This is harder than I thought

britishpub said:

OK

I was under the impression the 2 to 2.5 mmol reduction related to the HbA1c not a random prick test.

If a random prick test will be reduced from 8 to 5.5 by taking Metformin I can't imagine why anyone would resist taking it.

I guess that equates to lowering your HbA1c from say 50 to 35 or more.

I didn't realise it was so potent.

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it's very potent.. maybe because you don't get time to digest your carbs before they come out the other end extremely rapidly...

@britishpub

The general way it is prescribed (as shown by posts on the forum) seems to be that there are guidelines not to prescribe met until the A1c is 53 or above.

So if it drops it by about 11-12 A1c units (to 40ish), you can see why. But unfortunately people often seem to believe it is a get-out-of-gaol-card and not look after their diet. when the truth is that met doesn't have much effect on carb spikes.

So they take met AND eat carbs, and still end up with higher A1cs and complications. I don't think docs and nurses explain it properly.

Plus of course, there are the side effects which makes it impossible for some.

Personally, I would definitely take it if it was offered for the insulin resistance benefits (I have a lot of insulin resistance), but my A1c is too low to hit their criteria, and I have no intention of harming myself for months with raised blood glucose to manipulate a prescription.

But it isn't 15-20 mmol
It is 11 or so mmol/mol (the A1c units)
Or 2.5 (ish) mmol/l (prick tests)

The other huge misconception about metformin is that 2000 mg is twice as effective as 1000mg.
It isn't.
The benefit from doubling the dose only increases the effectiveness by around 25%.
But it increases the tummy upsets far more!

I would never call it a wonder drug. The main reason it is widely prescribed is price (it is cheap), and tolerated by most (debateable) and fairly predictable. And has fewer contraindications than the rest of the available drugs.

Pink_Minx said:

Yikes, my problem with the Metformin is exactly the opposite - it hangs around for FAR too long! :-D

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Are you on the slow release? That caused me constipation and then explosive diarrhoea two days later.Not nice at all.

britishpub said:

@Brunneria Thank you. I watched the video this morning, and did some further research.

Very interesting, thanks for the prompts.

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No worries!

@Pink_Minx - I just wanted to make a couple of general comments.

I don't think you have given your body long enough to get used to working on its own again, whatever impact the Metformin might, or might not have been having on you. The impact of Metformin builds up in our systems, and for most folks, it could be fair to assume it also trails off over a few days. Additionally, our bodies like to work to routine, and like to run within unwritten parameters. To illustrate that, think of carb flu and the withdrawal many people experience, with some even experiencing false hypos. Those symptoms are because they have pushed their bodies into a new, temporarily uncomfortable zone, and their body is trying to "correct" it to where it has been running for the period before the changes.

Our bodies can also experience, what I call, enzyme lag, whereby our systems are used to metabolising certain amounts of food, in certain ways, and will therefore be ready to pump out certain enzymes on a regular basis. And change to diet or lifestyle (and meds) can mean a change of enzymes could be required to cope with that new situation. That the body doesn't catch on immediately is irritating, but not catastrophic. There is much written about it, and it's sometimes referred to as the "Last Meal Effect". Have a Google.

Finally, you may find that although your insulin resistance has improved it still has a way to go; one way or another - whether by catching up with your body, or perhaps trimming up a bit more might help. I have no idea what your poundage shift has been, or where that leaves you in the BMI stakes, but I did find my body's "performance" improved in notches, as opposed to a a straight line reducing graph. My body would chugg along, then my scores and so on, would drop a notch, then stabilise, then drop.

If you are still carrying any poundage, it could be worthwhile considering dropping a little more to see if that had an impact?

There is no doubt in my mind that the maintenance stage is the trickiest to get right, as we don't want to go yo-yoing in terms of either weight or blood scores. I think I was probably at my most nervous and scared at the point of maintenance; achieving goals was (relatively!) easy for me.

I hope something in that brain dump might help, but don't be too hasty to make big changes.

As always I would be an advocate of documenting what you are doing, so that you have data to discuss with your HCP, if you need to, rather than what could appear to be random thoughts - especially if your HCP is a reduced carb resistor!

Good luck with it all.