Metformin/feet

[Marcone]

Hey all,

Relatively new here, hba1c 51 (6.8) in November (after being prediabetic 42-46 for a few years), my GP put me straight on metformin (2x500mg per day, as apparently 'there's only so much diet and exercise can do') and nurse added 20mg statins. (I'm 49, 87kg, 6'1, no history of diabetes in my family).

Since then, and especially since Xmas, I've noticed vibrations in one and then both feet, tingling/pins and needles, pretty much constantly (apart from after exercise). I've never had these symptoms before and they've scared the living daylights out of me - I've read up about peripheral neuropathy but didn't think it would be so sudden and soon. And my question is, could it be the metformin causing this and has anyone else experienced these symptoms? Apologies if this is a recurring topic, but it's the first time I've faced it 😱

(a footnote, a new GP just contacted me to say the first one may have been too hasty and to reduce metformin dosage immediately and to come off the statins until 3 month blood test)

Thank you!

 

[childofthesea43]

To say that there’s only so much diet and exercise can do greatly understates what the science of T2D has clearly established, which is that reducing weight significantly reduces A1c significantly in the majority of cases. Have you tried this? Your BMI is 25.3 and I would expect that if you spent 3 months bringing it down to 22 then your A1c would normalise and other benefits would then follow. See my own signature as an example.

 

[rebrascora]

Following a low carb way of eating is also more powerful than most diabetes medication for many people and there are cases of Type 2 diabetics who have been on insulin quite long term, coming off it and all other meds by following a low carb way of eating, so I agree with @childofthesea43 that your doctor has no understanding of the power of dietary changes and probably more faith in medication than they perhaps should have. Dietary changes are probably the key to managing Type 2 diabetes well, either through weight loss and maintaining that loss or changing the way you eat for life to low carb. Both are known to be very effective. Add in daily exercise and it increases the effectiveness further.

 

[harbottle]

Well 1000mg of Metformin has very little effect on hba1c. Diet and exercise are far more effective.

It got my hba1c from 83 to 36 in 3 months, so Metformin was halved to 500mg and it didn't make difference as hba1c remained in the 30s and my last one was 36.

I'm not sure about the tingling. Shortly after diagnosis I went low carb and did get some weird itching on my legs for a while, but it went away after some months.

Sounds like your new GP is a bit more in tune with current ideas on how to treat T2 diabetes.

 

[Deb_l]

I have weird feet! Nothing ever formally diagnosed because my GP totally dismissed my symptoms but I get occasional pins and needles but more often than not, I get a burning sensation in my feet despite my feet feeling cold to touch.

I have found compression socks have helped me a lot and funnily enough, as I’m sat here browsing the forum, I was just thinking I need to go and get my socks! My feet have got overly cold today which I’ve found doesn’t help.

 

[trophywench]

Hi @Marcone - so, what did either GP actually tell you about diet then? (er, and have you done that considering its just past Xmas)

 

[Marcone]

Wow, thank you so much for all your responses. To be honest, nobody has had much time for me (the first clinician told me, verbatim 'you must stop eating sugar' and left me to understand what that actually meant) - and it pains me to say this, but whenever I call my GP I feel like a bit of a burden, all my communication has been on the phone, apart from a 20 minute face to face chat with the nurse (when I was given a fact sheet). However, the second GP certainly seemed more confident in my ability to work through this alone and I feel like I might stick with him in future.

My diet has been fairly healthy and I'm taking steps to improve it more, I've limited the intake of refined carbs, eat lots of veg, green/dark foliage, white meat/fish and pulses, the odd egg - and only really drink water and herbal teas, however, portion control HAS been an issue historically (as has eating late), combined with a desk/home job and a sedentary existence (apart from walking and yoga once a week), I don't really do anything to get my heart pumping, so I've started running and swimming more regularly.

My fear is still this foot thing though. It's the first real symptom I've had and it's fairly consistently there - sometimes less so, sometimes more so. I'm going to stop the metformin at this point and see if it makes any difference whatsoever.

 

[childofthesea43]

Do bear in mind that the key to getting T2D into, or approaching, remission is achieving substantial weight loss. “Healthy diets”, low-carb regimens and so forth will not sort out the problem at a fundamental level in themselves UNLESS they achieve concomitant serious weight reduction. This has been stressed over and over again by leading scientists and GPs in the field such as Prof Taylor and Dr Unwin. It’s not good enough to reduce A1C transiently (although that’s a good thing) while taking one’s eye off the ball regarding weight loss. Look at the trials and you will see how much the probability of remission depends upon weight loss, it is a dramatic dependence.

 

[Bloden]

I used to wake up with pins and needles in my fingers and arms (not my feet) when I was taking statins. (Not everyone gets side effects from statins, but I do). Maybe it’s the statins, not the Metformin. Just a thought.

 

[AndBreathe]

@Marcone - relating to your feet; do you know what your Vitamin B12 levels are like?

Metformin can impact B12, so levels should be tested fairly regularly. They rarely are in reality.

Whilst lower B12 associated with Metformin is usually associated with longer term use, but it would be good to rule it out - just in case you are either very sensitive to it, or you have been running a bit low for a while and just dipped a bit lower still.

It is tested by a simple blood test.

 

[Leadinglights]

Wow, thank you so much for all your responses. To be honest, nobody has had much time for me (the first clinician told me, verbatim 'you must stop eating sugar' and left me to understand what that actually meant) - and it pains me to say this, but whenever I call my GP I feel like a bit of a burden, all my communication has been on the phone, apart from a 20 minute face to face chat with the nurse (when I was given a fact sheet). However, the second GP certainly seemed more confident in my ability to work through this alone and I feel like I might stick with him in future.

My diet has been fairly healthy and I'm taking steps to improve it more, I've limited the intake of refined carbs, eat lots of veg, green/dark foliage, white meat/fish and pulses, the odd egg - and only really drink water and herbal teas, however, portion control HAS been an issue historically (as has eating late), combined with a desk/home job and a sedentary existence (apart from walking and yoga once a week), I don't really do anything to get my heart pumping, so I've started running and swimming more regularly.

My fear is still this foot thing though. It's the first real symptom I've had and it's fairly consistently there - sometimes less so, sometimes more so. I'm going to stop the metformin at this point and see if it makes any difference whatsoever.

You may benefit from keeping a food diary with everything you eat and drink with an estimate of the carbohydrates you are having as it really is easy to underestimate how much you actually are having.
Following a low carb regime it should be possible to reduce your blood glucose without metformin from a starting point of only 51.
As you perhaps don't appreciate it is not just 'sugar' that is the problem but all carbohydrates which convert to glucose. People often think they have a healthy diet but it can be too carb heavy if Type 2 diabetic. Low carb is suggested as being no more than 130g per day so you could see how close you are to that from your diary. When you consider that a sandwich can easily be 40g g carb or more and 2 small boiled potatoes the size of an egg about 10g carb or a jacket potato of a size often served in a cafe about 75g carbs, it can soon mount up.
Having meals based on any meat, fish, eggs, cheese, dairy, veg and salads, fruits like berries with very small portions of any oft those high carb foods like rice, pasta, bread, breakfast cereals and starch veg.
Have a look at this link for some ideas for low carb meals and a way forward.

Freshwell Low Carb Project - Home

lowcarbfreshwell.com

Getting blood glucose down should help your feet, but if they continue to give you trouble then do ask for a foot check from your surgery.

 

[childofthesea43]

But whatever the tactics, ensure they result in weight loss.