From insulin to metformin

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Smorg14

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Type 2
Hi, I first joined here in August when I found out I had type 2. I was literally terrified, hadn't a clue about anything, I had to inject insulin straight away, and do 6 finger prick tests a day. my HBA1c was 112!!. Now three months later I've just had my second HBA1c and it's now 44!! And dare I say it, in the pre diabetic range. I was so scared when I first found out, lived on my own, no one to talk to late at night when I couldn't sleep from worrying, and had my first panic attack. So I had no choice but to give my head a wobble. I started a very strict low carb intake, no more than 30 carbs per meal, and no more than 15 carbs per snack. I was scared to death of eating anything at firstand just stuck to eggs, fibre cereal, apples and peanut butter, omelette, just simple stuff with salad and chicken too. In 3 months I've lost a stone in weight, now fluctuate between 11st 13lbs and 12stone. Feel like inches are coming off tho even tho the scales stay the same. After the last reading of 44, I am being put on metformin, 1 a day to start with and no more insulin. My diabetes nurse warned me of bad stomach and nausea with metformin. I just wondered what other people on it think of it and what are the choices if its not suitable for me. My aim is eventually to do this by diet alone and reverse this. Thanks in advance for any info on Metformin. Sue x
 
If you do get bad side effects with the metformin that don’t go away you can try changing the timing or type of food you take it with. If that doesn’t help there is a slow release version that has less side effects.
 
Ok thats really helpful thank you x
 
If you are definitely type 2 then it is odd that you were put straight onto insulin - but I'm unable to fathom out these things today.
If you are actually a type two then eating a low carb diet might well do the trick.
Some people can take Metformin no trouble, others, like me, it tries to turn inside out.
I found I never needed it in the first place, but I only eat low carb foods - no cereal nor starchy anything, no sugary foods.
I do eat a fair bit of low carb plant based foods, mushrooms (not a plant) amounting to around 35gm of carbs most days but I do eat a dessert a couple of times a week which is usually sugar free jelly with berries and cream, sometimes proper custard if I have cream to use up.
 
Yes im hoping I don't need the metformin for too long. I think its because my reading of 112 was so high they put me on insulin, I've actually just remembered they had me on gliclazide(?) Over a weekend then put me on insulin instead. Yes im getting used to the low carbs, I do get some foods from the company Seriously Low Carbs , the brownies are delicious and hust over 3 carbs each for a treat.I have a keto cinnamon porridge in the morning , use almond no sugars milk. I love the sugar free jelly I have it with a blob of marscapone cheese, tastes like clotted cream. It's great to have a few go to treats that are low in carbs it definately what keeps me on track with the low carbs. I don't go over 100 carbs a day, some days it's a lot less
 
Drummer said:
If you are definitely type 2 then it is odd that you were put straight onto insulin - but I'm unable to fathom out these things today.
If you are actually a type two then eating a low carb diet might well do the trick.
Some people can take Metformin no trouble, others, like me, it tries to turn inside out.
I found I never needed it in the first place, but I only eat low carb foods - no cereal nor starchy anything, no sugary foods.
I do eat a fair bit of low carb plant based foods, mushrooms (not a plant) amounting to around 35gm of carbs most days but I do eat a dessert a couple of times a week which is usually sugar free jelly with berries and cream, sometimes proper custard if I have cream to use up.
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Hi, when you say you never needed metformin in the first place what do you mean? I feel that I can do this by low carbs, I don't find it difficult, expensive sometimes but not difficult. I hate taking any form of medication and have always wanted to do it by diet alone. 3 months ago when I had my first HBa1c and it was 112, this was the reading for the prev 3 months and I'm not suprised the reading was high, I'd moved house and was living on takeaways, and all things bad for 3 months until I got yhe house set up. I normally eat fairly healthy so the type 2 diagnosis was a shock, although I did find out that my birth mother had diabetes. With me getting the 112 reading down to 44 in the next 3 months using low carbs I would really just like to do it like that, but if I have to go from insulin to metformin for a bit that's OK but I don't want to get stuck on it. All my checks came back fine, eyes , feet, liver, kidney, spleen etc, I'm getting cholesterol and blood pressure done on Monday because they forgot to do it. Last day of insulin this coming weds, metformin Thursday evening before evening meal but I've got this little voice in my head saying not to take it. Sue.
 
Sounds like you are doing all the right things well done My prescription for Metformin says to take with or just after a meal I find that taking it in the middle of a meal it is easier on the stomach .Also if you are prescribed regular Metformin and you have stomach problems ask for the Slow Release version right away it is much kinder but more expensive so the GP usually prescribe the regular first
Carol
 
Smorg14 said:
Last day of insulin this coming weds
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How much insulin are you taking at the moment? And have you gradually been reducing it? I’m just wondering if you’ll see a jump in your numbers if you stop it. I’m not detracting from your hard work in getting to grips with your situation, but I wonder if your team think you’d benefit from a 'bridging' medication to smooth you over the discontinuation of the insulin.
 
I'm T1 on a pump so using only fast acting insulin but I take 2 x Metformin tabs / day as well.
My figures are quite stable being in range some 60-70% of the time. It was my DSN and not my Dr who added the Metformin and I take them just before my B/fast. They don't seem to cause too much grief to my stomach just the occasional sick feeling but nothing that puts me off my food. I also find that once I've eaten those feeling disappear anyway.
Trying to remember why she started me on them I think it was to try and even my BG through the day but I have not tried stopping them to see how things are and she doesn't want me to either. My daily results are better but i still suffer a 6 point drop in my overnight BG's which I carb against nightly.
 
chaoticcar said:
Sounds like you are doing all the right things well done My prescription for Metformin says to take with or just after a meal I find that taking it in the middle of a meal it is easier on the stomach .Also if you are prescribed regular Metformin and you have stomach problems ask for the Slow Release version right away it is much kinder but more expensive so the GP usually prescribe the regular first
Carol
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Hi, thanks for the reply, yes I thought that would be the case with regards to the cheaper meds first. I do have a sensitive stomach anyway so I don't think I'll be using the first one for too long before I. Requesting the slow release version!
 
Robin said:
How much insulin are you taking at the moment? And have you gradually been reducing it? I’m just wondering if you’ll see a jump in your numbers if you stop it. I’m not detracting from your hard work in getting to grips with your situation, but I wonder if your team think you’d benefit from a 'bridging' medication to smooth you over the discontinuation of the insulin.
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Hi. Thanks for your reply. Since day 1 3 months ago I've been on humilin 3, 8 units in the and 6 in the evening, this has never changed. I've been told to stop taking the insulin weds eve and start 5 taking the metformin Thursday eve. 1 tablet a day, 500mg for 2 weeks, then 2 tabs a day for another 2 weeks rising to 4 a day and at that point I can stop doing the finger prick tests. Sue.
 
@Smorg14 - are you aware that Metformin does not directly affect your BG one way or the other, but rather assists the body to use the insulin which it still naturally produces, more efficiently?

Just wondering if anyone has checked (with a blood test which normally takes weeks to get the result for) how much insulin you are still naturally producing? It just seems a bit 'sudden' to stop all the insulin in one fell swoop - but that's just my own non medically trained observation.
 
It will be interesting to see how your body manages with a significant reduction in insulin like that. I could understand it if you were having lots of hypos but if you aren't and you are eating low carb already, then I suspect your levels may increase significantly even with the Metformin, which has a minimal impact on levels compared to a low carb eating plan anyway.
I wonder in fact whether you might not be Type 2 but possibly Type 1 if you are managing with low carb on a mixed insulin, especially when your HbA1c was as high as 112 at diagnosis.
 
@Smorg14 My Hba1c went down to normal on diet alone, so the 5 weeks I endured taking Metformin and Atorvastatin were not necessary.
 
trophywench said:
@Smorg14 - are you aware that Metformin does not directly affect your BG one way or the other, but rather assists the body to use the insulin which it still naturally produces, more efficiently?

Just wondering if anyone has checked (with a blood test which normally takes weeks to get the result for) how much insulin you are still naturally producing? It just seems a bit 'sudden' to stop all the insulin in one fell swoop - but that's just my own non medically trained observation.
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Hi, thank you for responding, the only blood test they've carried out recently was my 2nd Hba1c? I think during the very fast telephone appointment I had with my diabetic nurse she did mention that it assists the body to cope better with insulin. I've been on Insulin for 3 months. I've not had any hypos with the insulin, I think u was on a fairly low does? 8 units in the morning 6 at night which the nurse said is pretty much what they start the 'newbies' on. When starting g the metformin and stopping the humalin, I'm still doing the finger pricks, she has told me to expect slightly higher readings, up to 10 and to do a keytone test if 13 or above. My readings for the past 3 months have been between 4.8 to 7.8 with the occasional 8 something and one 9, but I believe this was down to stress readings as I nearly lost my job due to having a few cognitive issues , Brain fog, pre diagnosis and for a few weeks after. I personally don't know anyone with type 2 so it's hard to compare how I'm doing really. Sue.
 
Hi @Smorg14 I've been on 2 x 500mg metformin and not had any problems with it, I believe it's prone to "make you go", whilst I was bunged up, though normal service has been resumed now!
I take a tablet with either lunch or breakfast, and the other with my evening meal. I guess it's the luck of the draw whether your digestive system is ok with it or not. Hopefully it's uneventful.
Well done on your weight loss, you're doing so well,
Sarah
 
Hi Sarah, thanks for responding. Could I ask if you were on insulin first and then put on metformin? What are your readings like on metformin? Sue.
 
rebrascora said:
It will be interesting to see how your body manages with a significant reduction in insulin like that. I could understand it if you were having lots of hypos but if you aren't and you are eating low carb already, then I suspect your levels may increase significantly even with the Metformin, which has a minimal impact on levels compared to a low carb eating plan anyway.
I wonder in fact whether you might not be Type 2 but possibly Type 1 if you are managing with low carb on a mixed insulin, especially when your HbA1c was as high as 112 at diagnosis.
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Hi Barbara thank you for responding. I'm not sure if the Hba1c was a true reading in August. Normally I eat quite healthily, however from May to July when I moved house I was hammering g the takeaways, pizza, Indian, Chinese, Greg's for breakfast while working from home while the new house was upside down so I'm not suprised my reading I. August was 112! It's not the way I normally eat. It will be interesting to see what the levels are like at first. I'm very nervous incase they go to 13 or above, it's the ketone test that scares the heck out of me! Sue.
 
The ketone test itself is no problem. Do you have urine sticks or Blood ketone strips for your BG meter? I am actually rather impressed that your nurse gave you a means of testing for ketones as Type 2 diabetics don't normally have a problem with ketones so aren't given a means of testing for them. Ketones develop if you are not producing enough insulin and most Type 2s produce excess insulin because they have become insulin resistant. ie their body is less responsive to the insulin they produce, so they have to produce more insulin to do the same job.
Obviously it is a worry if you do develop ketones in any significant amount and you need to seek medical care if that happens but I had a reading of 27 one night and no ketones and certainly regular readings in the mid teens in the early days of diagnosis and didn't get ketones, so don't worry that it will happen if you get readings in the mid teens, just that there is a slight possibility that you might produce some.
I too had a rather bad diet pre-diagnosis so it was certainly easy to understand how I had developed Type 2 diabetes and my HbA1c was 112 but it subsequently turned out I was Type 1. I wonder if they had started me on insulin straight away, if it would have preserved more of my beta cells.

Anyway, just saying to keep an open mind about your diabetes type and be prepared to push for additional testing (C-peptide and GAD antibody tests) if your levels do start to skyrocket when you come off the insulin, despite a low carb diet with or without what is unaffectionately referred to as "Metfartin" 🙄
 
Smorg14 said:
Hi Sarah, thanks for responding. Could I ask if you were on insulin first and then put on metformin? What are your readings like on metformin? Sue.
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Hi Sue, I was only diagnosed just over a month ago and have never been on insulin.
I'm afraid I've not taken any blood sugar readings yet, I've booked in with the diabetes nurse next week so she can do the first one with me to make sure that I'm doing it right, but mostly because I'm a bit of a coward and don't like seeing the needle going into me, I'm hoping it's easier with her there.
My HbA1C was 80mmol/mol when I was diagnosed, fingers crossed I'll have got that down using diet and exercise when I have my three month diabetes review in the new year.
@rebrascora Metfartin :D. I will be using this as an excuse in the future.
 
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