Metformin & Type 1

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Hello wise ones!

Just wondering if any of you have first-hand experience of taking Metformin alongside Insulin?
I've just had a consultant review and he has prescribed Metformin (to be incrementally introduced) to help with the insulin resistance I'm experiencing.
As I have only been an official T1Der since May 2022, I think I'm past the 'honeymoon' phase and have been continuing to up my dose without it having much impact on my hba1c (65+, higher than when I was diagnosed :/).
I'm hoping that Metformin may help to reduce my resistance, but am a bit worried about it causing hypos whilst I get used to it.
I found this helpful blog which explains what may be encountered when taking both medications: https://beyondtype1.org/taking-metformin-type-1-diabetes/
Does anyone else with type 1 also use Metformin, and do you have any advice?
Thanks in advance 🙂
 
Hi. Can I ask... Are you needing large doses of insulin? I know that can be subjective and you need as much as you need but some people confuse insulin resistance with insulin taking a long time to work, but not actually needing large doses and I think this is two different things.

Also, the honeymoon period can last for many, many years in some people. I think @helli felt that hers went on for about 8 years. Mine seemed to last about 2 years but for me there were 3 quite distinct phases where my insulin needs increased over a period of a month or two and then levelled out for a few months and then started to increase again. Mine have now been fairly stable for the last 3 years give or take fluctuation for exercise and change of seasons, illness etc. so I am reasonably sure (but not certain) that my honeymoon period is over and I am coming up to my 5 year diaversary next week.

I would be very surprised if Metformin was to cause hypos. I was on it for about 4 months from starting insulin because they didn't know if I was Type 1 or Type 2 and I can't say that it made any difference when I stopped taking it, but I was taking Metformin first and then insulin added , so the insulin doses where increased gradually whilst I was on Metformin, so that probably doesn't help you, but gradually increasing the Metformin dose over a period of several weeks should allow you to adjust to any change with your insulin doses. Metformin doesn't have a huge impact though and it takes time to build up to an effective dose over a period of days if not weeks.

You can also improve your insulin sensitivity by exercise and losing weight if either of those things are applicable, so Metformin is not the only option to tackle insulin resistance if indeed that is what you have. Of course you are also at risk of hypos from those options too, if you don't also reduce your insulin doses as necessary, so I don't feel Metformin is any more likely to cause hypos than exercise and it isn't really the metformin or exercise which causes the hypos but injecting more insulin than your body needs, if that makes sense, so you have to watch your levels closely and be ready to adjust your doses as necessary.












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@Adup Diet can also help insulin resistance. That’s the premise of Cyrus Khambatta’s book and course (Mastering Diabetes) - what you eat affects your insulin sensitivity (and not just because you might put on weight).

What insulins are you taking and how much of each?
 
I do take Metformin with my insulin. My previous DN was keen for me to continue it as it has 'several other benefits'? I'm slim and don't have any noticeable IR. Metformin by itself won't normally cause hypos as it doesn't work on the pancreas.
 
I’ve taken metformin with insulin for 15 years, I wouldn’t expect loads of hypos but keep an eye on your bg as you would with any change in med
 
I gind low fat, high veg / fruit / carb helped increase my insulin ratios
 
I do not take Metformin but @rebrascora is correct, my insulin dose slowly increased over 8 years. I would be surprised if an adult found their honeymoon period was over in a year. It could just be another batch of insulin producing cells dying off.

With regards to insulin resistance and diet, do you eat a low carb diet? Some people with Type 1 chose a low carb diet to reduce their insulin dose. However, I have read that a low carb diet can increase insulin resistance
 
Thanks All,

I'm on Novorapid (up to 42 units per day) and Abasaglar (usually 20 units per day)​

I am peri-menopausal so there are some days when I don't need half that much. I eat a fairly consistant low carb diet and am not needing to lose any weight at the moment.​

The Dr also spoke about the extra benefits Metformin has for the heart, etc. Good to hear it won't bring on hypos as I think the fear of hypos I may be keeping my levels high anyway!

Thanks again 🙂​

 
How low is your low carb diet? As @helli said, very low carb diets can cause a form of insulin resistance. A higher carb very low fat diet can improve insulin sensitivity immensely. So much so that I’d suggest you introduce any changes gradually so you can adjust your doses as needed over time.

If you find your blood sugar varies by the day due to the erratic hormones of the perimenopause, you could investigate HRT if you’re not already on it. This can help calm the mad sugars.
 
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