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Alternatives to Metformin?

dannybgoode

dannybgoode

Well-Known Member
Relationship to Diabetes
Type 2
Sorry, full of questions tonight.

Just trying to get my ducks lined up in case my tests come back as T2.

I'm pretty sure that if they do I'll be on some form of medication however the potential side effects scare me.

As an ileostomate stomach pains, flactulence and diarrhoea are about the last things I need! I can't take slow release anything either.

Are there many alternatives? I will of course discuss with the DSN when/if that is the pathway I end up on. Just curious as to what's out there.
 
dannybgoode said:
Sorry, full of questions tonight.

Just trying to get my ducks lined up in case my tests come back as T2.

I'm pretty sure that if they do I'll be on some form of medication however the potential side effects scare me.

As an ileostomate stomach pains, flactulence and diarrhoea are about the last things I need! I can't take slow release anything either.

Are there many alternatives? I will of course discuss with the DSN when/if that is the pathway I end up on. Just curious as to what's out there.
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Although metformin is the first to be prescribed it is not suitable for everyone especially those who have gut issue anyway. So yes there are other medications which have different modes of action so you would need to discuss those options with your doctor.
 
Not really my area of expertise but there are numerous alternatives to Metformin (I had a brief flirtation with it, which was, ahem, interesting) but stick with the insulin for now
 
Thanks guys. One by-product of not having a definitive diagnosis of type of that the DSNs are keeping me on insulin at least until they do know.

I'll have to see what they say I guess and of course the antibody test my show T1 anyway at which point it's all rather academic anyway...
 
Evening Danny.Can understand that until you get an exact diagnosis you can’t be sure of what is best medication but as Inka says if insulin is working for you then that may be best option.
The difference is that if you are Type 1 you need exogenous insulin whereas if you are Type 2 there are a range of options including insulin.
I am an odd one so am Type 3c so in some ways it is like Type 1 in that I likely need external insulin but I have not had a C Peptide test to see if I could get by with say a SGLT2 inhibitor.
I was given insulin to get my BG u der control and found I could manage it well on the insulin so just had no wish to consider any other approach though it may be I do get a C Peptide in the future
 
dannybgoode said:
Thanks guys. One by-product of not having a definitive diagnosis of type of that the DSNs are keeping me on insulin at least until they do know.

I'll have to see what they say I guess and of course the antibody test my show T1 anyway at which point it's all rather academic anyway...
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I think whichever way your results and classification go, I’d say it’s really important for your Drs to bear in mind your whole wellbeing, including your ileostomy.

There’s a flowchart of T2 med options here which might give you an overview of the different classes and types of meds.

everydayupsanddowns

Thread 'NICE / SIGN flowchart for T2 medication'

Thanks to @gll and @Docb for recently sharing these helpful resources.

SIGN (Scottish equivalent to NICE) flowchart for the introduction of medications to help with T2 diabetes


And the section of the NICE guidelines on which the flowchart is based

Recommendations | Type 2 diabetes in adults: management | Guidance | NICE

www.nice.org.uk www.nice.org.uk

And again as a flowchart
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@everydayupsanddowns - thank you. That is useful. Gives me something to be armed with if I go that route.

The clinic seems pretty good here in Sheffield based on experience so far and I'm jumping the gun a little I know but that's the kind of guy I am 🙂

I'll update folk when I know more
 
I know you’re just starting on insulin and it will take some time to get your levels under control, but once they are ok and if it works ok for you then I would fight to stay on insulin regardless of whether you are T1 or T2. Why change something that is working and you are happy with (assuming you are) for drugs that may cause other problems?
 
Eternal422 said:
I know you’re just starting on insulin and it will take some time to get your levels under control, but once they are ok and if it works ok for you then I would fight to stay on insulin regardless of whether you are T1 or T2. Why change something that is working and you are happy with (assuming you are) for drugs that may cause other problems?
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I wouldn’t go into it thinking of it as a fight though, a simple “I’m used to the insulin now and I’d rather stay on that for the time being” should be all that’s needed
 
Lucyr said:
I wouldn’t go into it thinking of it as a fight though, a simple “I’m used to the insulin now and I’d rather stay on that for the time being” should be all that’s needed
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I do meetings and negotiations for a living so I'm very good at achieving the outcome I desire without getting into a fight.

The Sheffield team seem very good too and the DSN last Friday did hint at me staying on it regardless so we'll see.

Of course it still may be T1 or T1.5 anyway so I'll stop being impatient and trying to second guess stuff. I just get like that sometimes!
 
I was quite surprised to hear through this forum that some T1’s use Metformin as part of their control, but then again many people I come across both in my personal and professional life are suprised when I tell them I take insulin, they usually say something like :confused: 🙄 with a slightly puzzled look your T1 then not T2
 
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