Metformin Type 1 help!!

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Trowell235

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Type 1
Hello all!
I’m Olivia, 26 and have been a Type 1 for 17 years! I’ve been on an insulin pump for 10+ years and using a freestyle Libre 2 which has been so amazing!! At my most recent hospital pump review I was told to start taking metformin to increase insulin sensitivity but I’m very reluctant to start it as my latest HBA1C was 40!! This was my first visit to this hospital and diabetes consultant due to moving in covid and the whole appointment only took 10 mins without looking at any of my pump readings so i feel very overlooked Are there any Type 1’s on metformin who can offer any help/advice??!!
 
Hi and welcome

Are you using large amounts of insulin which would suggest insulin resistance as that would be the main reason for prescribing Metformin so that you needed less.

There has been the odd Type 1 member who has had Metformin prescribed along side insulin but I can't think of any regular members who take both.
I was initially misdiagnosed Type 2 and started on Metformin and Gliclazide. Then the Glic was stopped and insulin started but I continued on Metformin with the insulin for several months before it was removed. It is hard to say whether it made any difference because I was very much in my honeymoon period and needing relatively small doses of insulin anyway.

Congrats on your fab HbA1c by the way!
 
rebrascora said:
Hi and welcome

Are you using large amounts of insulin which would suggest insulin resistance as that would be the main reason for prescribing Metformin so that you needed less.

There has been the odd Type 1 member who has had Metformin prescribed along side insulin but I can't think of any regular members who take both.
I was initially misdiagnosed Type 2 and started on Metformin and Gliclazide. Then the Glic was stopped and insulin started but I continued on Metformin with the insulin for several months before it was removed. It is hard to say whether it made any difference because I was very much in my honeymoon period and needing relatively small doses of insulin anyway.

Congrats on your fab HbA1c by the way!
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Hey! I’m averaging on about 30units of bolus during the day with a carb ratio 1/8g and 32 basal during the night! I’ve more or less been on this insulin amount for years & my HBA1C is the best it’s ever been so couldn’t understand as to why I’d now been an used for start on metformin!
 
Bruce Stephens said:
I'm still taking both, because they suspect some insulin resistance.
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Well, wadda ya know!

I think what isn't really explained is that we all experience an element of insulin resistance. I suppose it is the extent of it which indicates whether Metformin might be helpful. I guess with pumping and insulin going into the same site for a few days, it might be more relevant to address it earlier with a view to preserving the integrity of injection sites.
 
Trowell235 said:
Hey! I’m averaging on about 30units of bolus during the day with a carb ratio 1/8g and 32 basal during the night! I’ve more or less been on this insulin amount for years & my HBA1C is the best it’s ever been so couldn’t understand as to why I’d now been an used for start on metformin!
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Interesting that you say 32 units of basal during the night.... Do you inject basal insulin separate of your pump?
 
rebrascora said:
I think what isn't really explained is that we all experience an element of insulin resistance. I suppose it is the extent of it which indicates whether Metformin might be helpful.
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I think so. I suspect if I weren't already taking it they wouldn't now suggest it: what I'm using doesn't seem that different to what other people report. [edit: which makes no sense, since this is while I'm taking metformin. I still suspect it's not doing that much for me, but I have no evidence.]

It was prescribed before I did the local not-DAFNE course and may have been while my control wasn't that great because (as it turned out) I had a brain tumour. (I say may have been because I don't remember the precise history. It was prescribed by my GP who's good with diabetes but is a GP). The DSNs didn't look shocked at the prescription.
rebrascora said:
I guess with pumping and insulin going into the same site for a few days, it might be more relevant to address it earlier with a view to preserving the integrity of injection sites.
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That may well be true but I'm still MDI.
 
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rebrascora said:
Interesting that you say 32 units of basal during the night.... Do you inject basal insulin separate of your pump?
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Hahaha no just very used to talking about nighttime basal rates since I sometimes come off my pump and back into injections when going on beach holidays etc! X
 
Interesting to hear your thoughts! I think I’m just finding it overwhelming to possibly having another thing to add to the prescription list and remember to do everyday for god knows how long! :(
 
Ah! I thought it might be a slip of the mind but people have all different ways of managing diabetes with or without a pump so it is best not to assume anything.

I think all you can do is try it and see what happens. I found Metformin had very minimal impact if any, which may be because I wasn't experiencing significant insulin resistance.
 
The thing about Metformin is that if you forget a dose one day, it is no big deal. It builds up slowly in the body over 2 weeks to have any impact, so any one dose doesn't really do anything to your BG levels, if that makes sense. It has a cumulative effect over weeks rather than hours or days.
 
Important to take it with food if you decide to give it a go to minimize the risk of digestive upset. I used to take it mid meal with a significant amount of food to protect my stomach. ie not just with a biscuit or something.
 
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