Told to stop metformin for ten days as having bowel problems. Concerned BG will increase?

[Maggie/Magpie]

Hi All,
I was prediabetic on 1500 normal metformin a day. Turned diabetic had metformin increased to 2G per day and put on slow release. Was working well with LC diet as well went from Hba1c of 53 to 40 in 3 months.
Always had constipation problems, but just recently changed to 5 days constipation then stools normal and then 2 days roughly of diarrhea then constipated again. Gp thought diarrhea was overflow and I was told to take cosmocol which is basically like fibergel. But it didn't improve Gp has now advised to stop metformin for ten days to see if diarrhea stops. I presume if so he will stop it all together, if not then he will investigate further. My concern is if I stop metformin will my blood sugars go up again? Does anyone have any experience of any of it? Or can anyone advise whats liable to happen? Feel rather in the dark and scarred of stopping it to be honest. Any advise would be appreciated.
Sorry for the unsavory subject matter.

 

[donnellysdogs]

There are two types of metformin, GP prob put you on the cheaper, standard option. There are other alternatives of drugs to try too.

Are you blood testing before and after meals? That would be the only way to see what the lack of metformin is doing to you.

If it doesnt resolve then ypu need to ask for a referral to a gastroenterologist.

 

[donnellysdogs]

I'm not on metformin but I certainly know how bad alternating with going to loo is so horrible... total empathy on that score!

 

[daisyduck]

I was only on 500 dose and felt so ill I stopped it myself after 11 weeks of trying to see if it would settle down. It had no noticeable effect on my BG

 

[Resurgam]

I stopped taking Metformin and statins and decided to rely on low carb, as I was in a dreadful state just before Christmas.
I test before and after my evening meal and the average is now down to 7.5 mmol/l. I have taken a few tablets this year as I find them a most effective laxative, but they make my insides hurt, so I will probably bin the remaining pills.
As long as you are not eating carbs and pushing your blood glucose up after meals then you should be OK.

 

[pleinster]

I was never on metformin because I wad diagnosed post renal transplant (ie. steroid induced diabetes) and my doctors were reluctant to prescribe it due to other drugs I was on (mainly immuno-suppressants, one of which can also cause problems with digestion). I was on Gliclazide instead (one that your doctor could consider instead), but I have to stress that the impact it had on my blood sugar was negligible compared to that of cutting carbohydrates. My levels came right down the more I got in control of my diet (ie, low cabrs - I have never had a weight problem or need to diet before hand) and was off the Gliclazide completely. Personally, I always wonder why doctors are so ready to give out these drugs when someone is diagnosed as pre-diabetic..and think that advice to alter the diet is wiser, to see whether the levels can be controlled without meds. You seem to have made good progress with low carbing; I would only concern myself with the drug again if you levels changed for the worse, but this seems doubtful at this stage...I would not be surprised if you were better off simply relying on diet alone. Discuss is further and show your doctor evidence of levels as a result of diet alone (ie. your records of what you eat and what your levels are before and two hours after)...he may well agree.

 

[Brunneria]

I am sorry you must be having so much unpleasantness and discomfort!

Metformin is a useful drug in many ways, but it has less impact on blood glucose than most people think. Dietary control has much more effect!

What dietary measures do you have in place to control your blood glucose?
And similarly, what dietary measures do you have in place to treat your constipation/diarrhoea?

My personal view is that these can have a much better effect than medication, but the trick is to find out what works for you, since we each seem to have remarkably different requirements for gut health.

 

[bulkbiker]

Hi All,
I was prediabetic on 1500 normal metformin a day. Turned diabetic had metformin increased to 2G per day and put on slow release. Was working well with LC diet as well went from Hba1c of 53 to 40 in 3 months.
Always had constipation problems, but just recently changed to 5 days constipation then stools normal and then 2 days roughly of diarrhea then constipated again. Gp thought diarrhea was overflow and I was told to take cosmocol which is basically like fibergel. But it didn't improve Gp has now advised to stop metformin for ten days to see if diarrhea stops. I presume if so he will stop it all together, if not then he will investigate further. My concern is if I stop metformin will my blood sugars go up again? Does anyone have any experience of any of it? Or can anyone advise whats liable to happen? Feel rather in the dark and scarred of stopping it to be honest. Any advise would be appreciated.
Sorry for the unsavory subject matter.

That's exactly what happened to me.. constant diarrhea on standard then constipation and explosive diarrhea on the slow release.. That's why I stopped taking it and went Ultra Low Carb.
To be honest your dietary changes have probably had the biggest effect on your levels so if you continue with that then you should be fine. Give it a go and monitor your bloods.. maybe cut a few more carbs out if you can.

 

[Sid Bonkers]

Hi, firstly I wouldnt worry to much about stopping your 1500 mg of metformin as even the highest dose of 2000 mg per day is only going to drop your bg levels by between .5 and 2 mmol/L.

Secondly did you start off on the 1500 mg dose or did you start off on 500 mg per day for a week or two and then increase it by 500 mg every couple of weeks as if it is started this way it often helps avoid the side effects you mention.

There is the prolonged release version of metformin which may suit you better and or other drugs that can be prescribed, follow your docs advice and stop the metformin for a couple of weeks and see if your symptoms ease which I imagine they will and then see your doc again and ask about the prolonged or SR version with a gradual increase rather than straight onto a high dose.

Hope this helps and good luck.

 

[Daibell]

Hi. Some posters over the years have had bowel problems even with the Slow Release version and have had to stop. As @Brunneria says, it only ever has a small effect on blood sugar and the right diet and exercise remain vital

 

[Bluetit1802]

As others have said, Metformin isn't a miracle drug. It only helps with blood glucose levels to a limited extent. It doesn't promote insulin production. It works on the liver to help reduce the amount of glucose the liver produces, but again only to a limited extent. It is mainly an appetite suppressant that helps with weight loss. Unless you had other health issues when you were pre-diabetic (such as PCOS) I am very surprised you were prescribed it. Even with a diagnostic HbA1c of 53 I am surprised. Most newly diagnosed with that level are normally told to diet and exercise, come back in 3 months and we'll see how you are. That was certainly the case for me. My HbA1c was 53 and Metformin has never been mentioned, at any time.

I would do as your doctor says and keep an eye on your levels before and after meals - especially before evening meal.

 

[Nicksu]

I could only stand Metformin for 2 weeks - felt vaguely nauseous from the start of taking it and then after 2 weeks my stomach revolted. On gliclizade now (40mg twice a day) and doing LCHF and hoping to get off that and go on diet controlled only. I tend to go as low carb as I can (which has helped the 2½ stone weight loss - but still more to go). Here's hoping you get this sorted out.

 

[Maggie/Magpie]

I am sorry you must be having so much unpleasantness and discomfort!

Metformin is a useful drug in many ways, but it has less impact on blood glucose than most people think. Dietary control has much more effect!

What dietary measures do you have in place to control your blood glucose?
And similarly, what dietary measures do you have in place to treat your constipation/diarrhoea?

My personal view is that these can have a much better effect than medication, but the trick is to find out what works for you, since we each seem to have remarkably different requirements for gut health.

Hi Brunneria,
I've reduced all carbs by half and stopped all obvious sugar. I have had some higher fats than normal but avoid it a lot, as its hard to break a habit of a lifetime re cooking etc. As for diet re constipation, I eat a reasonable diet with lots of veg, fruit and roughage. I also try to have a reasonable amount of water as well. But it's been a life time problem, the only time they seem to be normal is when I'm binging on carbs and sugar. So don't know the answer to that one.
Maggie

 

[Maggie/Magpie]

Hi, firstly I wouldnt worry to much about stopping your 1500 mg of metformin as even the highest dose of 2000 mg per day is only going to drop your bg levels by between .5 and 2 mmol/L.

Secondly did you start off on the 1500 mg dose or did you start off on 500 mg per day for a week or two and then increase it by 500 mg every couple of weeks as if it is started this way it often helps avoid the side effects you mention.

There is the prolonged release version of metformin which may suit you better and or other drugs that can be prescribed, follow your docs advice and stop the metformin for a couple of weeks and see if your symptoms ease which I imagine they will and then see your doc again and ask about the prolonged or SR version with a gradual increase rather than straight onto a high dose.

Hope this helps and good luck.

Hi Sid Bonkers,
I started on 500mg twice a day, then increased to 500mg three times a day. Then have been increased to 1G twice a day of the slow release version, so I'm already on the SR or prolonged release tablets.
Maggie

 

[bulkbiker]

OK but @Maggie/Magpie are your concerns less now that you have read all that has been written?
You seemed very concerned about stopping the meds for a while but I don't think it will do you much (probably no ) harm at all.
I'm guessing the vast majority of your improvement has come about by changing your diet rather than the pills.

 

[Maggie/Magpie]

As others have said, Metformin isn't a miracle drug. It only helps with blood glucose levels to a limited extent. It doesn't promote insulin production. It works on the liver to help reduce the amount of glucose the liver produces, but again only to a limited extent. It is mainly an appetite suppressant that helps with weight loss. Unless you had other health issues when you were pre-diabetic (such as PCOS) I am very surprised you were prescribed it. Even with a diagnostic HbA1c of 53 I am surprised. Most newly diagnosed with that level are normally told to diet and exercise, come back in 3 months and we'll see how you are. That was certainly the case for me. My HbA1c was 53 and Metformin has never been mentioned, at any time.

I would do as your doctor says and keep an eye on your levels before and after meals - especially before evening meal.

Hi Bluetit1802
Thanks for the advise, I think I was prescribe it for its weight loss properties as well as having diabetes. As I have quite a lot to loose. Also my Hba1c kept continuing to rise despite being on metformin when pre-diabetic which is why they put it up to max dose.
I've asked the Diabetic Nurse at GP to phone me tomorrow so I can discuss it with her and see if she will give me some more test strips so I can test every day and keep a proper eye on things for if nothing else a good piece of mind.
Cheers
Maggie

 

[Maggie/Magpie]

OK but @Maggie/Magpie are your concerns less now that you have read all that has been written?
You seemed very concerned about stopping the meds for a while but I don't think it will do you much (probably no ) harm at all.
I'm guessing the vast majority of your improvement has come about by changing your diet rather than the pills.

Hi Bulk Biker,
Everyones advice is always gratefully received and goes a long way to putting my mind at rest. Which is why I keep posting. I now have a plan for going forward with all of this so thank you and everyone else for replying.
Maggie

 

[Maggie/Magpie]

Thank you all for all your help and advise
Maggie/Magpie

 

[Tiger boy1]

I stopped taking Metformin and statins and decided to rely on low carb, as I was in a dreadful state just before Christmas.
I test before and after my evening meal and the average is now down to 7.5 mmol/l. I have taken a few tablets this year as I find them a most effective laxative, but they make my insides hurt, so I will probably bin the remaining pills.
As long as you are not eating carbs and pushing your blood glucose up after meals then you should be OK.

 

[Tiger boy1]

Resurgam, I also stopped taking Metformin and Statins due to unbearable stomach pain waking me up early hours most mornings..I went to Doctors several times and was given advice to drink more fluids etc, My aches pains and bowel and stomach problems stopped with in 24 hours.. Asked my doctor for six months diet and exercise, until my next Diabetes review..my Blood glucose with 1500 metformin was between 6.5 and 7,5....with a low carb diet..i test every morning and evening after meals..usually about 8...i know its still la bit high..but so much better feeling than all the pain and suffering on metformin and Statins...i hope i can get it down even more, we will see..