Should I Keep taking Metformin?

[Huw 2]

I was diagnosed with Type 2 diabetes in early December with an impressive HbA1c of 93. I was immediately put on Metformin and on 1000mg twice a day after a couple of weeks. I am not a big sugar consumer but did all the obvious things and made positive choices to reduce carb portions (as much as I like it in all its guises) and avoiding beer. I also started exercising by cycling to work a few times a week. At a routine appointment last week I found that my HbA1c had come down to 41. Unsurprisingly I was rather pleased but now have to decide whether to stop taking the Metformin. My diabetic nurse said I don’t need it but I am concerned that my result will go back up because the tablets are clearly helping reduce it. Any experience or thoughts to help me decide?

 

[shelley262]

Hi @Huw 2 and well done you on reducing your hbaca1 so much so quickly.
I think you may find that in fact the Metformin has only played a very small part in your overall numbers drop. Your dietary, drinking and exercise habits changing will have been much more powerful than Metformin.
It’s up to you but I chose to stick with the dietary changes and made it into a new way of life rather than continue to take the tablets. By doing this despite stopping Metformin my blood sugars have still continued to go down. Also the lower my blood sugars got the more digestive problems I was having with the Metformin.
Others chose to mix dietary changes with a small dose of Metformin. You could go for a reduction as an interim measure or move on to diet only if you are prepared to monitor your own bloods and how they react to different foods do you test at the moment?
I’m sure others will also give you their help and advice to enable you to make an informed decision

 

[shelley262]

Just spotted you are a new member tagging @daisy1 to give you some new member info

 

[Guzzler]

Stunning work on your numbers, well done! Tagging @daisy1 who will swing by and give you some really good information offered to all newbies but it seems like you have a handle on this already.

Your DN may advise you to lower the dosage of your Metformin. It has only the slightest affect on blood glucose levels so that means it was all your efforts with diet and excercise that are responsible for your great HbA1c result. Metformin is considered a safe drug and if you are happy to take it then make your feelings known to your GP/DN.

Again, well done.

 

[LouWilk059]

I'm type 2 and never had meds but just wanted to welcome you to the forum and congratulations reducing those numbers!

 

[Shahnaz2357]

I was diagnosed with Type 2 diabetes in early December with an impressive HbA1c of 93. I was immediately put on Metformin and on 1000mg twice a day after a couple of weeks. I am not a big sugar consumer but did all the obvious things and made positive choices to reduce carb portions (as much as I like it in all its guises) and avoiding beer. I also started exercising by cycling to work a few times a week. At a routine appointment last week I found that my HbA1c had come down to 41. Unsurprisingly I was rather pleased but now have to decide whether to stop taking the Metformin. My diabetic nurse said I don’t need it but I am concerned that my result will go back up because the tablets are clearly helping reduce it. Any experience or thoughts to help me decide?

Your results are just great and that too achieving them in a very short time. 2000mg of Metformin per day is a big dose maybe you should consult your nurse to bring it down to a maintenance dose.

 

[Rachox]

Hi Huw, I was diagnosed Type 2 last May and with low carbing and 1500mg of Metformin/day. I have had my last three HbA1cs in the mid 30s. I am going to ask to reduce it if my next HbA1c remains good. I’m actually happy to stay on a small dose as I tolerate it well and it does have other health benefits. Have a read of these:
https://www.selfhacked.com/blog/uses-benefits-metformin/
https://www.diabetesdaily.com/blog/5-surprising-potential-benefits-of-metformin-324858/
https://www.empoweryourhealth.org/magazine/vol7_issue3/the-many-benefits-of-metformin

 

[Mbaker]

Great result, if you have any Kidney issues then Metformin should be stopped. Your turn around has been dramatically quick with lifestyle. When I removed Metformin I never looked back. My initial blood sugars were in the 20's, but during the first week without Metformin I dropped to 16 (it could be argued that I never needed the drug).

 

[daisy1]

@Huw 2

Hello Huw and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will be able to help.


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 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
  
  
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
  

 

[Resurgam]

The only definite thing about Metformin's action I have read is that it slows the release of glucose from the liver.
That seems rather counter to what I want to happen - now I have got down to normal levels I'd want my liver able to supply energy if I decided to go on a long walk or bike ride, or if my now less painful joints ever allowed me to dance again.

 

[britishpub]

Great result, if you have any Kidney issues then Metformin should be stopped.

Yes, that is the most important point.

Make sure that they have done a proper Kidney function test before any decision on Metformin is taken.

If your kidneys are fine, then continuing the Metformin, or reducing the dose is unlikely to do you any harm and may benefit you in other ways.

 

[kokhongw]

I was diagnosed with Type 2 diabetes in early December with an impressive HbA1c of 93. I was immediately put on Metformin and on 1000mg twice a day after a couple of weeks. I am not a big sugar consumer but did all the obvious things and made positive choices to reduce carb portions (as much as I like it in all its guises) and avoiding beer. I also started exercising by cycling to work a few times a week. At a routine appointment last week I found that my HbA1c had come down to 41. Unsurprisingly I was rather pleased but now have to decide whether to stop taking the Metformin. My diabetic nurse said I don’t need it but I am concerned that my result will go back up because the tablets are clearly helping reduce it. Any experience or thoughts to help me decide?

All studies shows that metformin does not have that kind of efficacy in HbA1c reduction. If it were so effective, I am quite certain that big pharma would have shouted from their mountain top...

So clearly it is not the tablet that help to reduce it, but the lifestyle changes that you made.

 

[Mimi's]

The only definite thing about Metformin's action I have read is that it slows the release of glucose from the liver.
That seems rather counter to what I want to happen - now I have got down to normal levels I'd want my liver able to supply energy if I decided to go on a long walk or bike ride, or if my now less painful joints ever allowed me to dance again.

My question ditto...does one get low blood sugar with Metformin?

 

[DavidGrahamJones]

I am concerned that my result will go back up because the tablets are clearly helping reduce it. Any experience or thoughts to help me decide?

I have read on this forum on several occasions criticisms of the effectiveness of Metformin. I stopped taking my 2gms (2 x 2 x 500mg) per day for a period of 6 weeks. It took a few weeks to notice a difference but by the 6 week mark my BG was not as stable as it had been. Even taking Metformin doesn't seem to stop those peaks in the morning and even after exercise in the morning, but those increases seem to be less dramatic while taking Metformin.

You will have read several times that we are all different and I think that is probably the key. Perhaps your best approach is to cut down gradually and see what happens. Fortunately I have a FreeStyle Libre and that made looking at differences, before and after, much easier to detect.

 

[ringi]

The only definite thing about Metformin's action I have read is that it slows the release of glucose from the liver.
That seems rather counter to what I want to happen

The liver will still release energy when your inslin level drop, anyway being on a long term low carb diet your body is trained to use fat for energy....

Metformin also make our gut bug convert more sugger into fats before we disgust it, along with reducing the inslin levels needed for most cells to take up glucose.

Overall Metformin is often responsible for a drop of about 10 in A1c. But a small dose can give at least 80% of the benefits of a large dose.

 

[New2ThisType2]

Great result, if you have any Kidney issues then Metformin should be stopped. Your turn around has been dramatically quick with lifestyle. When I removed Metformin I never looked back. My initial blood sugars were in the 20's, but during the first week without Metformin I dropped to 16 (it could be argued that I never needed the drug).

Boy can I relate to your post.
Had kidney issues and likely should not have been given pills either.
But even worse apparently were the blood pressure pills I was given, which are often given automatically to those with diabetes, with the idea it will prolong their having higher blood pressure.

Was rushed into emerg for kidney issues in Nov and the specialists were aghast, mainly at the BP meds. Over 5 days my BP was never high.They believed those pills, more so than the Metformin were terrible for me but I had already gone off of the Metformin 2-3 months earlier or they would have insisted i stop then anyhow.
Afterwards, I purchased an Omron BP bluetooth home machine and test myself twice daily and am never above normal. If anything, have low blood pressure and always did. But have "white coat syndrome" so when I visit a doctors office, that alone sends my BP higher, which was why they gave me BP pills LOL &^*^ Idiot that prescribed me all those pills

 

[Brunneria]

The liver will still release energy when your inslin level drop, anyway being on a long term low carb diet your body is trained to use fat for energy....

Metformin also make our gut bug convert more sugger into fats before we disgust it, along with reducing the inslin levels needed for most cells to take up glucose.

Overall Metformin is often responsible for a drop of about 10 in A1c. But a small dose can give at least 80% of the benefits of a large dose.

Hi Ringi,

Can you provide some references for that into? Thanks

 

[Mbaker]

Boy can I relate to your post.
Had kidney issues and likely should not have been given pills either.
But even worse apparently were the blood pressure pills I was given, which are often given automatically to those with diabetes, with the idea it will prolong their having higher blood pressure.

Was rushed into emerg for kidney issues in Nov and the specialists were aghast, mainly at the BP meds. Over 5 days my BP was never high.They believed those pills, more so than the Metformin were terrible for me but I had already gone off of the Metformin 2-3 months earlier or they would have insisted i stop then anyhow.
Afterwards, I purchased an Omron BP bluetooth home machine and test myself twice daily and am never above normal. If anything, have low blood pressure and always did. But have "white coat syndrome" so when I visit a doctors office, that alone sends my BP higher, which was why they gave me BP pills LOL &^*^ Idiot that prescribed me all those pills

I hope many get to see your post, as I think we just accept the pills in ignorance and trust, in the same way as 3 meals a day and 2 snacks. My kidney function is at the low end of normal and had deteriorated under Metformin; I was infuriated when I found out that this drug was not meant for persons like me. It worried me so much, I would look for the kidney function before HbA1c, as I know a life on dialysis would be no joke. My kidney function thankfully has not got worse and stayed in the normal range.

 

[Ajax]

A year into Metformin therapy ..my physician suggested I could stop taking my single daily tablet because I control was so good ..I was considered a ✻star✻ patient at that time.

I remember this giving me a ✻sinking feeling✻ ..I politely declined the offer ..and she backed down.

My first-ever glucometer reading was 23.8 mmol/L ..and even after my probationary ✻diet & exercise✻ stint ..my fasting blood sugar level was still an elevated 12.1 mmol/L

It was only after my Metformin therapy kicked in that my blood sugar level came down to 8.6 mmol/L

A nagging fear of going back to the bad old days motivated me to stay on the medication.

I believe Metformin helps treat my hyperglycæmia in combo with my food plan and by taking long daily walks.

 

[Mbaker]

Do you have any links for stopping metformin with kidney issues?

What kind of kidney issues?

I will try and find tomorrow as I am knackered now. I remember it is like a medical bible which GP's can use to show contraindications.