Metformin reduction - time to see an effect

[Lucyr]

I only am circumspect about the lows due to the DVLA'S 5 to Drive doctrine.

There is no 5 to drive rule that’s just a rhyme

People on tablets or non insulin injections don’t sign any diabetes related driving agreements but should be generally sensible and not drive if they feel unwell.

People on insulin sign to say they won’t drive if bg has been under 4 in the past 45 minutes, and if under 5 they’ll have a snack but they don’t agree to waiting until it’s over 5 after that snack so long as haven’t been hypo.

As you’re only on metformin you don’t need to test or snack or do anything before you drive you can just drive regardless of bg. If you feel too unwell to drive safely then don’t drive.

 

[Lucyr]

Either I’ve missed something or you take more than just metformin for your diabetes @MarkStAlbans - regarding you uploading that leaflet. What point are you trying to make?

 

[everydayupsanddowns]

Further update Im down to 500mg daily of metformin with numbers staying as they were at 2g. My stomach is back to normal now 🙂

Good to hear your BG levels have stayed consistent while you have reduced your Metformin doses.

I understand your concerns about the DVLA guidance, which occasionally seems to say slightly different things in different leaflets (in between leaflets aimed at the public, and those for doctors and HCPs).

However the consistent things are that while 5 to drive is a handy mnemonic (and is more of a buffer than being in the 4s and gobbling a snack). The guidance allows people on insulin to start a drive in the 4s if they take a snack as long as they don’t go below 4.0.

And people treated with Metformin-only are not required to check there BG levels around driving.

 

[helli]

@MarkStAlbans your attachment says
“ Car and motorcycle drivers do not need to tell us if their diabetes is treated by tablets, diet, or both and they are free of the complications listed over the page.”
And
“ If your diabetes is treated by tablets carrying hypoglycaemia risk (for example Gliclazide, Glimepiride, Repaglinide or Nateglinide) you should monitor your blood glucose levels at times relevant to driving.…”

Metformin is not “a tablet carrying hypoglycaemia risk”. Therefore you do not need to test your BG to drive.

 

[MarcR]

Guys,

Ive just reduced my MF by half from 2g to 1g a day as my numbers were lowering well, seeing lots of 4.5s and high 3s.

Any views on how long before I see a change?

I found coming off Metformin my fasting BG has gone up a bit, but nearer to the middle of the normal range, rather than the lower end. I think if your going below 4, the Metformin might be making BG go too low.

 

[Martin.A]

And people treated with Metformin-only are not required to check there BG levels around driving.

Nor tell the DVLA, as per this from DUK's own webpage about Diabetes & Driving:-

Other diabetes medication​

Do I need to tell the DVLA?	No
What are the rules about severe hypos when I’m not driving?	You're not at risk of severe hypos
Do I need to check my blood sugars?	No

 

[MarcR]

Nor tell the DVLA, as per this from DUK's own webpage about Diabetes & Driving:-

Other diabetes medication​

Do I need to tell the DVLA?	No
What are the rules about severe hypos when I’m not driving?	You're not at risk of severe hypos
Do I need to check my blood sugars?	No

Unless your driving a bus or hgv, in which case you just inform them.

 

[Martin.A]

Unless your driving a bus or hgv, in which case you just inform them.

Yes - I should have made it clear that it referred to Cars and Motorcycles, which is what the thread has been discussing.

 

[Martin.A]

However the consistent things are that while 5 to drive is a handy mnemonic

Without wishing to prolong the debate, below is a screenshot from the DUK webpage on Diabetes and Driving.

5 to drive?

 

[Lucyr]

Without wishing to prolong the debate, below is a screenshot from the DUK webpage on Diabetes and Driving.

5 to drive?

View attachment 36449

That is exactly the same as the guidance we’ve already shared but just less detailed. If you’re 5 then you’re ok to drive. If you’re in the 4s snack then drive, if you’re under 4 then fix it, wait 45 minutes, then drive

 

[Martin.A]

That is exactly the same as the guidance we’ve already shared but just less detailed. If you’re 5 then you’re ok to drive. If you’re in the 4s snack then drive, if you’re under 4 then fix it, wait 45 minutes, then drive

I know all that. I was only wondering whether this might be where the '5 to drive' mantra had originated.

 

[Lucyr]

I know all that. I was only wondering whether this might be where the '5 to drive' mantra had originated.

It’s just originated in the fact it rhymes and that people don’t seem to read what they’re signing up to agree to when they get their restricted driving licence