Decreased HbA1c and Metformin question

[Sperato]

Hi everyone, I've just had a 3-month blood test after being diagnosed in December, My level has gone from 119 to 46, Which I think seems quite good.

I'm wondering what people's experiences were with reducing metformin and the impacts this has on HbA1c level. If you can reduce it And keep the level down is this what is classed as remission or is that when you can come off the tablets completely? Obviously I know I'm still high but thought that the doctor might talk to me about reducing the medication so wanted to be prepared with information before that conversation.

 

[Eddy Edson]

Well done! That's excellent.

"Remission" at the moment is formally defined as no meds and HbA1c less than 48.

(But there's no real difference between 50 and 45 or whatever - it's not like there's a bright line dividing the healthy from the diseased. So the numbers are really just bureaucratic convenience.)

Once your HbA1c is this low dropping the Met will probably have little if any impact. Anyway, I noticed no effect when I stopped taking it at around 40 (I think - can't remember exactly).

 

[harbottle]

Well done, that's quite an achievement.

I was reduced from 1000mg to 500mg after 3 months (83 -> 36) and then 4 months later it was 39, although I did increase carbs a little in that time (Usually a small portion of potato or some sweet potato). Last year I was told I could stop it, but decided to stay on it as I don't have any side effects.

Its effect on hba1c and fasting blood glucose is classed as 'moderate' - max effect is on a dose of around 2500mg but a smaller dose can sill make a slight difference. I've seen some research that showed even 500mg can have a slight effect on fasting blood glucose and hba1c. Never found any decent research into its effects combined with weight loss and lifestyle change, though, as most of the research seems to just be on patients who carry on as normal. I've seen a lot of research that considers 1500mg taken 3 times a day to be the lowest dose for 'clinical significance'... (Japan, until recently, only allowed a max dose of 750mg)

Not sure what the guidelines are for stopping it. I was just told 'you could stop it and see what happens'

 

[Docb]

Have you made any other changes, for example losing weight or changing your diet, that might also have helped with the reduction in HbA1c?

 

[Deleted member 21371]

Great result.

I actually wanted to stay on Metformin for the other alleged benefits it had.
The doctor stopped prescribing it anyway!
From memory, it made no difference, it was the weight loss that seems to have reversed it for me.

 

[Sperato]

Thanks everyone really appreciate your input and advice.

I have made massive changes to my diet cutting out carbs so only have around 100 g per day normally whereas before I was probably some days 10 times that amount.

I have lost 11 kg to date which also may have helped although I've still got a way to go.

 

[Sharron1]

Hi everyone, I've just had a 3-month blood test after being diagnosed in December, My level has gone from 119 to 46, Which I think seems quite good.

I'm wondering what people's experiences were with reducing metformin and the impacts this has on HbA1c level. If you can reduce it And keep the level down is this what is classed as remission or is that when you can come off the tablets completely? Obviously I know I'm still high but thought that the doctor might talk to me about reducing the medication so wanted to be prepared with information before that conversation.

Hi,

Well done on the reduction. As you can tell from numbers my Hba1c has been low for quite a while. However I am still on metformin (2 × twice daily) whenever I mention reducing them to see what might happen, the response is 'if it ain't broke .. 'etc etc. While I don't mind taking the stuff I am curious to know the thinking behind maintaining this number of tabs. In my amateur and non medical opinion I think the metformin is doing very little now but it is my choice of food and lifestyle doing the heavy lifting. It is still a very odd response from the surgery.Sigh

 

[Windy]

Hi everyone, I've just had a 3-month blood test after being diagnosed in December, My level has gone from 119 to 46, Which I think seems quite good.

It is good, you should be really proud of yourself to have made such a massive difference, well done!

I started on 2 x 500mg metformin when my HbA1c was 83 mmol/mol, and had it reduced to a single 500mg tablet 6 months later when I'd got my HbA1c down to 42 mmol/mol through weight loss/dieting.
A year later (last week), I had a review with the GP and stopped taking metformin, with an HbA1c of 34 mmol/mol. I could have stayed on metformin, and the GP seemed happy to continue prescribing it, but the D nurse had suggested I didn't need it any more, so I mentioned that to the GP and she took it off. I'm not aware if there's any hard and fast rules about stopping or reducing it. I liked having the safety net of taking it for the last year, but I'm also happy to stop taking it, and know I can restart in the future if I need to (hoping that I won't need to, of course).

You've done splendidly, so, metformin or not, it sounds like you've found something that works for you. Best wishes for keeping that going, Sarah