Metformin

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Lizzie

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I am a type 1 and my doctor wants to put me on metformin, because they think I am too fat. I have read that you cannot have hypos on metformin - how does this work? As I understand it, metformin increases insulin sensitivity so at least at first until I worked out my new lower sensitivity I would have thought I would have more hypos since the drug would make me more sensitive. And would this apply to me as a type 1 or is that just type 2s? Would I stop having hypos which are caused by other things?

I would also like to know what to expect. Several people have told me they have had horrible side effects from it. Is this common?

Sorry if these are stupid questions.
 
The only stupid question is the one you don't ask.

Metformin is associated with far fewer hypoglycaemic episodes than other oral hypoglycaemia agents (blood glucose lowering tablets). But if you're on insulin, then you'll still need to take normal precautions to avoid hypoglycaemia. The most common side effects of metformin are gastro-intestinal upsets / excess wind - these effects usually subside over a few weeks, but if they remain a problem, then enteric coated tablets may help - they are far more expensive, which is why they are not prescribed initially.
You mention being too fat - I'm not asking for details, but as you know, the other issues in weight management are food intake and energy expenditure / exercise / activity - so have you and your GP also considered ways of increasing your activity levels? Eg, some areas have exercise on prescription schemes, and Health Walks schemes are available all over the UK - see http://www.whi.org.uk/ for walks in England. I have posted websites for Scotland, Wales and Northern Ireland before, so won't repeat.
 
metformin doesn't stimulate the pancreas to produce more insulin so doesn't cause hypos.
It won't protect you from hypos from the insulin you inject. you should hopefully see your insulin doses go down as you are more sensitive to the insulin you inject, so yes you will need to watch out for lower blood sugars until you have adjusted.

the main side effects tend to be gastro ones, there are a few posts here about it. If the regular metformin doesn't suit you there is a modified release one that is sometimes better for people.
 
Lizzie said:
I have read that you cannot have hypos on metformin - how does this work?
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Hear this one a lot and its flat-out wrong. Metformin does not CAUSE hypos. Its perfectly possible to go hypo while on met, particularly if you are on something else as well. Having a true hypo (under 2) is rare on metformin only. However I have recorded a 2.6 in the last 6 months.

T1s who are overweight run the risk of what is termed double diabetes. This is where you develop insulin resistance which the metformin combats.

However in combination with injected insulin you will just have to watch your ratios. If there is insulin resistance at the moment and metformin helps to deal with it, then you'll find your ratios change. But bear in mind that it takes 3 weeks for met to become fully effective. This is because it takes that long to reach an adequate background level.

Regarding the weight - hows your thyroid results? I know people who have developed double diabetes as a result of untreated hyperthyroidism.

Also a reduction in carbs on its own can result in weight loss.

Lizzie said:
I would also like to know what to expect. Several people have told me they have had horrible side effects from it. Is this common?
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Its very common in people who eat a lot of carbs. One of the actions of metformin is to block the absorbtion of carbs in the gut. This effectively means that they drop out of the other end ;) The more carbs you are eating when you start to take met, the more chance you have of having side effects.

But moderate your carb intake and you will have less problems - which gives you less margin for error in your bolus calculations as well of course.
 
I take the slow release metformin and have less side effects with that. Normal metformin and my body hate eachother..lol I could take 1350mg ok but anything over that and my days would be spent in the bathroom so to speak.. some people are fine on it.
 
can i ask a really stupid question?!

what is this metaformin drug?

what does it do if both T1 and T2 can take it?

xxx
 
hellbell84 said:
can i ask a really stupid question?!

what is this metaformin drug?

what does it do if both T1 and T2 can take it?

xxx
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It makes your insulin receptors more sensitive to either the insulin in your body, or the insulin you inject.
 
It does nothing for T1s if there is no insulin resistance - usually because of being particularly overweight. Causes for T1s going badly overweight are usually thyroid related or simply using premix insulin rather than a proper basal/bolus regime
 
HI Lizzie
I am type 2. first of all I have had a number of hypos whilst on metfomin, the side effects I had, although are different for others, were feeling sick for a few days and they do make more wind down south if yoou know what i mean fa*%^ng. The best person to talk to is your diabetic doctor or nurse

Good luck
Dean
 
Metformin does have something of a bad press on this site. The first few days on regular Metformin made me feel odd too but I only went nauseous on a 1500 dose or more - after which my nurse put me onto the slow release kind, and since then I've had no problems at all with them (I take 3 each evening with food).

Personally I don't think you should stop taking the tablets because I was told that they are the best treatment for diabetes. Only one dose can't really give you much of an experience of them good or bad can it ? However, only you know how you feel, of course, and perhaps if you really feel odd you could have a quick word with your surgery. Advice from us is only that - "advice" based on our personal experience.

I hope you get something sorted soon - report back to us please ?
 
Thanks. I did feel a bit nauseous earlier but I managed some lunch and now I feel a bit better. I ended up deleting my earlier post since I felt a bit better in case anyone is wondering what Vince13 is replying to! I was low all morning so maybe thats why I was feeling bad although I don't usually feel like that with low blood sugars.
 
Lizzie said:
. I ended up deleting my earlier post since I felt a bit better in case anyone is wondering what Vince13 is replying to! .............
It's OK Lizzie - I'm used to talking to myself having been married a good many years ! Do hope you're feeling better now anyway - all best wishes,
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This might seem like an odd question Faith, but what is metformin supposed to do for LADA?
 
Now I'm only going by what the surgery and consultant say 'cos I'm very new to all this but I'm told that the mixture of Metformin (1500) and Gliclazide (2x80) per day are "milking" my natural insulin (i.e. using it to its full potential) to the point when it all packs up and then I'll be on insulin - the consultant intimated that I am "honeymooning" now rather than doing it by being put on insulin and the body putting in its own natural insulin until it's whacked which I think is the normal way of happenings. Anyway the levels have come down from 12-18 fasting to between 5.5-6.4 so something is going right just at present.
 
Well thats an odd approach.

Firstly metformin would only help if there were insulin resistance so I still don't see much logic behind that. LADA doesnt usually involve IR. The blocking of carb absorbtion might be a factor I suppose but it would surprise me if that were the reason.

Glic will force your beta cells to produce, so probably accelerating their death and hastening the end of your honeymoon period. There is a body of opinion that putting people on insulin gives the pancreas a bit of a rest in that it does not need to produce quite so much and extends the life of the betas. Interesting that this seems to be a deliberate attempt to kill off whats left of your betas.

I suppose the plus side is that if the honeymoon period is over quickly then the transition is over quicker. Just unusual to hear about docs deliberately killing off whats left of your pancreas!
 
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