Hello

[GSB]

Decided to try here as struggling to get information from GP.

Was diagnosed with type 2 diabetes in December.

My blood glucose was 11.5

I was put on Metformin 500mg gradually up to 2000mg now.

I'm a wee bit terrified of this drug.and think it's a high dosage.

I immediately started trying to lose weight exercising much more and cutting down on carbs ( advice from doctor was stop eating bread and potatoes and that was basically it ) and started only eating between noon and 6 pm.

I've lost 8% of my body weight....22lbs in those 5 to 6 weeks and purchased one of those blood sugar monitors......my blood sugar has been 6.4, 6.6 and 7.0 the 3 times I've measured it.

Is this the drug that's helping most or changes I've made?

Not due back at Doc until April for another fasting test........but I'm a bit worried about taking this drug at what I consider to be a high dosage whilst blood sugar appears to be considerably better.

Doctors surgery not the most approachable place in the world but should I ask for another appointment or bide my time until April.

Apologies for long winded post but I've discovered it's so much more complicated than "stop eating bread and potatoes".

 

[Lucyr]

I was put on Metformin 500mg gradually up to 2000mg now.

I'm a wee bit terrified of this drug.and think it's a high dosage.

2000mg is the standard dose of metformin, the lower doses are just to reduce side effects as you build up. It doesn’t do much for blood sugars, think of it more as helping slightly. Any change in diet and exercise will make more difference. Metformin is very safe though, why are you terrified of it?

 

[GSB]

Just because I thought it lowered blood sugars and if I was doing that myself why am I taking a drug to lower them.

I've read it increases risk of certain cancers.

If it dosent lower blood sugars.......what's it for?

 

[Leadinglights]

Just because I thought it lowered blood sugars and if I was doing that myself why am I taking a drug to lower them.

I've read it increases risk of certain cancers.

If it dosent lower blood sugars.......what's it for?

Metformin only really works alongside dietary changes and depending on how high an Hba1C is and how committed people are to changing their diet many are given a chance for 3 months to make changes. The metformin is a helping hand as it helps your body use the insulin it produces more effectively to reduce blood glucose and also reduces the glucose the liver releases, so in that respect does lower blood glucose but it is not by acting directly on the carbs you eat.
It is thus important to reduce your intake of all carbohydrates as they convert to glucose so your GP was correct as potatoes and bread are high carb but also rice, pasta, cakes, biscuits, pastry, breakfast cereals etc etc.
It is good you have a monitor but strategic testing is more useful than random readings as blood glucose goes up and down throughout the day and night . Many find it useful to test their tolerance to the meals they have by testing before eating and after 2 hours when the aim would be for no more than a 2-3mmol/l increase or when levels come down no more than 8-8.5mmol/l 2 hrs post meal with before meals and fasting in the 4-7mmol/l range.
People can find that readings can be higher after a period of fasting as the liver releases glucose to give your energy and for your organs to function.
For good information and some recipes and menu ideas have a look at this link. https://lowcarbfreshwell.com/

 

[Lucyr]

Just because I thought it lowered blood sugars and if I was doing that myself why am I taking a drug to lower them.

I've read it increases risk of certain cancers.

If it dosent lower blood sugars.......what's it for?

It helps to reduce insulin resistance so that if you’re eating well and exercising your body has a slightly better chance of managing your glucose levels. But, metformin isn’t that strong as in you can’t just eat what you like and have good blood sugars just because you take metformin, it doesn’t do enough for that. It is also found to have some cardiac benefits.

 

[GSB]

Cheers, the confusing bit also for me is why do they test after not eating when they know the reading is going to be higher.

 

[PerSpinasAdAstra]

Metformin works in two proven ways to help lower blood glucose levels (and possibly a third, unproven way which to the best of my knowledge has only been demonstrated conclusively in mice).

Firstly it inhibits glucose production in the liver. In a healthy person the liver pumps out glucose when fasting, such as at night. In a typical Type 2 diabetic with an 'insulin resistant' liver this process runs out of control and the liver pumps out more glucose than it should. Metformin helps to control this problem, reducing your blood glucose levels a bit.

Secondly it reduces insulin resistance a little. I've read on this forum that this occurs in muscle tissue. In effect, Metformin helps circulating insulin work a little better, which also helps reduce blood glucose levels a little bit.

As to how effective it is, this small study indicates that a 2550mg dose of Metformin per day lowers fasting blood glucose levels by 25 to 30%. There are links to some other similar studies in the 'Discussion' section.

Mechanism by Which Metformin Reduces Glucose Production in Type 2 Diabetes - PMC

To examine the mechanism by which metformin lowers endogenous glucose production in type 2 diabetic patients, we studied seven type 2 diabetic subjects, with fasting hyperglycemia (15.5 ± 1.3 mmol/l), before and after 3 months of metformin ...

www.ncbi.nlm.nih.gov

It's likely that the improvement you're seeing in blood glucose levels is a combination of the medication, diet changes, and possibly even the weight loss to some extent. As to how much is due to the medication versus the diet changes; it's very difficult for anyone to say with certainty. What does seem certain is that if you're starting from a place where you had a lot of weight to lose and could increase your exercise significantly, then you're definitely on the right track to resolve the problems associated with insulin resistance which Metformin targets.

Congratulations on the diet changes, the weight loss and the blood glucose numbers by the way; it's a big achievement. With any luck you might soon be in remission territory and your doctor may be able to take you off the Metformin.

 

[Leadinglights]

Cheers, the confusing bit also for me is why do they test after not eating when they know the reading is going to be higher.

An HbA1C is an average over the previous 3 months so it does not matter whether it is fasting or not but sometimes they do because of the other tests that are being done. Result in mmol/mol.
If it is a finger prick then fasting is sometimes done to see what your level is after not eating. results in mmol/l
It is important to specify the units when giving numbers.

 

[everydayupsanddowns]

I've lost 8% of my body weight....22lbs in those 5 to 6 weeks and purchased one of those blood sugar monitors......my blood sugar has been 6.4, 6.6 and 7.0 the 3 times I've measured it.

Welcome to the forum @GSB

And huge congratulations on your weight loss, and the changes you have made.

Metformin is very unlikely to cause low blood glucose alongside the diet changes you have been making, so keep doing what you are doing.

Then after your review, when you see how you HbA1c has changed, you can review the situation with your GP or nurse, and get their advice on whether to keep taking the Met for a while longer.

Well done!