Metformin slow release. Puzzled

[SHORAN]

7/10/18

Hi there,

I haven't been on here in a while. Something has cropped up - I'd very much appreciate your advice / ideas.

I'm a T2 diabetic, diagnosed just over a year ago.

I'm on a LCHF diet. I was getting hypos early on when I took Gliclazide so I stopped that and stuck to 2 x 500mg Metformin daily. I always took my tablet in the morning but I often forgot in the evenings and in any case I often thought that my evening meals were so light in carbs I didn't really need my evenings dose of Metformin anyway ! ( on occasion when I had a Metformin in the eve after a salad / fish or meat supper by blood sugar level would go a little on the low side between 4 and 5... sometimes less )


Just under 3 weeks ago my doctor thought it was a good idea to put me on a double strength Metformin 1000mg to take one a day - a SLOW RELEASE version.The logic being presumably I get daily my "proper" levels of Metformin because I'd often forgot to take my old version ( 500mg ) in the eves .......

Now I'm finding my fasting levels are higher than normal usually between 8 -10 . Prior to the slow release Metformin it was usually in the 5.8 - 7.5 range

I did a test today, at 11.30 am and to my horror my fasting level was 8.8 !... I then had a coffee with full fat milk, some full fat yogurt with a few raspberries and nuts / seeds. I then took a 1000mg slow release Metformin. Two hours later and my blood glucose has gone up to a 10 !!.... I feel flipping hungry too !

I've lost about 1/8 the of a stone. That's a lot to me because I am on the skinny minnie lean side, I'm 5' 6" ( old weight before diabetes diagnosis was 9.25 stone, after diagnosis it went down to 8.5 stone ..... then quite quickly up until very recently I've been about 8.25 stone . Now I am between 8 to 8.25stone. It's odd - my appetite has lessened somewhat even though usually 2 hours after my breakfast I'm hungry.

I've been rubbish exercising daily ( depressed so keep procrastinating ) - done nothing recently so that may have complicated matters a little.... and I am stressed out at the moment with just " life" in general - worries about my son my ex etc bla bla bla. Mind you I'm usually stressed anyway !

So any ideas about what is going on here ?

Looking around online I saw this comment left by someone discussing Metformin.
"My previous doctor was adamant that the XR version was not as effective or "bio available" as the non-XR version. I'm not sure if he was right or not, I still use the non-XR version"
https://www.diabetesdaily.com/forum/type-2-diabetes/74182-metformin-vs-metformin-xr/


Another thing - I had an idea, is 'testerone therapy' worth thinking about if I could convince my doctor ? it's meant to - increase muscle mass, appetite, libido, lower blood sugars. What's not to like ?.....

Thanks in advance,

Shoran

 

[eggyg]

First thing I would say re testerone therapy, you may not like the beard! Re SR metformin, I take 2x 750 mg with my evening meal or whenever my largest meal is. The metformin doesn’t directly affect your BG results, it works by helping the insulin you have work better. So it may be just coincidence that your BG levels appear higher than usual. It can dull your appetite and therefore you will loose weight, can’t say that has happened to me! I see you did your fasting BG at 11am, was this on waking or had you been pottering about? If the latter, it could be the dreaded dawn phenomenon or foot on the floor syndrome. Try and take your fasting glucose if possible before you start your day, infact before you get up. Stress will definitely raise your readings, so I would give it a wee while before you do anything about it. 3 weeks isn’t long for a new/ amended medication. In the meantime, try snacking on nuts, cheese, boiled eggs, just to try and put a bit more weight on if that’s what you want. Good luck. Elaine.

 

[SHORAN]

Eggy,
Thank you for your input.

A beard ? - that wouldn't worry me !

'Foot on the floor syndrome' - I've not heard of that one before, my mistake - I did my fasting reading pretty much as soon as I woke up. About 90 mins later when It was 11.30am I then drank a coffee and ate my yogurt breakfast, took my Metformin slow release. Did my test again 2 hours after that and it had shot up to a 10.

If as you say the Metformin helps make the insulin more efficient... then theoretically it would bring down my sugar levels surely ? ( Gliclazide used to do that - too efficiently, I assume made me make too much insulin and therefore = hypos )

I thought Metformin increased the sensitivity of muscle cells to insulin. This enables these cells to remove sugar from the blood more effectively. ( is this "making insulin more effective"? ) It also reduces the amount of sugar produced by cells in the liver. ( I thought this was Metformin's main function ? ) then I believe Metformin also delays the absorption of sugar from the intestines into the bloodstream after eating so that there is less of a spike in blood sugar levels after meals.

Yes I definitely want to put on more weight. I plan to start light exercises again as of tomorrow and see how things go... I've a doctors appointment in 15 days time ! ( bit of a wait eh ?!)... I'll try hurry things up a bit and see if I can see my diabetes nurse before then - see what she says.

As I'm supposed to take 1 x 1000mg slow release Metformin daily - I assumed I should take that straight after my first meal of the day.... Is that right ?

Thanks,

Shoran.

 

[Deleted member 21371]

I'd never heard of "foot on the floor" syndrome.

But, I did decide that if my fasting level was so easy to influence, "dawn phenomenon, stress, getting up, cleaning your teeth, eating a few nuts in bed etc, did I really need to play all these tricks just to fool my body into a lower or higher reading?
Bear in mind the only real reading for most people consists of getting up, getting dressed, and either walking or driving to the doctors and sitting in a waiting room for an hour or so.

So I just take it occasionally now.
And test after food.
I also have my Hba1c checked.

I take a balanced view that if everything is normal, without striving simply for a number on a meter, and playing tricks on my body to achieve it, I'm still good.

As to the Metformin, I found any change at all to my regime could affect me for up to 4 weeks, so give it time.
As to when you take it, I believe it's an accumulative drug, so personally, when I did take it, it was usually in the evening.

 

[eggyg]

I was told to take mine with my evening meal, as @travellor says. Don’t know why, just do as I am told! Foot on the floor is just another name for dawn phenomenon, ie as soon as your feet touch the floor your BGs rise! Diabetes is not an exact science as we know, unfortunately.

 

[SHORAN]

Brilliant,

Thanks Eggy and Traveller.

I may see about switching to taking Metformin in the evening .... though to me for me I know I am more insulin resistant in the mornings. I need to speak to my diabetic nurse asap.

Maybe I do need to give it another week or so before fretting a bit !

Shoran

 

[mikeyB]

Blimey, you don’t want to take testosterone. Side effects include male pattern baldness, reduced testicular size, breast enlargement, aggression, increased risk of blood clots. Oh, plus nausea as well. And it can either increase or decrease libido.

What’s not to like? Sheesh

 

[SHORAN]

Mike.... if you put it like that... maybe not then !

Shoran