Best medication for DB T2

[Kestrel521]

As I didn't see any obvious places on the forum to look I am going to ask hear.

I was diagnosed with T2 at the beginning of October this year and was initially put on standard metaformin 500mg twice a day. After a few weeks of uncontrollable diarrhea. My GP then suggested that I go onto slow release metformin which he said would be better for me than the standard tablets. Well the diarrhoea has continued although slightly better. I agreed with the doctors surgery that I would try taking only one tablet a day for a week to see if things settle down with a bit more time. I have decided tonight that I am fed up with running to the loo multiple times every day.

Before I speak to the doctors pharmacy staff tomorrow, I would like some advice from you about possible alternatives to metformin which seems to be the preferred medication for treatment?
I am certain that being extremely overweight does not help me but I am hopeful that a different medication will improve things a good deal. TIA

 

[Kaylz]

I think those may be the only option to begin with, others come with the risk of hypo's, why don't you ask if you could try with diet and exercise alone first? xx

 

[Kestrel521]

My preference would like you mentioned is not to take medication at all and just improve my health with exercise and weight loss. The good news is I have already lost just over 8kg since diagnosis by improving my diet but exercise has gone out of the window with me constantly running for the loo. I don't know how keen doctors are to go down that route rather than just medicate. Now I have just started testing my blood glucose 4 times a day (b4 meals & bedtime) hopefully it will help me decide on a good option

 

[Kaylz]

I'd personally just say to them - look this isn't working, I'd like to try diet and exercise alone first and if that doesn't work then I'll further discuss medication, they can't MAKE you take the metformin, it isn't about exercise and weight loss only though, if you want to avoid medication then diet plays the major roll and you may find you need to go quite low carb to gain the control you want xx

 

[Kestrel521]

I think you are right in saying doctors can't make me take the medication so I will tell them that I want to stop the metformin however they suggest as not sure how stopping will affect me but I doubt that it can be worse than the side effects of taking it at the moment. I will agree a time period for recording my bg readings so we can review how bad or not my dB is looking and decide if I can take the time to improve everything without medication or if I should take tablets to help me hopefully in the short term to better control my db.

 

[Kaylz]

But you can start improving without medication from the time you receive a diagnosis so I'm not sure why you want to wait and review before trying that route, I'd have loved the chance to resolve my diabetes with changing the way I ate but sadly not how it works for us with Type 1, take the bull by the horn and make your adjustments based on your readings and take immediate action rather than recording with no intention to use the information without a review xx

 

[grovesy]

There are many other medications you need to have that conversation with your Doctor not all cause Hypos.

 

[Drummer]

I had a reaction to Metformin which was, if anything, more severe than yours. I stopped taking the tablets and just ate a low carb diet.
I was back to normal in 6 months and feeling a lot better than I had done for decades. I lost weight without effort, and have continued to shrink - I change over my clothes twice a year and every time I find I have shrunk out of some of them and need to replace or remake. The first year I lost almost a foot off my waist measurement, and the 'bay window' effect went too.

 

[everydayupsanddowns]

Sorry to hear that both standard and slow-release metformin have caused you unpleasant gastric upheaval @Kestrel521

If you’d like to systematically review your eating plan to make it more BG-friendly you might find this ‘test review adjust‘ framework very helpful. It allows you to use your BG results in a very practical and direct way to improve post-meal results, rather than simply collecting the information

Test, Review, Adjust

Managing blood glucose levels for type 2 diabetes. Learning how to achieve long term control by testing and diet.

loraldiabetes.blogspot.com

To begin with the numbers themselves are less important than the differences between the ‘before’ and ‘after’ readings. Aiming for a meal-rise of no more than 2-3mmol/L will gradually bring down your overall levels.

 

[DaveB]

Hi. Metformin never does a lot for blood sugar but GPs love the drug as it shows they are doing something. If it continues to cause bowel issues then I would say to the GP that you are stopping it. Your number one priority is to get your weight down to a good BMI area. That means a low-carb diet as well as exercise. I would start by going for something like 150gm/day of carbs and see how you do. BTW there is no other drug like Metformin, There are other tablets but some are not ideal if you have excess weight and hence insulin resistance.

 

[Kaylz]

I would start by going for something like 150gm/day of carbs

Thats more than what I consume lol xx

 

[Drummer]

Remember - weightloss and exercise are not going to be any use if you are not keeping your blood glucose down by avoiding high carb foods - as you are just starting out getting control and lowering your levels, gradually sinking down into the normal range is what to concentrate on.
I did that on 50 gm of carbs a day, then dropped to 40, with no discernible improvement, and achieved normality in 6 months.