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<blockquote data-quote="Dennis" data-source="post: 16233" data-attributes="member: 1338"><p>Hi Henry,</p><p>I sympathise with you about the stomach problems associated with metformin, as will many others. As I have just posted elsewhere on this forum, there is a version of metformin that is kinder on the stomach. This is Glucophage SR, which is metformin but in a slow release form - but see my comment below before you ask you GP to prescribe this, as metformin in any form may not be what you need. To answer your question above, yes there are certainly consultants that you can be referred to, either NHS or privately. Some like to call themselves diabetologists and some endocrynologists, but essentially they are the same breed. They will have forgotten more about diabetes and its treatment than your GP will ever have learned.</p><p></p><p>In response to your previous post, am I right in thinking that you were on gliclazide, then came off it, then went on to metformin 11 months later, but no longer have any reduction in your BS?</p><p></p><p>If so then that proves several things, but let me first explain the difference between gliclazide and metformin. Gliclazide forces your pancreas to produce insulin. The fact that whilst on gliclazide you experienced low BS is proof that it worked for you (ignoring the side effects) in terms of making your pancreas produce insulin. Metformin doesn't make you produce insulin, but it makes what insulin you do produce work more effectively by reducing insulin resistance (i.e. it makes it easier for the insulin to transport the sugar into your body cells where it can be stored as energy).</p><p></p><p>The fact that you are no longer seeing BS reduction since coming off gliclazide indicates to me that your pancreas doesn't want to produce insulin without needing a prompt to do so (which it got from the gliclazide). Your problem doesn't seem to be one of insulin resistance because the metformin doesn't seem to be making any difference, it is more a case of needing something to get your pancreas kick-started.</p><p></p><p>If that hypothesis is correct then there are several other medications that you could take instead of gliclazide and that you may not have the same allergic reaction to. This is certainly something that you would be far better talking to a consultant diabetologist about as he/she will have a far greater knowledge of the subtle differences between the different meds than your GP would be expected to have.</p><p></p><p>Also, as Sue mentioned, a high carbohydrate diet is the worst possible thing that a Type-2 with inadequate blood sugar control can eat. All carbohydrates convert to blood sugar, so when your body is having difficulty in metabolysing blood sugar, then you need to eat less of what causes blood sugar, not more of it. Its a simple matter of cause and effect - eating less carbs results in less blood sugar - results in less insulin needed to metabolise the sugar.</p><p></p><p>That doesn't mean that you should ditch carbohydrates altogether, but have a look at the highest-carb foods that you eat (like bread, cereals, pasta, rice, potatoes) and try reducing the portions of each - if you normally have cereal and 2 slices of toast for breakfast (around 65g carbs), try instead having scrambled eggs on a single slice of toast (around 15g carbs); with your main meal have half the potatoes but more of another veg.</p></blockquote><p></p>
[QUOTE="Dennis, post: 16233, member: 1338"] Hi Henry, I sympathise with you about the stomach problems associated with metformin, as will many others. As I have just posted elsewhere on this forum, there is a version of metformin that is kinder on the stomach. This is Glucophage SR, which is metformin but in a slow release form - but see my comment below before you ask you GP to prescribe this, as metformin in any form may not be what you need. To answer your question above, yes there are certainly consultants that you can be referred to, either NHS or privately. Some like to call themselves diabetologists and some endocrynologists, but essentially they are the same breed. They will have forgotten more about diabetes and its treatment than your GP will ever have learned. In response to your previous post, am I right in thinking that you were on gliclazide, then came off it, then went on to metformin 11 months later, but no longer have any reduction in your BS? If so then that proves several things, but let me first explain the difference between gliclazide and metformin. Gliclazide forces your pancreas to produce insulin. The fact that whilst on gliclazide you experienced low BS is proof that it worked for you (ignoring the side effects) in terms of making your pancreas produce insulin. Metformin doesn't make you produce insulin, but it makes what insulin you do produce work more effectively by reducing insulin resistance (i.e. it makes it easier for the insulin to transport the sugar into your body cells where it can be stored as energy). The fact that you are no longer seeing BS reduction since coming off gliclazide indicates to me that your pancreas doesn't want to produce insulin without needing a prompt to do so (which it got from the gliclazide). Your problem doesn't seem to be one of insulin resistance because the metformin doesn't seem to be making any difference, it is more a case of needing something to get your pancreas kick-started. If that hypothesis is correct then there are several other medications that you could take instead of gliclazide and that you may not have the same allergic reaction to. This is certainly something that you would be far better talking to a consultant diabetologist about as he/she will have a far greater knowledge of the subtle differences between the different meds than your GP would be expected to have. Also, as Sue mentioned, a high carbohydrate diet is the worst possible thing that a Type-2 with inadequate blood sugar control can eat. All carbohydrates convert to blood sugar, so when your body is having difficulty in metabolysing blood sugar, then you need to eat less of what causes blood sugar, not more of it. Its a simple matter of cause and effect - eating less carbs results in less blood sugar - results in less insulin needed to metabolise the sugar. That doesn't mean that you should ditch carbohydrates altogether, but have a look at the highest-carb foods that you eat (like bread, cereals, pasta, rice, potatoes) and try reducing the portions of each - if you normally have cereal and 2 slices of toast for breakfast (around 65g carbs), try instead having scrambled eggs on a single slice of toast (around 15g carbs); with your main meal have half the potatoes but more of another veg. [/QUOTE]
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