at what was going on.. )

I know. Those pricks only give you a general picture, but still I hope the day will never come when it's absolutely necessary for me to have something more advanced in the way of BG reading equipment