New to Type 2 Diabetes…

[AnniePE]

Hi All…I have recently been told I am type 2 diabetic - all my Dr said was I have to go on Metformin immediately, 500mg working my way up to 2000mg a day - that was the sum total of the conversation plus he sent me some diet info via text! Having done some research I am petrified of taking the Metformin, so many people seem to have stomach issues and I am putting off starting it - any reassurance/tips would be gratefully received

 

[jagdriver52]

I'm on 2000mg metformin, no issues with it. Make sure to take it with food

 

[Drummer]

Some people can take it no problem.
Personally it was probably the worst five weeks of my life though I did get a professional level carpet cleaner out of the situation.
Happily, after throwing the tablets in the bin I found I can stay at normal glucose levels quite easily and my HbA1c is at the top end of normal.

 

[saffron15]

Hi All…I have recently been told I am type 2 diabetic - all my Dr said was I have to go on Metformin immediately, 500mg working my way up to 2000mg a day - that was the sum total of the conversation plus he sent me some diet info via text! Having done some research I am petrified of taking the Metformin, so many people seem to have stomach issues and I am putting off starting it - any reassurance/tips would be gratefully received

Welcome to the forum. I asked to be tested in June and my first reading was 69 having changed my eating the second reading was 64 and three weeks later I was started on metformin. The test is an hba1c which is an average of glucose over three months. I was bewildered and grieving. Some people have decided to deal with the condition by lifestyle changes including diet and exercise. A lot depends on what you think you can achieve and how high your reading is. 48 and over is diabetic. I was put on slow release metformin which is kinder to the stomach. I took it towards the end of a meal. The dose increased by one tablet each week til I was on four. For the first two weeks it bunged me up. On the second tablet it took me 8 days before I poohed but it became looser as the dose increased. However a few days later my dose was reduced to two tablets and I was put on an SGLT2.
I was overweight and realised my dietary changes had made me go low carb. I was eating 80 to 120 a day but the SGLT2 means I have increased my carbs. I go swimming and have a short walk after eating.
Write down what you eat then decide what to cut, what to reduce the portion size or substitute eg cauliflower rice for rice or edamame or lentil pasta. Reduce then cut out any added sugar. If low carb appeals the Freshwell site app is good.
There are lots of recipes and a learning ing zone on the diabetes UK site.
This site from the New Forest is informative including links to lots of other websites on the left handside. It does get easier!
My Internet connection went down and I see you have some replies

Diabetes & Metabolic Health | New Forest PCN

newforestpcn.co.uk

 

[rebrascora]

Hi and welcome.
Knowledge is power, so you really need more info about what your HbA1c result was, if you are considering not taking the medication. The HbA1c result is the blood test used to diagnose diabetes and track your diabetes management thereafter and will be a number above 47 if you have a formal diagnosis. How much over that threshold is important in deciding about whether medication might be required or if dietary measures alone may be enough. Personal motivation to make those dietary changes is also a key factor and something it is quite hard for a doctor to assess, so they often reach for the prescription pad and offer Metformin as a first line option.

Taking metformin with food is important and I took it mid meal with a substantial amount of low carb food to protect my digestive system and had very little in the way of digestive upset. It is important to start with a low dose and build it up over several weeks if you need it. My HbA1c was 114 at diagnosis, so it was important to start bringing it down promptly as levels that high put you at significant risk. If it had only been 50 or 60 dietary changes alone would have been a reasonable starting strategy, so knowing your HbA1c is key to making a decision about how you want to tackle your diabetes. I would also say that I had minor digestive upset which included some loose stools and some flatulence and occasional colic type pain which made me feel like I wanted to break wind but didn't feel confident that it was just wind, so would wait until I was able to go to the loo before letting rip, if you know what I mean! That said, I never had an accident even when I was out horse riding and got those colicky pains.
If you do have problems with the standard metformin, there is a slow release verion which is kinder on the digestive system, that you can ask your GP or nurse to swap you to. Also, if you do get bad side effects, you can of course stop taking them and the side effects will stop, so you have options. I took the regular Metformin for about 5 months and didn't have any serious issues with it, just those I have mentioned which were pretty manageable and certainly no "accidents".

You do however need to make dietary changes alongside any medication and those dietary changes can have a far more powerful effect than the medication itself, which is why many people here have been able to come off medication and achieve remission (ie lower their HbA1c below the diagnostic threshold). It doesn't work for everyone, but there is certainly a realistic prospect for many, so worth giving it a go in my view.

 

[Felinia]

Excellent advice above. I was switched to slow release Metformin as I had issues, but that was probably because I already had a bowel issue - Diverticular Disease. I'm fine on 1 SR Metformin a day plus supporting medication. I would just add that I got an app to help me keep my food diary and manage my carb intake. I use NutraCheck (UK based) but there are others.

 

[Captainmartin]

I used to take metformin, amongst others, and didn’t have any problems with it. You need to be gently weaned onto it to stop any side effects. If you are counting carbs the carbs&cal app is very good.

 

[Leadinglights]

You may want to have a look at this link as it has lots of good explanation and menu plans so you can see just what a varied and tasty diet you can have by adopting a low carbohydrate approach. https://lowcarbfreshwell.com/
As mentioned knowing what your HbA1C result is will help you assess if you could try this before taking the medication as if not too high then it could be possible if you are committed to making lifestyle changes.
The threshold for diagnosis is anything over 47mmol/mol so you can judge what yours is compared to that.

 

[silver minion]

I was prescribed slow release metformin at diagnosis. Fortunately my side effects of wind, loose stools etc were fairly mild and short lived. Only a couple of days after each dose increase. I always take them with food.
Others have not been so lucky and can't tolerate it at all. If your hbA1c is quite high and you need medication at the moment, there are alternatives you can try.

 

[pjgtech]

All good advice above. If your Dr has not told you your HbA1c, you might be able to see what it was if you use any of the NHS apps, I use Patient Access. If you log into the app it usually shows you any recent test results.
Sorry, should have also said welcome!
When you are first diagnosed it is a bit of a shock and can be a lot to take in, but as above, knowledge is power.
Many people can manage their diabetes effectivley with diet, and usual advice (for T2's) is to go low carb. That means ALL carbs, not just sugars, so potato, rice, pasta, baked goods, sweets, cake, etc, etc.
Be careful with fruit, as many think its ok, but for diabetics many fruits are high in sugar/carbs, so (EDIT: may) need to be avoided, eg: bananas, exotic fruits, etc. Same with veg, many veg are high in carbs, eg@ potato, parsnip, sweet potato, most below ground root veg, etc, so (EDIT: may be) best to stick to above ground green leafy veg, salads, etc.
Good news is you can lots of meat, fish, poultry, etc (assuming not a veggie/vegan!)
Check out the learning zone on here, and also check out the lowcarbfreshwell website and the sugarfreelondoner website for lots of good diabetes friendly recipes.
EDIT: As mentioned below we are all different and react to diabetes and foods/carbs differently....
Good luck with it all and let us know how you get on....

 

[AnniePE]

All good advice above. If your Dr has not told you your HbA1c, you might be able to see what it was if you use any of the NHS apps, I use Patient Access. If you log into the app it usually shows you any recent test results.
Sorry, should have also said welcome!
When you are first diagnosed it is a bit of a shock and can be a lot to take in, but as above, knowledge is power.
Many people can manage their diabetes effectivley with diet, and usual advice (for T2's) is to go low carb. That means ALL carbs, not just sugars, so potato, rice, pasta, baked goods, sweets, cake, etc, etc.
Be careful with fruit, as many think its ok, but for diabetics many fruits are high in sugar/carbs, so need to be avoided, eg: bananas, exotic fruits, etc. Same with veg, many veg are high in carbs, eg@ potato, parsnip, sweet potato, most below ground root veg, etc, so best to stick to above ground green leafy veg, salads, etc.
Good news is you can lots of meat, fish, poultry, etc (assuming not a veggie/vegan!)
Check out the learning zone on here, and also check out the lowcarbfreshwell website and the sugarfreelondoner website for lots of good diabetes friendly recipes.
Good luck with it all and let us know how you get on....

 

[helli]

Some great advice above but it is important to remember that we are all different and some lifestyles or other medical conditions can make it harder to make the changes that others have done.
And not all of us understand numbers in the same way,
I think it is important to make suggestions rather than "you really need ..." or "you must ..." or "doing .. is important".

These may sound like semantics but when people are newly diagnosed they may be more anxious and their personality and lifestyle mean these recommendation come across as orders and threats.
Those of us who have been on the forum for longer know these comments are not meant that way and we know that the forum members mean well with their suggestions.

I just ask you to take care with the language we use and remember the statement at the start of every page

everyone manages their health differently

 

[AnniePE]

Thank you all for the advice - my HbA1c reading was 55 - I asked if I could try diet and exercise for 3 months first (as I can be disciplined and do this) to see if this helped, if not I would start the Metformin but my Dr said categorically no, I have to start the drugs. So I am still undecided what to do, I'd rather try the no drugs route first before taking anything 😳

 

[murf]

Hi, my reading was 54,was put on Metformin 500 then 1000 a day wasnt given opportunity to change diet just straight on pills,had no issues with pills other than felt bit sick in mornings but soon passed, 3 months on now ive been on a low carb eating plan and lost 10kg had bloods done yesterday awaiting to see if levels gone down.

 

[Felinia]

Thank you all for the advice - my HbA1c reading was 55 - I asked if I could try diet and exercise for 3 months first (as I can be disciplined and do this) to see if this helped, if not I would start the Metformin but my Dr said categorically no, I have to start the drugs. So I am still undecided what to do, I'd rather try the no drugs route first before taking anything 😳

How disappointing for you, and sorry that your GP insisted on drugs. Did the GP give reasons why you must start the drugs, for example other medical conditions? Many GP's now do give people the opportunity to trial for 3 months. May I suggest you still trial 3 months lifestyle changes anyway, and hopefully get a really good result in 3 months time. Of course, the lifestyle changes are for life.

 

[Felinia]

Hi, my reading was 54,was put on Metformin 500 then 1000 a day wasnt given opportunity to change diet just straight on pills,had no issues with pills other than felt bit sick in mornings but soon passed, 3 months on now ive been on a low carb eating plan and lost 10kg had bloods done yesterday awaiting to see if levels gone down.

Well done, do let us know the results, and if you were able to stop taking the Metformin.

 

[Drummer]

Thank you all for the advice - my HbA1c reading was 55 - I asked if I could try diet and exercise for 3 months first (as I can be disciplined and do this) to see if this helped, if not I would start the Metformin but my Dr said categorically no, I have to start the drugs. So I am still undecided what to do, I'd rather try the no drugs route first before taking anything 😳

That is barely into diabetic numbers - I started off at 91, and was at 47 in a few months - I took the Metformin and Atorvastatin for about 5 weeks but have been at the top of normal numbers for many years. I was at 41 at 6 months from diagnosis.
Your GP has obviously got no idea how effective a low carb diet can be - but then, all the HCPs I meet seem astonished by my numbers these days.

 

[pjgtech]

Some great advice above but it is important to remember that we are all different and some lifestyles or other medical conditions can make it harder to make the changes that others have done.
And not all of us understand numbers in the same way,
I think it is important to make suggestions rather than "you really need ..." or "you must ..." or "doing .. is important".
I just ask you to take care with the language we use and remember the statement at the start of every page

Great advice, I have edited my original response to reflect this, must think more before I type!!!

 

[rebrascora]

Thank you all for the advice - my HbA1c reading was 55 - I asked if I could try diet and exercise for 3 months first (as I can be disciplined and do this) to see if this helped, if not I would start the Metformin but my Dr said categorically no, I have to start the drugs. So I am still undecided what to do, I'd rather try the no drugs route first before taking anything 😳

Your doctor should be working with you to create an action plan of how to tackle your health issues not dictating to you. Of course they can insist on prescribing you medication but they can't make you take it. It is up to you if you take it now or perhaps see how you go with lifestyle changes and you can always start taking the medication at a later stage if you are not seeing any progress.
If you decide not to take them, I wonder if doing some home finger prick testing might be a good option so that you can get an idea of whether your lifestyle changes are having the desired effect, rather than not taking the meds, going 3 months or whatever until your next test at the doctors and perhaps having to eat humble pie! Many people here on the forum find home testing an invaluable tool in enabling them to tailor their diet to their individual body's response to particular kinds of carbs by testing just before a meal and then 2 hours after to see how their body coped both in terms of helping you avoid the things which really increase your levels, but also finding foods which have minimal effect.

 

[JITR]

Hi All…I have recently been told I am type 2 diabetic - all my Dr said was I have to go on Metformin immediately, 500mg working my way up to 2000mg a day - [...] Having done some research I am petrified of taking the Metformin,

I was in the same situation just over two years ago, except my HbA1c was 104 not 55. The side effects of Metformin would have been incompatible with my lifestyle. So I looked for alternative both to taking the medication and putting up with T2D for the rest of my life. Fortunately the answer was on the kitchen bookshelf in Michael Mosley's '8 week blood sugar diet'. This introduced me to Professor Roy Taylor's work at Newcastle University, as he recounts in this talk.

I informed my GP that I intended to go on a real food version of the Newcastle Diet, which stops Metformin and other diabetes medication on day 1. Fortunately I was a 'responder'. My HbA1c was down to 39 three months later.

With HbA1c at 55 you would not have to go on such an extreme diet. For example Dr Kim Andrews simple meal planner and food lists or Dr David Unwin's diet sheet may provide all the guidance you need, not to mention the wealth of information here at Diabetes UK.

The World Health Organisation recommends doctors recommended all newly diagnosed T2Ds (without complications) to start with diet and exercise to reach an agreed target, and only presicribe medication when that fails.

Your GP/DN will have a good reason for prescribing Metformin and you should discuss that with them. Before that discussion it might make sense to prove you can make diet and exercise work by recording your FBG and weight coming down for a few weeks (as @rebrascora said).