Can I work safety critical job with Metformin?

[David J]

Hi guys,

Sorry it's my first time her but I really need your help and advice.

I have been working with my Railway company for five years now, and I was diagnosed with diabetes type 2 since 4 years ago and I am taking Metformin since then.

After three years working at the same company I was offered a train manager job and I passed my medical assessment and declared at this medical assessment that I am diabetic and taking Metformin.

The result was he is fit.

Last week my Gp prescribed me Ibuprofen for my back pain so I declared it to my line manager and I added my Metformin as well.(you should add all your medications every time)

Surprisingly two days later my manager put me OTR which means of train running, when I asked him why? He said because you can't work your job with taking Metformin and he sent me the Medical report which says with taking the Metformin he should be accompanied by someone else, which means I can't work my job anymore.

Is that true? And does the Metformin stopped me working my safety critical job?
I am type 2 and well controlled and my last results was 6.5 and my Gp was happy with me and I never went sick in my work even for one day...

I don't know what shall I do? I am very stressed and worried

 

[Pumper_Sue]

You need to find out why they think Metformin is dangerous.
Met does not cause hypos so unless it's one of the side effects ie farting which might derail a train in extreme circumstances I can not see a problem. So you need a written explanation from your company.

 

[David J]

Hi, David

Bus drivers, coach drivers and lorry drivers have to notify the DVLA if they have diabetes and take medication for it, even if it's non-insulin, so I wonder if your rail company has taken that as guidance.

Do you belong to a Trade Union that could take up your case?

Martib

Martin

Thanks mate for your reply
The company provided me with the Medications details review which was sent to them by a Chemist calling centre:

Metformin: must be accompanied at the times when performing safety critical duties and must report any side effects to the manager, this applies for the duration of medication and for further 24 hours after last dose.

 

[David J]

Hi, David

Bus drivers, coach drivers and lorry drivers have to notify the DVLA if they have diabetes and take medication for it, even if it's non-insulin, so I wonder if your rail company has taken that as guidance.

Do you belong to a Trade Union that could take up your case?

Martib

Martin

Yes mate I am a member of the union and I am just waiting till the end of this week then I'll contact the union rep.

 

[Eddy Edson]

Thanks mate for your reply
The company provided me with the Medications details review which was sent to them by a Chemist calling centre:

Metformin: must be accompanied at the times when performing safety critical duties and must report any side effects to the manager, this applies for the duration of medication and for further 24 hours after last dose.

If these guidelines https://www.rmt.org.uk/news/publications/guide-for-medical-assessors-diabetes/ apply to your job then they don't seem to provide any justification for a Metformin-related restriction:

Biguanides (metformin). This drug alters the sensitivity of the cells to insulin, thereby improving the action of insulin and also reducing the amount of extra glucose produced by the body. Since it acts only in the presence of endogenous insulin it is effective only if there are some residual functioning pancreatic beta cells. Metformin rarely causes hypoglycaemia.

....

5.1 Hypoglycaemia or impairment unlikely

Medical restrictions are not normally necessary for employees with uncomplicated diabetes treated with diet alone or with tablets that are unlikely to cause hypoglycaemia. These individuals should be reassessed annually by a member of the occupational health team, with referral to the responsible occupational physician when necessary. Some providers may choose to incorporate a self declaration approach similar to that used by the DVLA and the employee should be reminded to report any progression in their condition including changes in treatment and medical complications

Make a fuss!

 

[Drummer]

I have been reprimanded elsewhere for writing that Metformin doesn't reduce glucose levels directly i.e. by hauling the glucose out of the blood - but I can't see in all the reading I have done about it that there should be any problem - unless you get serious side effects, which I did so I would not take the stuff under any circumstances, but that is just me.
Perhaps you could feel unwell after suffering gastric upsets for long enough that you become dehydrated, you could become confused, I suppose - but to such an extent that you need a minder? That is totally over the top. You have been taking it without such problems, I deduce, so just not relevant.
You could always ask your doctor it you could stop taking it and rely on low carb eating for a while to see how you do - prescribing Metformin seems to be a knee jerk reaction at diagnosis and the fact that eating low carb can sort things out for many type twos seems to be a surprise to many.

 

[everydayupsanddowns]

I would suggest contacting the Diabetes UK Careline when it opens on Monday (office hours) as they should be able to support you with your employment rights.

https://www.diabetes.org.uk/how_we_help/helpline

I am also under the impression that Metformin is very unlikely to cause hypoglycaemia as I did not believe it was a directly hypoglycaemic agent.

 

[David J]

I would suggest contacting the Diabetes UK Careline when it opens on Monday (office hours) as they should be able to support you with your employment rights.

https://www.diabetes.org.uk/how_we_help/helpline

I am also under the impression that Metformin is very unlikely to cause hypoglycaemia as I did not believe it was a directly hypoglycaemic agent.

Thanks for your reply mate, yes I am going to give them a call Monday.

 

[DaveB]

Metformin only rarely causes low blood sugar. Yes, you need to get some good guidance to your employer instead of the nonsense they have been given

 

[Stitch147]

I used to work at TfL and being on Metformin was fine for carrying out safety critical duties, many train operators, managers and station staff. They even changed the ruling a couple of years ago about train operators ability to operate trains whilst using insulin. Unless the rules have change in the past year since leaving the company.

 

[David J]

Thanks mate