T1D & Metformin

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Rogit85

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Type 1
Hi,

I'm new to the forum, so I'm hoping this is being posted in the right section.

I'm 34 years old and have had T1D for 16 years. I inject Novorapid and Levermir (morning and evening). I've taken part in the DAFNE course and carb count when injecting novorapid.

I've exercise around 3 x times a week and fast 2 x days a week (skipping breakfast and lunch). I'm pretty healthy.

I'm finding the amount of Levermir I'm injecting is increasing, currently 38 units twice a day. I find this amount very high, considering I'm in reasonable shape. I'm also starting to put on weight as well.

I've looked into taking Metformin as a T1D and from what I've read, it should help to reduce the amount of insulin I need to inject and potentially reduce weight. I appreciate the weight loss element isn't always the case, but studies in the US have showed it 'can' do.

1. Does anyone have experience taking Metformin as a T1D? If so, which Metformin did you take (I understand XR's can be gentler on the tummy).

2. Does the NHS prescribe Metformin to T1D's?

3. Did you lose weight taking Metformin and injectiung insulin?

4. Did you notice the ability to drop the amount of insulin you were injecting?

5. Any tips?

Any help would be greatly received.

Thank you,

Chris
 
You need to talk to your hospital D consultant or nurse Specialist - when a person's diabetes isn't actually looked after in primary care but has been passed over to a hospital D clinic, from what I've seen both for myself and others in different parts of the country, GPs are more than a tad loath to prescribe anything different without the hospital clinic confirming it's been agreed.

If you live in part of the country where GPs look after T1 patients and don't refer them all to hospital clinics routinely, then OK, speak to your GP and ask him - I mean he knows you and your medical/mental/personal situation far better than a forum ever can.

However - there's an old Levemir dosing table (dating back to when it was first let loose into The Wild) I can use to see what they reckoned when the invented it. I know how much you take - ie 76u per day, BUT I need your weights in kgs to use said chart. If you can tell me that, I'll see what it says.
 
Thanks for your response Jenny. I've got an appointment with the hospital in 2 x weeks.

That'd be great if you could share the details of the card. I weigh 83 kgs.
 
I take regular (non-SR) metformin (500mg twice.a day). I haven't lost weight, and I'm not sure whether my insulin doses changed particularly. (I suspect the metformin might be stopped next time I have a review.)

I'm not sure why Metformin might cause someone to lose weight. In broad terms weight gain/loss is straightforward: to lose weight, eat less (and use less insulin, to compensate).
 
Bruce Stephens said:
to lose weight, eat less (and use less insulin, to compensate).
Click to expand...

That's a bit reductive: losing/gaining around 15% of your usual weight is usually straightforward. Beyond that things become much harder. (I seem to remember reading accounts of people who'd made dramatic decreases to their weight and maintained it. They were all obsessive about their diets, constantly feeling hungry.) But in principle the idea holds, even if in reality it's horribly difficult. (And gut bacteria are likely also acting to maintain body weight.)
 
As a rule of thumb the total daily amount of insulin in IU should be between 0.5 ant 0.7 times your body weight in kilos, and about half of this should be long acting insulin. So you are using more than this rule would suggest.

It would be worth doing a base test, if you did not do this when increasing you long acting dose.

Metformin ONLY works for type 1 where there is insulin resistance, which might be the reason for your need for such a high dose. In my case it had no effect whatever. It was prescribed on the NHS,
 
Welcome to the forum @Rogit85

Metformin isn’t a common addition, but it’s certainly not unheard of.

Sounds like you are already working quite hard at getting in shape, with intermittent fasting and exercise.

What is your carb intake like on non-fasting days?
 
Thank you everyone for your input. I saw a private doctor (who also lectured and works for King's in London), when I discussed Metformin, he recommended the idea, but spoke about a recently approved drug by the FDA, Forxiga or also known as Dapagliflizon).

I've started on 5mg and already my basal has dropped from 34 units twice a day, to 26 today. It encourages weight loss but also has its risks, if not managed correctly.

I've started to lose weight and my sugar levels are so much better.

Check it out. Lots of case studies into clinical trials run.
 
NICE Guidelines only mention it being taken by T2s.
 
I was started on Metformin when my insulin requirements started riding when I passed 110 kilos. It did nothing apart from.giving me wind and diarrhea! Insulin dose is now down 30% after reducing carbs and getting down to 90kilo!
 
I'm not particularly in love with anything that can damage the kidneys or cause UTIs, so would only want to take it if there is absolutely no other way humanly possible.
 
I seem to remember reports of the risk of high ketones and even DKA while bgs remained fairly normal in T1s.
 
silentsquirrel said:
I seem to remember reports of the risk of high ketones and even DKA while bgs remained fairly normal in T1s.
Click to expand...

Yes SGLT2s seem to have both promising results and also significant risks.
 
I found this thread very interesting because I am a long term (40 plus years) type 1 at present on dmi of Novorapid and Levemir but because my Levemir rates are so high and the very slow response I am getting to Novorapid the hospital specialist has just prescribed Metaformin to try and sensitise me a bit more to insulin. I take 38 units Levemir in the morning and then another 32 units 12 hours later. Tonight is a nightmare! Started off about 4pm with bg rising to 17 and trending up so I injected 11 units Novo, 2 hours later and I'm at 21 so I inject another 10 units and now at 9.30 pm I'm finally down to 11.8 but trending level - so do I inject more Nova and risk it going low later on or just wait it out till the morning? I used to be really well controlled but nowadays I have lost all my hypo symptoms and rely on the G6 sensor to give me warnings. They have also just picked up the first signs of damage to my eyes and I have an hospital appointment to have that checked but the first doctor told me that it was really important to have good control to minimise future damage so obviously I am very worried indeed! I think my insulin resistance is increasing because I used to use an injection ratio of 1 to 10, then that increased to 1 to 8 and now I'm on 1 to 4 - do you think Metaformin could help?
 
Sorry to hear that you are having a frustrating and worrying time with your diabetes @Darzad

Hope the Metformin works well for you. It does seem to have a positive effect for some people with T1. Hope you don’t have too much gastric upset with it.
 
Oh - blimey @Darzad! In 2 years time when I'll be the same age you are now, I'll be '40 years in'. Wonder if a change of insulin might do the trick - or have you already tried that?
 
Hi @Darzad

Sorry to hear that you are becoming desensitised to insulin. Have you considered a low carb diet and increased exercise/activity to help reduce your insulin requirements and perhaps thereby increase your insulin sensitivity?
I find that getting out for a brisk walk after taking a correction helps to get it going.

As regards Metformin, I found it best to take mid meal with a significant amount of food for least digestive upset. Good luck with it. I hope you see some improvement.
 
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