Metformin or not

[Vonny]

Hi, something @Drummer posted about metformin on another thread has set me thinking. I don't want to hijack that thread so am posting this separately.
I was v reluctant to start metformin, and asked the doctor if I could go it alone with diet and exercise and was told, basically, no. I know my BS was high, ie 10 with an hba1c of 76, and I also knew I had about 3.5 - 4 stones to lose.
With Metformin, diet and exercise, I'm now hba1c 54, BS is between 5.7 and 6.7 on a usual day, and I've lost 18lb. Still got 2.5 stones to go.
Would people recommend I try coming off metformin now to see if I can maintain my steady BS, or should I stay on it until I've reached my target weight when I'll potentially have more chance or reversing it?
I know no one can give me a definitive answer, and I know every person's experience is different, but I'd be really interested to hear other people's thoughts on this. Many thanks x

 

[Tim Aylesbury]

Hi Vonny, my suggestion would be to discuss this with Diabetes Specialist Nurse or GP, before stopping your medication, they may start by reducing the dose, until eventually you can come off the medication and they declare that you Diabetes is in remission. I am looking to do something similar at the moment.

 

[Becka]

Why were you reluctant to start Metformin? Have you been suffering ill effects because of it?

I believe a full Metformin dose normally reduces HbA1c levels by around 1.5% points, which was the old way of measuring it. 54 mmol/mol is 7.1%, so an increase of 1.5% points is 70.5 mmol/mol. If you are on a lower dosage the effect will not be that great, but it is just a general illustration of the benefit you gain from Metformin.

The purpose of medication is to help reduce your levels to prevent them from doing damage. Stopping now will at best limit the reduction you will see your next HbA1c test, and quite possible see it rise a little. That is because your continued efforts to get your them under control will be going to making up for the what the Metformin did rather than continuing to add to the decrease.

So unless you are experiencing side effects I would say not to think about stopping medication until you are at your target weight and your levels are good. But you need to discuss with your doctor why you do not want to take the medication and why they think you should, that way you can both understand the situation to decide what is best for you circumstances. Something none of us know to be able to offer any sort of meaningful advice.

And you especially should talk to you doctor if Metformin is causing you side effects.

 

[Vonny]

Why were you reluctant to start Metformin? Have you been suffering ill effects because of it?

I believe a full Metformin dose normally reduces HbA1c levels by around 1.5% points, which was the old way of measuring it. 54 mmol/mol is 7.1%, so an increase of 1.5% points is 70.5 mmol/mol. If you are on a lower dosage the effect will not be that great, but it is just a general illustration of the benefit you gain from Metformin.

The purpose of medication is to help reduce your levels to prevent them from doing damage. Stopping now will at best limit the reduction you will see your next HbA1c test, and quite possible see it rise a little. That is because your continued efforts to get your them under control will be going to making up for the what the Metformin did rather than continuing to add to the decrease.

So unless you are experiencing side effects I would say not to think about stopping medication until you are at your target weight and your levels are good. But you need to discuss with your doctor why you do not want to take the medication and why they think you should, that way you can both understand the situation to decide what is best for you circumstances. Something none of us know to be able to offer any sort of meaningful advice.

And you especially should talk to you doctor if Metformin is causing you side effects.

Thanks Becka. I've had no side effects from Metformin, I just prefer to not take medication if I can fix the problem some other way! Many thanks for your reply, it has put my dislike of medication into perspective. It's still early days, so I'll continue with the metformin and plod on with the diet and exercise 🙂 x

 

[DaveB]

Hi. Metformin is one of the very safe drugs and has some other benefits of which the mechanism is not really understood. If you have kidney disease you may need to be concerned but as long as your kidney tests are OK there is no need to stop the Metformin

 

[trophywench]

Thanks Becka. I've had no side effects from Metformin, I just prefer to not take medication if I can fix the problem some other way! Many thanks for your reply, it has put my dislike of medication into perspective. It's still early days, so I'll continue with the metformin and plod on with the diet and exercise 🙂 x

Well I also think stopping or reducing it right now would most likely be counter productive - so I agree with your continuing at the moment and plodding on with diet and exercise - the latter will of course become gradually easier as you reduce your weight - and this is for life, not a short term thing.

 

[Ljc]

Hi. Decades ago Metformin was originally designed as a medication to aid weight loss , then it was found to be beneficial for folks with T2 , it also helps reduce insulin resistance which many people with T2 and some with T1 have. TBH as you have no side effect from it then think about staying on it till your BG levels come down a bit more, then discuss with your nurse/ Gp about reducing it.
As you lose weight your BG levels should reduce even more as your body should become more sensitive to your own insulin. .

 

[Becka]

Good luck, Vonny, you are doing the right things so hopefully soon you will be in a position where you no longer need medication.