When to stop the Metformin

At diagnosis I was immediately prescribed 500mg of Metformin 3 times per day. At the time I knew nothing about T2 only that it was diet related. I was quite surprised to be put on medication immediately like that as I thought the first option was to try to sort your diet out.

My first blood test after diagnosis showed a drop in HbA1c from 84 to 52. Some of you might have seen these figures in other posts. I have a diabetes review next Friday at my GPs and I'm thinking of suggesting stopping taking the Metformin.

I would like to ask you,

1. What do you think the practice nurse will say.
And
2. What is you thoughts on stopping the Metformin.

I realise the HbA1c of 52 is still high but I made a lot of mistakes in those first 3 months. I have now moved from simply having a lower carb diet to LCHF and have started 16 hour IF.

If you wonder why I want to stop taking the Metformin it's because currently I don't know if it's the change in lifestyle that is bringing the numbers down or the medication or both. Would it be worth risking 3 months to see if the Metformin is really necessary. If my numbers went back up then fair enough I need the Metformin. But I've never been given the chance to see what I can manage on my own.

I value your opinions so please don't hold back if you disagree with my proposed plan I appreciate any advice.

Thanks once again

Alan

Mike D said:

Metformin is not the silver bullet many think .... but we all want to dump it when our BS are under control

Yours are still a little high but far be it for anyone to advise you on your next move. Your next HBA1C with an improved diet should influence the outcome

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Thanks Mike D

Mbaker said:

The most powerful intervention is diet. When I removed Metformin I never looked back. Your drop has been dramatic, there is no reason for your LCHF / IF to not further improve your situation. I will declare that I am anti drugs.

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Thanks Mbaker. Im not anti drugs. But I think the dose kind of scared me a bit.

JohnEGreen said:

I would say the time to dispense with metformin is when it is no longer needed.

I am not anti drugs. There are many here who would not be alive today without the drugs that keep them so.
They have their place

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Thanks for your reply JohnEGreen

Bluetit1802 said:

My HbA1c on diagnosis was 53. Metformin was never mentioned. I was sent away for 3 months to lose weight and tweak my diet. In that 3 months I brought my HbA1c down to pre-diabetic levels and it has continued to improve ever since, so I have never been on any medication. In my case, diet was the key and I avoided any potential unpleasant side effects.

I honestly doubt your nurse will be happy for you to stop Metformin until tour levels are at least under 48. Sadly, doctors and nurses seem to think Metformin is a magic pill. However, there is no harm in discussing it with her, and even if she says no, the decision to take it is yours, not hers. All she can do is advise.

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Thanks for the reply Bluetit1802

Rachox said:

Maybe it’s my nursing back ground but meds don’t phase me. I was put on Metformin (3 x 500mg/day) straight away on diagnosis with an HbA1c of 70. That along with low carb eating bought my HbA1c down to a non diabetic level within 4 months. Come this August having maintained my HbA1c in the mid 30s for nearly a year and having lost six stone in weight, I dropped one tablet per day. After three months my HbA1c only rose from 34 to 35, however my weight loss completely stopped, so in consultation with my GP I have gone back up to 3 tabs per day. I am lucky that side effects were very short lived, I take vitamin B complex to hopefully avoid B12 deficiency. I have also done a lot of reading about Metformin and aside from blood sugar levels and weight I’ve read that there are other benefits of taking it.
Here’s an interesting read about it:
https://www.lifeextension.com/magazine/2001/9/report_metformin/Page-01

Edit to add, my weight loss has now resumed

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Thanks for replying again Rachox and well done for what youve achieved. I will checkout the link and have a read.

Jim Lahey said:

I found Metformin’s greatest benefit to be in taking the edge of the dawn highs. One of its key functions is to discourage the liver from pouring glucose into the bloodstream with reckless abandon, and the liver tends to do this in the early hours of the morning, assisted by cortisol and adrenaline. When I was incrementally reducing my dose from 3x500mg to where I am now (none), always the biggest challenge would be managing the elevated blood glucose concentration throughout the morning.

I wouldn’t be in a rush to simply stop taking it, especially if you don’t use a glucose monitor and only rely on HbA1c. It’s probably giving you more benefit than you might give it credit for. Slow reduction of the dose to a planned zero would be my advice, and don’t be in a rush to do so unless you struggle with side effects.

That’s my experience at least. Not everyone is in the same place on the sliding scales. It would also very much depend on the severity of progression prior to diagnosis - it can take quite some time to really purge the body of glucose/glycogen, and for the liver and pancreas to deplete their fatty deposits. Remember that diabetes can take decades to develop - you’re unlikely to beat it overnight unless you were diagnosed very early. Take your time, and in the meanwhile Metformin is your ally

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Jim Lahey, Thanks for replying and for the advice. What you said makes good sense. I do use a monitor two hours after each meal and first thing in the morning. I was a bit spooked by the dawn highs at first until people on here explained that it was hardest to get this reading down. I've since cut out breakfast as I figure my body doesn't need any extra energy at this time of day.

DavidGrahamJones said:

Tricky one. I lowered my BG by following a low carb diet (last HbA1c was 44) but continue to take Metformin. I wasn't convinced of it's effectiveness and stopped after a prolonged bout of the runs again. My BG did creep up but there could have been other issues at play, specifically the flu (the real one). I'm taking it again but might be tempted to stop. I'm guessing that DNs and GPs might not be too happy, can always ask.

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Thanks for the reply DavidGrahamJones

walnut_face said:

As my HBA1c dropped I suggested to the NP that I reduce the dose - she agreed without hesitation

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Thanks walnut_face