Which Medication Is Best?

I would expect your doctor to know what's best for you......

I always assume that metformin is the first pill a doctor would use for a type 2........but, being a type 1, that may be wrong...

novorapidboi26 said:

I would expect your doctor to know what's best for you......

I always assume that metformin is the first pill a doctor would use for a type 2........but, being a type 1, that may be wrong...

Click to expand...

IMO doctors don't always know best, but as you say they generally prescribe Metformin as the first medicine for anyone with diabetes, and NICE is now encouraging GPs to prescribe it also for pre-diabetics, though not many GPs know about this. However, most T2s on this Forum would agree with me that no drug can be anywhere near as helpful as reducing the carbs in the diet. Metformin alone just won't do it.

Having seen my grandmother dying from the complications of type two - I will only ask - you think this is hard?

MKD75 said:

I know your right and I have managed for last 2 years by diet but I do struggle to maintain it every day and get stages where I go off course for a few weeks and want to eat carbs and can’t be motivated to exercise. I know it’s my health but am finding it hard

Click to expand...

Indeed, it IS hard! I have only been aware of my bg problem for well under one year, and have only gradually realised by trial and error how very low carb I personally need to eat in order to keep my bg down. I can quite understand that over years it is tough to keep motivated and maintain control. Ironically, it is when I am upset by seeing an undeservedly high meter reading that I feel a strong urge to console myself with large quantities of fruit, bread, chocolates - anything really high in carbs!!!

Metformin won't be able to do anything to stop you getting BG levels in double figures, if you eat the wrong things. It's not a get out of jail free card.

If you are finding it hard to modify your diet to the right extent, you probably should be talking to your GP about other medications.

MKD75 said:

Which other medications will help keep levels down?

Click to expand...

Insulin?

MKD75 said:

They wouldn’t give me insulin would they? From no medication then straight to insulin?

Click to expand...

Almost certainly not. What about Metformin? I pestered my GP for it and I think it has helped my bg levels. I always take it with meals, and no serious trots have resulted.

MKD75 said:

Well I bit the bullet on Friday and called the DN and got a batch of Merformin. My levels are good again, am back on track after a wobble but I will probably start taking them on Monday. Have you noticed it has made a major difference to your A1C test?

Click to expand...

In case you haven’t seen it, here’s an interesting and informative articles about the many benefits of Metformin:
http://www.lifeextension.com/magazine/2001/9/report_metformin/Page-01

MKD75 said:

Well I bit the bullet on Friday and called the DN and got a batch of Merformin. My levels are good again, am back on track after a wobble but I will probably start taking them on Monday. Have you noticed it has made a major difference to your A1C test?

Click to expand...

My home meter readings were lower after I had worked slowly up to the maximum dose of 2g Glucophage XR. (I took on board Dr B's recommendation that Glucoophage may be more effective than generic Metformin, and managed to persuade my GP to prescribe it, as nowadays Glucophage is not much dearer than the generic.) After a difficult 3 months with health problems and meds that appeared to raise my bg, my A1c at the beginning of January was 37. After starting Glucophage and 3 months of much better home readings, with fasting numbers throughout May never over 5 and more often 4.9, I had another A1c test at the beginning of June. I was confidently expecting eg 34, so I was shocked to get a rise to 38. I still don't understand why, except that my haemoglobin level was very slightly above normal,which may have skewed the test, but I would not have thought to that extent.

A1c 38 = an average of 6.4, but the days when I see a 6 on my meter are very rare.

This has not discouraged me from taking Glucophage. Since I have already cut carbs to the bone, all I can do now is try to increase the quantity and intensity of my exercise. I will have another A1c test at the end of July. Luckily for me, I have accepted the views of Dr Bernstein and Jenny Ruhl that post prandial readings are more important than A1c, but I'd dearly like to see a lower A1c too.

Rachox said:

In case you haven’t seen it, here’s an interesting and informative articles about the many benefits of Metformin:
http://www.lifeextension.com/magazine/2001/9/report_metformin/Page-01

Click to expand...

I remain to be convinced... if you effectively "don't have Type 2" i.e. completely normal BG levels and HbA1c I can't see the benefits of taking something alien to your system. The CVD risk will be mitigated by not having hyperinsulinaemia, PCOS I know nothing about and the rest sound a bit flaky.. Each to their own as always but everything has side effects whether you notice them or not..

Please remember this not just about getting your bg levels down. All that won't matter if you still get complications such as those suffered by your grandma. There have been studies showing that taking insulin or meds that encourage you to make more insulin still will not prevent complications and are likely to worsen them ( if 2 people have a good hBA1c of 5% then the person who achieved this with diet will be so much better off than the person who acieved it with meds). Dr Bernstein may well suggest glucophage but I am guessing this is in tandem with a low carb diet.
I wold not assume that your Doctor knows which drugs are best in terms of preventing complications but if they say that the only measure of success is HBA1c then be cautious and ask if that drug will reduce my chance of getting heart disease (what most type 2s die of) or kidney failure? Clue - according to Dr Jason Fung (nephroloist and diabetes/obesity clinician the SGT 2 inhibtors e.g. canegeflozin or acrabose that work by exaggerating loss of glucose via the kidneys have the best renal and cardiovascular outcomes. ALL drugs have side effects though so surely you might want to see if you can find a way to do low carb consistently enough to feel good and prevent inflammatory stuff in your body in reaction to a skin infection (boils) ?
Hope this is helpful - i am giving my 2pence worth because I feel that just because you can measure your bg levels (and they are important) on this forum lots of people are just looking at that. If you are type 1 like me then bgs are the most important thing but for type 2s the other issues should be considered!

I just stopped taking the tablets as I felt so ill - one tablet of Metformin and one of a statin and I was losing the will to live and really scaring my husband - he's stopped the statins after seeing me wandering about in a daze for weeks.