Newly diagnosed...Metformin...Advice please...???

[ANuvva]

Hi All,

Need a little help / advice regarding Metformin. I was diagnosed Type 2, about 18 months ago, and have been trying to control glucose levels & cholesterol on increased exercise and diet alone.

This worked for a while up to around Sep 2010. After a difficult winter, a recent review & blood tests indicate HBA1C gone back up to 6.6 and cholesterol that was lowered to within acceptable range now also up.

Taking Simvastatin 20mg daily, and last week was prescribed Metformin - 500mg twice daily.

It is a massive step for me - as I am sure it is for every one on the forum - to go through the door of having to take tablets everyday for life.

I fully understand the long term consequences of poorly controlled glucose levels so I am not burying my head. On a practical level, my lifestyle over the last 25 years has featured regular modest consumption of alcohol.

Firstly, I never drink during the day or go to the pub to drink for the sake of a drink. However probably on 4 to 5 days of the week, while preparing our evening meal I would have one or two halfs of beer, and then 2 to 3 glasses of wine with dinner.

As I have indicated above, I have tried to make lifestyle changes and brought in more alcohol free days.

All over the Metformin notes it says "Do Not Consume Alcohol While Taking Metformin". Side effects mentioned include the possibility of 'Lactic Acidosis', where half the cases can be fatal!

My intent is to 'wean' myself off my regular vino with dinner before starting on Metformin. I do not perceive myself to have a drink problem, but a glass or two with dinner is one of lifes pleasures.

Can anyone here share their social drinking habits with me in relation to the use of Metformin...

I have read some of the threads here, and it looks like a really supportive group. As my experience of the diabetic blight grows, it is reassuring to know there are others to swap notes with.

 

[Northerner]

Hi ANuvva, welcome to the forum 🙂 I am surprised that you have been given the metformin when your HbA1c is only 6.6%, especially given that the rise may simply be due to winter and less opportunity to get out and about combined with the higher carb meals we tend to eat in the cold weather - what was your previous HbA1c? I'd also be interested to know what your cholesterol was, and what the rise has been?

Regarding metformin and drinking - as far as I know it is perfectly OK to drink in moderation, which would seem to be your drinking habits anyway. The likelihood of lactic acidosis is rare, and as far as I know is more likely to occur if metformin is taken when you are ill and blood sugar levels are very high. I know many T2s who take the maximum dose of metformin but still enjoy a drink, so I don't think you need to worry about that. Might be worth talking to your doctor or pharmacist for their views, and hopefully some of our T2 members will also be able to reassure you 🙂

I moved your post to its own thread so it wouldn't get missed 🙂 I look forward to hearing more from you - any questions you have, we'll be happy to help!

 

[Mark T]

Hi and welcome to the forums ANuvva

I've not really been a big drinker for the past few years, but I did look at going tee-total when I first went onto Metformin. However, I did read a few stories from the others which showed they were still drinking (in moderation) and suffering no ill effects.

Currently my normal tipple is a large glass of red wine on weekends.

The one thing to remember is that alcohol delays the absorption of glucose, this is probably more of an issue when injecting then with metformin.

I believe that wine (particularly non-sweet wines) are better then beers and larger because they have less glucose in them.

 

[ANuvva]

Thank you for the welcome and the prompt reply.

Figures were not accurate! Just checked.

HBA1C in Sep 2010 was 6.2. Now 7.5

Cholesterol total - Sep 2010 - 5.6, Now 6.6.

Advice regarding modest consumption of my favourite tipple appreciated!

Recently, I have been experiencing quite significant thirst, drinking a lot of water in the day, probably 2 to 3 pints in addition to Tea etc, and also wanting to go to the loo regularly.

A water bottle is usually with me, and I like to know where the loo is!

Do these symptoms abate quite quickly when moving on to Metformin? Do BG levels drop fairly immediately.

I have been testing with strips and a meter for some time. Average readings now are around 9. Fasting readings are not good - 7 to 8.5.

I have been prescribed Metformin - 500 mg twice daily, starting with half a tablet for 2 weeks and then going onto a whole tablet after 2 weeks.

I would imagine the body would be very responsive to introduction of a new drug. Is 500mg the smallest dose? Would it be feasible to stay on the 250mg twice daily and measure the impact rather than go straight to 500mg.

Apologies if these questions seem a bit daft.

Just finding my way, and want to make sure using the minimum medication.

Thanks

 

[Mark T]

A water bottle is usually with me, and I like to know where the loo is!

Do these symptoms abate quite quickly when moving on to Metformin? Do BG levels drop fairly immediately.

I have been testing with strips and a meter for some time. Average readings now are around 9. Fasting readings are not good - 7 to 8.5.

Do you test at 1 hour post meal? that thirstiness and needing trips to the loo are symptomatic of high blood glucose levels. Metformin can take a while to be effective.

Have you read the advice on How to Lower Your Blood Glucose??

I have been prescribed Metformin - 500 mg twice daily, starting with half a tablet for 2 weeks and then going onto a whole tablet after 2 weeks.

Metformin has some unfortunate side effects of wind and stomach upsets. These usually clear after a month (but not for some people). The Doctor is probably starting you on that dose to try and edge your body in slowly.

 

[Northerner]

I believe 500mg is the minimum dose, with 3000mg the maximum, I haven't heard of anyone having 250mg, but I could be wrong! I've also heard that it can take a week or two for the effects of the drug to become established. From your readings, and elevation in your HbA1c the move to metformin does seem more logical, as does the introduction of simvastatin - ideally, you would want your HbA1c to be below 6.5% and cholesterol around 4.0 (5.0 is considered OK for non-diabetics).

The thirst and consequent trips to the loo will be due to the higher BG levels - this should abate once the metformin starts doing its stuff and your BG levels come down. It's actually the trips to the loo that make you thirsty, rather than the other way round - your kidneys are trying to remove the excess glucose from your body and takes liquid out of your system to do this, hence the thirst. None of your questions are daft! In fact, there is no such thing as a 'silly' question here - if it concerns you, then please ask! 🙂

I'd suggest you take a look at our 'Useful Links' thread for some good information, and would also recommend getting a copy of Type 2 Diabetes: The First Year by Gretchen Becker - even though you are not in your first year it will be very helpful in understanding your diabetes and how best to manage it 🙂

 

[Steff]

Hi Anuvva and a warm welcome to the forum

 

[woolstone2]

hi, warm welcome!
You will get loads of good advice from this forum, my only contribution is re the drink. Wine and beers are high in carbs, which you need to avoid, but thankfully, spirits such as vodka, whiskey etc are low in carbs or have none at all.Im not a pharmacist, but never heard of anyone having problem drinking moderately with metformin, I certainly have a couple of vodkas occasionally! You really dont have too give up much, just find an alternative. best wishes, julie

 

[Vicsetter]

hi, warm welcome!
You will get loads of good advice from this forum, my only contribution is re the drink. Wine and beers are high in carbs, which you need to avoid, but thankfully, spirits such as vodka, whiskey etc are low in carbs or have none at all.Im not a pharmacist, but never heard of anyone having problem drinking moderately with metformin, I certainly have a couple of vodkas occasionally! You really dont have too give up much, just find an alternative. best wishes, julie

Don't know where you get that from! Dry white wine has 0.6g carb per 100ml, Red wine is about 0.2g per 100ml, avoid sparkling wine and non-alcoholic wine. Canned beer about 2.3g per 100ml. Are you sure you not thinking of calories? Spirits are generally 0g carb.