Reversing type 2

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jimmybonsai

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Type 2
Hello everyone. I am having some concerns about my sugar levels and side effects after my latest blood test. But i will give a little history first. I was diagnosed with type 2 about 5years ago. And prescribed Metformin. This was one tablet(500mg) every day from then on. Over time and starting this year I didn't feel i had a problem. But I was kidding myself. Leading up to May this year, i was once again getting up 2 or 3 times a night to go to the toilet, my mouth was always dry, feet were always cold, and really I wasn't at my best. Went to the doctors, and two things happened. I had a prostate examination and an MRI scan, all came back negative. But, my urine sample, and blood tests showed high sugar once again. I was duly sent over to Kettering general hospital for further checks. Spent the day there, and eventually met up with the Diabetic team. I was told in no uncertain terms that I was close to being admitted. I was given in Insulin pen and my Metformin was increased to 4 x 500 mg per day. I used the insulin before meals twice a day(12mg), and two tablets in the morning and two at night. I stuck to this religiously. I kept a record of my blood sugars 4 times each day. After about 3 months I was told to reduce the insulin down to 6mg, and then just over a month ago I was told to come off the insulin completely as my blood sugars were doing really well. I was still taking the same amount of Metformin. When I stopped the insulin I noticed that my "wind",(sorry trying to be polite), was more frequent and very strong. Over the next few weeks and up to the present I have developed very bad Diarrhea. I have given two "stool "samples to the doctors which have come back all ok(no infection). I have been told I need a scan on my pancreas as well. My latest blood test has come back to say I am below the Diabetic level (90 day HbA1c level 5.3%) or below 42 mmOl.Im really interested if anyone has had similar symptoms with stopping Insulin but keeping on the Metformin. Thank you for your time in reading this,
 
Hi and welcome.

Yours is an interesting story! I am not sure if you are aware but diarrhoea and excessive wind are very well known side effects of Metformin more affectionately known as "Metfartin" 😳 here on the forum, but why you would only get side effects from it when you stopped using insulin is strange. Did you change your routine of taking the medication when you stopped the insulin? Taking Metformin on an empty stomach can certainly increase the chances of digestive upset, so if you stopped having breakfast when you stopped the insulin, that might well do it. We always recommend people take Metformin mid meal with a substantial amount of food rather than just a small snack or just after the meal. Personally I found mid meal was best as if it stuck going down the next mouthful of food would take it on down and prevent it from causing indigestion or heartburn. Which brand of Metformin are you on? Has the brand changed as that can have an impact on digestive upset. Some people have been fine on one particular brand but their pharmacist has changed to a different supplier and suddenly horrendous diarrheoa. It can be to do with the binding agents or coating as much as the active ingredient, so that would be worth considering. There are slow release versions of Metformin which are less aggressive when it comes to side effects, so that might be worth discussing with your GP too or a dose reduction since your levels are so good. To be honest, Metformin don't have a huge impact on BG levels anyway.

As regards your coming off insulin and your HbA1c dropping to normal levels, did you make any changes to your diet or lifestyle as they can have an extremely powerful effect on blood glucose levels.
The other possibility is if you are perhaps having flare ups of pancreatitis which is impacting your ability to produce or release insulin and then settles back down again. Hopefully a scan will pick that up if it is the problem. It does sound like your medical professionals have been quite thorough, so hopefully they will get to the bottom of it, but I would be very surprised if the Metformin is not responsible for your antisocial digestive problems. Hope you can at least get a swap or reduction of medication sorted to fix that as many of us know too well how unpleasant and positively embarrassing that can be. As I said, it could be as simple as a brand change or asking for slow release version. Your GP should be well aware of this side effect. My nurse warned me when she prescribed it, which I think is only fair considering that it can be explosive!!
 
Thank you so much for the reply. It helps to have that communication with people who have a shared experience. I will never run down our NHS,but sometimes, you wish they could give you an extra 5 minutes to inform and console.When i stopped my Insulin i was still taking my Metformin (1000mg in the morning and at night), about 20 mins before meals.But knowing me, sometimes i would not be strict enough, and i would not be in sync with my meals. Thats an interesting point about taking them on an empty stomach. I am also taking Forxiga (1 a day), apparently this allows you to get rid of all sugars when you go to the toilet (as explained to me, the body tries to keep a little bit back). I have been on that for 2 months.My diet hasn't changed as such, i am just being more aware of what im eating, and portion size, i agree that it can have a huge effect on my sugar levels.Once again thank-you for your reply, and i will keep the forum up to date as i find out what is happening.
 
Welcome to the forum @jimmybonsai

Hope you can find a way to settle your tum, either with the ‘mid meal’ tactic, or by switching to slow release.

Have you lost much in the way of weight? This can help the pancreas to work more efficiently too.
 
Hi again. i would say over the past month ive lost 6-7 lbs in weight. I was 13st to begin with.I will definitely take on board the mid meal suggestion. it sounds so logical.Just waiting now for conformation of a scan, and blood test.Thanks again.
 
rebrascora said:
Hi and welcome.

Yours is an interesting story! I am not sure if you are aware but diarrhoea and excessive wind are very well known side effects of Metformin more affectionately known as "Metfartin" 😳 here on the forum, but why you would only get side effects from it when you stopped using insulin is strange. Did you change your routine of taking the medication when you stopped the insulin? Taking Metformin on an empty stomach can certainly increase the chances of digestive upset, so if you stopped having breakfast when you stopped the insulin, that might well do it. We always recommend people take Metformin mid meal with a substantial amount of food rather than just a small snack or just after the meal. Personally I found mid meal was best as if it stuck going down the next mouthful of food would take it on down and prevent it from causing indigestion or heartburn. Which brand of Metformin are you on? Has the brand changed as that can have an impact on digestive upset. Some people have been fine on one particular brand but their pharmacist has changed to a different supplier and suddenly horrendous diarrheoa. It can be to do with the binding agents or coating as much as the active ingredient, so that would be worth considering. There are slow release versions of Metformin which are less aggressive when it comes to side effects, so that might be worth discussing with your GP too or a dose reduction since your levels are so good. To be honest, Metformin don't have a huge impact on BG levels anyway.

As regards your coming off insulin and your HbA1c dropping to normal levels, did you make any changes to your diet or lifestyle as they can have an extremely powerful effect on blood glucose levels.
The other possibility is if you are perhaps having flare ups of pancreatitis which is impacting your ability to produce or release insulin and then settles back down again. Hopefully a scan will pick that up if it is the problem. It does sound like your medical professionals have been quite thorough, so hopefully they will get to the bottom of it, but I would be very surprised if the Metformin is not responsible for your antisocial digestive problems. Hope you can at least get a swap or reduction of medication sorted to fix that as many of us know too well how unpleasant and positively embarrassing that can be. As I said, it could be as simple as a brand change or asking for slow release version. Your GP should be well aware of this side effect. My nurse warned me when she prescribed it, which I think is only fair considering that it can be explosive!!
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Hi rebrascora
I have been thinking of your question as regards my reaction to coming of Insulin. When i was first diagnosed about 5 years ago, I was only taking 1 x 500mg tablet. i took this every morning whether id eaten or not. Working shifts etc. throws your eating habits way out of sync. Fast forward to May this year, and I'm on 12mg of Insulin x 2, and my Metformin has now gone up to 2000mg a day. I slowly reduce the Insulin and eventually stop, but I was still taking all that Metformin. Do you think the Insulin could have been keeping the side effects of the Metformin at bay? So, from 500mg to 2000mg, and now my body is reacting. i have been in touch with my Diabetic nurse at Kettering hospital, and she has told me to stop the Metformin. I'm a little wary of this so I have replied that I will take 1 a day at evening meals, as when I get home from work I do tend to graze a bit more and sometimes eat late. Thanks again to you and the forum for your responses i really appreciate them. My Metformin type is RXfarma, and I take 1 x10mg of dapaglifozin(I've been told to keep taking this).Take care
 
jimmybonsai said:
and I'm on 12mg of Insulin x 2
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Sorry for being a pedant but do you mean 12mg of insulin or 12 units?
1 unit of insulin is equivalent to 0.0347mg (no ideas why they use this number - perhaps it means something in imperial measures). So 12mg would be 345units, which given each pen/cartridge contains 100 units, would mean you would use 3 and a half pens each dose. Whilst we all take the insulin we need, this is an unusually high dose (I use less than 30 units per day).

I hope you manage to get to the bottom (pun unintended) of your potential Metformin issue.
And once again, my pedantic nature apologises for derailing the thread slightly.
 
Oh dear. I'm certain it must be units, not mg's. I stupidly assumed it was mg's, i should really read the label. Thanks again. do you think the Insulin kept the Metformin at bay?
 
No, I don't think the insulin kept the Metformin side effects at bay.... which was why I was looking for another reason connected to the insulin.... ie wondering if you had stopped eating breakfast when you stopped the insulin as perhaps you were only eating breakfast because you had been told you needed to with the insulin. If ou were only on 1 Metformin and then got upped to 4 when you stopped the insulin, that would certainly cause the digestive problems, but as I mentioned a change of brand of Metformin can be the cause, even if they are all generic ones that you are using. It seems to be a medication which can be particularly troublesome in this respect. I wouldn't worry too much about coming off the Metformin as it really has a minimal effect on BG levels compared to insulin or dietary changes although it sounds like you haven't made any effort in that respect so far..... Might be something to thing about for your future health.
I think knocking the Metformin down to just 1 tablet a day seems to be a good compromise though and should hopefully see a big improvement in the problems you are experiencing. Looking at reducing your carbohydrate intake might be a wise decision regardless of medication, since you have had this diabetic episode though.
 
Hi again. I was on Insulin and 4 Metformin together from May this year. Stopped the Insulin about 5-6 weeks ago, but carried on with the 4 Metformin. I have made big changes to my diet as well, which has probably helped in keeping my BG down too. Smaller portion sizes, and lots of green veg.
 
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