Metformin query

Status
Not open for further replies.
S

Sharron1

Well-Known Member
Relationship to Diabetes
Type 2
Not sure if i should leave well alone. Had my review this week , nurse delighted with my Hba1c over the years and has moved my blood test to annual ones. I asked if that was ok why am i still on 4 met (2in the morning and 2 in the evening). She said the GP hadn't suggested any reduction and she didn't know why. While taking them doesn't bother me I am i interested in the thinking why no reduction. Not sure if I have the energy for this discussion with the surgery .Past efforts have shown me the surgery doesn't react too well to questions...
 
Interesting. My hba1c was 83, I was put on 2x500mg of Metformin, but 3 months later when it was 36 the GP said we could reduce that to 500mg. A few months ago I was told I could stop taking it if I wanted (Last hba1c was 39).

There doesn't seem to be any guidelines about when/how to take people off them. Not sure why I was only put on 1000mg, when people with lower hba1c than mine have been put on larger doses. Maybe it's up to the doctors on how they proceed?
 
I think the problem is that some GP's and nurses believe that Metformin has a much bigger impact on levels than it actually does and it is cheap, so from their perspective they would rather play it safe and keep a patient on it, especially if the patient is not having side effects from it. In their mind, the medication is fixing the diabetes..... mostly because they have no idea of the power of dietary changes although in your case @Sharron1 I really do believe that your one diabetic HbA1c, which I seem to remember was done by a private company and the result lost and then found and came back high was most likely erroneous and you may not ever have actually been diabetic.... That is just what I have gleaned from reading your posts over the years and I accept that I may not have picked up the story correctly and could well be wrong.
Not intended as any criticism of you by the way..... You can only go on the information and results you are given and no doubt you have put a lot of work into your diet which is probably a benefit to your long term health regardless of whether you are or were ever diabetic.
 
rebrascora said:
I think the problem is that some GP's and nurses believe that Metformin has a much bigger impact on levels than it actually does and it is cheap, so from their perspective they would rather play it safe and keep a patient on it, especially if the patient is not having side effects from it. In their mind, the medication is fixing the diabetes..... mostly because they have no idea of the power of dietary changes although in your case @Sharron1 I really do believe that your one diabetic HbA1c, which I seem to remember was done by a private company and the result lost and then found and came back high was most likely erroneous and you may not ever have actually been diabetic.... That is just what I have gleaned from reading your posts over the years and I accept that I may not have picked up the story correctly and could well be wrong.
Not intended as any criticism of you by the way..... You can only go on the information and results you are given and no doubt you have put a lot of work into your diet which is probably a benefit to your long term health regardless of whether you are or were ever diabetic.
Click to expand...
Hi,

You remember my story only too well. I tend to agree with you that the view of my GP is that Metformin is doing the heavy lifting wrt diabetes mangement. Hey ho...
 
I've read quite a few papers on the effects on Metformin and one said the reduction in BG had been overstated in the past and its findings were that its effects were lower than thought, and after a max dose of 2000mg there's no substantial improvement (I believe the effect doubles from 1000 to 2000 then stalls at 2500). It's still effective (And even 500mg can make a difference in non-overweight patients) but change of lifestyle is really what is required (As my GP friend said, 'your change of lifestyle has had far more effect than Metformin'). They found an average of around 1.1% or something in that region.
 
harbottle said:
I've read quite a few papers on the effects on Metformin and one said the reduction in BG had been overstated in the past and its findings were that its effects were lower than thought, and after a max dose of 2000mg there's no substantial improvement (I believe the effect doubles from 1000 to 2000 then stalls at 2500). It's still effective (And even 500mg can make a difference in non-overweight patients) but change of lifestyle is really what is required (As my GP friend said, 'your change of lifestyle has had far more effect than Metformin'). They found an average of around 1.1% or something in that region.
Click to expand...
That was my understanding. I think i must have read it somewhere on this site.
 
Sharron1 said:
Not sure if i should leave well alone. Had my review this week , nurse delighted with my Hba1c over the years and has moved my blood test to annual ones. I asked if that was ok why am i still on 4 met (2in the morning and 2 in the evening). She said the GP hadn't suggested any reduction and she didn't know why. While taking them doesn't bother me I am i interested in the thinking why no reduction. Not sure if I have the energy for this discussion with the surgery .Past efforts have shown me the surgery doesn't react too well to questions...
Click to expand...
If taking them doesn’t bother you, and your a1c with them is good, then why risk seeing what your bgs are like without them? If it’s not broke don’t fix it etc… If you had negative effects from them then it might be worth trying reducing them.
 
I agree. I am simply interested in why GP hasn't chosen to make any reduction. I am curious.
 
Yes, GPs have over-much faith in Metformin. It does help but often only by a little. GPs are therefore keen to keep you on it. My DN wanted me to stay on it as it does have some other benefits e.g. possible cancer risk reduction. It has very few downsides apart from the bowel issues which the SR version can fix for most.
 
harbottle said:
They found an average of around 1.1% or something in that region.
Click to expand...
Remember, that 1.1% refers to the drop in HbA1c when it's measured in US-style % terms. So eg from 7.5% to 6.4% = 58 mmol/mol to 46 mmol/mol.
 
Eddy Edson said:
Remember, that 1.1% refers to the drop in HbA1c when it's measured in US-style % terms. So eg from 7.5% to 6.4% = 58 mmol/mol to 46 mmol/mol.
Click to expand...
That's what I was wondering if it meant, so thank you for answering my unspoken question!
 
harbottle said:
I've read quite a few papers on the effects on Metformin and one said the reduction in BG had been overstated in the past and its findings were that its effects were lower than thought, and after a max dose of 2000mg there's no substantial improvement (I believe the effect doubles from 1000 to 2000 then stalls at 2500). It's still effective (And even 500mg can make a difference in non-overweight patients) but change of lifestyle is really what is required (As my GP friend said, 'your change of lifestyle has had far more effect than Metformin'). They found an average of around 1.1% or something in that region.
Click to expand...
In my case I was put on 500mg once a day when I was diagnosed and I cut my carbs down to the stage where it wasn't sensible to be taking it because I didn't have carbs for it to be doing anything to. I stopped taking them and then later when I second guessed myself and tried taking them again without changing my carb intake up at all - my bloods actually started showing higher bg levels on the metformin than when I was off the tablets. So I stopped again and stayed off them ever since. I tend to have a contrary body when it comes to meds for some reason it usually does the opposite to what is expected when I take them or wildly overreacts so I need tiny doses compared with other people so I try and avoid them wherever I can.
 
NotWorriedAtAll said:
In my case I was put on 500mg once a day when I was diagnosed and I cut my carbs down to the stage where it wasn't sensible to be taking it because I didn't have carbs for it to be doing anything to. I stopped taking them and then later when I second guessed myself and tried taking them again without changing my carb intake up at all - my bloods actually started showing higher bg levels on the metformin than when I was off the tablets. So I stopped again and stayed off them ever since. I tend to have a contrary body when it comes to meds for some reason it usually does the opposite to what is expected when I take them or wildly overreacts so I need tiny doses compared with other people so I try and avoid them wherever I can.
Click to expand...
Wow.
 
Metformin's main effect is to improve the fasting blood glucose level, and it seems to be quite good at lowering it, even on a small dose (Hence why I remained in 500mg even though the GP said I could stop.)

I have seen research that did show glucose release from the liver actually increased on Metformin when taken by non-diabetic individuals - probably because the lowering of the FBG level by the metformin (Which inhibits gluconeogensis, which is the mechanism by which glucose is created when fasting) caused the alpha cells to release glucogen to stimulate the release of glycogen from the stores.

So I wonder if a T2 with good control might see the same effect?
 
Hi , Metformin has been prescribed and have started taking the single 500 pill at breakfast.

However, not yet had the main symptom but my joints ache , feel tired , muscle problems and don't want to do anything meaningful.

I had my C19 booster 7 days prior to me starting the Metformin so I have no idea am I reacting to what drug.

I told the nurse I had my booster and was informed that it was OK to start the Metformin.

The nurse told me one pill in the morning for 7 days and then one pill in the evening ( both with food )

The prescription stated 1 pill for 21 days and if all OK go to two pills.

Prior to my C19 booster I was a fit 72 year old.

Any suggestion please ?
 
harbottle said:
Metformin's main effect is to improve the fasting blood glucose level, and it seems to be quite good at lowering it, even on a small dose (Hence why I remained in 500mg even though the GP said I could stop.)

I have seen research that did show glucose release from the liver actually increased on Metformin when taken by non-diabetic individuals - probably because the lowering of the FBG level by the metformin (Which inhibits gluconeogensis, which is the mechanism by which glucose is created when fasting) caused the alpha cells to release glucogen to stimulate the release of glycogen from the stores.

So I wonder if a T2 with good control might see the same effect?
Click to expand...
That makes a lot of sense. Especially when I did more exercise than usual too. A bit like the dawn phenomenon?
 
Were there thoughts of other positive benefits of Met too (cardio protective?)

Best to have a chat with your GP @Sharron1 and raise the question. That way you can get their advice on it and know it has been actively considered, not just possibly overlooked.
 
Hi,
Tbh will carry on as I have read there are other benfits to metformin, it doesn't cause any problems.I was really just curious i suspect I will continue with it for ages! Chat with my GP? Ha ha. Funny. Curiousity killed the cat.
 
Last edited:
I know we've discussed this before @Sharron1 as our levels are pretty similar, and I can't for the life of me think why my DN dropped me down to 1, and you are still on 4! The old postcode lottery rearing its head again I suppose! xx
 
Hi,

It is curious, as I said earlier I am not that bothered but would find it interesting to get an answer. But that ain't going to happen anytime soon. So I will live with it.
 
Status
Not open for further replies.
Back
Top