Hi after a year of BC treatment including surgery, chemo and radiotherapy I had a routine blood test and my HbA1c was 58. I was immediately prescribed metformin and given advice to manage my diet. To say I was gutted was an understatement having just finished active cancer treatment. My GP said that the steroids you take to cope with the chemo can raise your blood sugars but they should have come down by now. I am taking tamoxifen and venlafaxine and wonder if they react with the metformin? I was having some nausea with standard metformin (2000 mg per day) so my GP has given me glucophage SR as it is better tolerated. Since I have taken it for last 7 days I have a gurgling stomach and diarrhea which is worse than the original metformin. Should I persevere with it or go back to the original metformin?
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T2 diagnosis after breast cancer treatment
- Thread starter GW1969
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Welcome to the forum @GW1969
Sorry to hear about your diagnosis, and the stomach upset youkve been having from the SR metformin.
Some forum members seem to find their symptoms settle in time, but I’d keep in contact with your GP so that they know how tricky you are finding things. They may also have a wider perspective on how long such symptoms typically continue and whether they are likely to ease in time.
Your GP shpuld have checked for any potential interactions between meds before prescribing, but if you are concerned you might chat to a local pharmacist who will be able to answer and questions you have about the meds you are taking 🙂
Sorry to hear about your diagnosis, and the stomach upset youkve been having from the SR metformin.
Some forum members seem to find their symptoms settle in time, but I’d keep in contact with your GP so that they know how tricky you are finding things. They may also have a wider perspective on how long such symptoms typically continue and whether they are likely to ease in time.
Your GP shpuld have checked for any potential interactions between meds before prescribing, but if you are concerned you might chat to a local pharmacist who will be able to answer and questions you have about the meds you are taking 🙂
Hi @GW1969 and welcome to the forum.
It's correct that both Steroids and Statin are quite likely to increase Blood Glucose whilst you are taking them.
While most T2 Diabetics can tolerate at least the extended release versions of Metformin, there are a large number who can't and have to stop taking them.
Since your HbA1C isn't very far into the diabetic zone, there is a good chance that you can get along fine without Metformin since what you eat can have a greater effect than metformin.
If you can reduce the carbohydrates that you eat then you may not need any diabetes medication, since it is the carbohydrates that immediately turn into glucose upon digestion. So potatoes are can be as 'bad' for a Diabetic as table sugar is. This includes all carbohydrates to a certain extent, unfortunately some can tolerate certain foods higher in carbs than others. The only way to know which are OK for you is to gat a Blood Glucose meter and test before eating and then 2hrs after first bite. If the rise in the BG reading is more than 3 mmol then either the food is best avoided or eaten in smaller portions.
Carby foods include all starches (like grains and flour), potatoe, starch underground veg, tropical fruit and especially fruit juices. Some people are OK with legumes, carrots, apples where others are not (me included).
What can be eaten (even in large quantities) are:- Eggs, meat (even fatty cuts) , fish (oily fish as well as white fish- but no batter/breadcrumbs), Cheese, leafy green veg, Avocado, Mushrooms.
So a great breakfast for a Type 2 diabetic could be eggs (with or without bacon , mushrooms, cheese). And breakfast foods unlikely to be well tolerated are Oats , Porridge, Breakfast Cereals, Toast, Those who don't like a cooked breakfast can eat something like full fat Greek yogurt (or Skyr) with a handful of berries and/or nuts in it. Berries are some of the lowest carbohydrate fruits!
It's correct that both Steroids and Statin are quite likely to increase Blood Glucose whilst you are taking them.
While most T2 Diabetics can tolerate at least the extended release versions of Metformin, there are a large number who can't and have to stop taking them.
Since your HbA1C isn't very far into the diabetic zone, there is a good chance that you can get along fine without Metformin since what you eat can have a greater effect than metformin.
If you can reduce the carbohydrates that you eat then you may not need any diabetes medication, since it is the carbohydrates that immediately turn into glucose upon digestion. So potatoes are can be as 'bad' for a Diabetic as table sugar is. This includes all carbohydrates to a certain extent, unfortunately some can tolerate certain foods higher in carbs than others. The only way to know which are OK for you is to gat a Blood Glucose meter and test before eating and then 2hrs after first bite. If the rise in the BG reading is more than 3 mmol then either the food is best avoided or eaten in smaller portions.
Carby foods include all starches (like grains and flour), potatoe, starch underground veg, tropical fruit and especially fruit juices. Some people are OK with legumes, carrots, apples where others are not (me included).
What can be eaten (even in large quantities) are:- Eggs, meat (even fatty cuts) , fish (oily fish as well as white fish- but no batter/breadcrumbs), Cheese, leafy green veg, Avocado, Mushrooms.
So a great breakfast for a Type 2 diabetic could be eggs (with or without bacon , mushrooms, cheese). And breakfast foods unlikely to be well tolerated are Oats , Porridge, Breakfast Cereals, Toast, Those who don't like a cooked breakfast can eat something like full fat Greek yogurt (or Skyr) with a handful of berries and/or nuts in it. Berries are some of the lowest carbohydrate fruits!
Sorry to say, but GPs usually either don't tell patients to test their Blood Glucose or indeed not to test it, because they want to avoid the cost of providing prescriptions for BG monitors and test strips!
I think almost everybody in this forum believes that T2 Diabetics need to be offered a BG monitor. As I think now does Diabetes UK. It is so much easier to get T2 D into remission when you can see the effect meal by meal rather than just an HBA1C test every 6 months !
Did your doctor tell you what dosage of Metformin you need for 'heart protection' ? Perhaps you could reduce down from 2000mg to something that your stomach cn tolerate.
I think almost everybody in this forum believes that T2 Diabetics need to be offered a BG monitor. As I think now does Diabetes UK. It is so much easier to get T2 D into remission when you can see the effect meal by meal rather than just an HBA1C test every 6 months !
Did your doctor tell you what dosage of Metformin you need for 'heart protection' ? Perhaps you could reduce down from 2000mg to something that your stomach cn tolerate.
rebrascora
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Hi and welcome.
Really sorry to hear about the health battles you have been fighting and hope ypu are winning against the big C and will soon be winning against diabetes too.
Metformin can cause digestive upset and sometimes it settles down after a while. It is important to start with a low dose and gradually build up, so that your digestive system gets a chance to cope and adjust. It is not clear from you post if the medication was gradually increased or if you were started on the higher dose. If the latter then you might be best going back to the original and starting off on 1 tablet for a week and then upping it to two etc until you are up to the dose prescribed. Some people find Glucophage better but others find it worse. I think the adverse reaction may be to do with the coating and binding agents used rather than the metformin active ingredient itself. It may be that if you go back to the original, that the nausea settles down, particularly if you ensure that you take the tablets mid meal with a substantial amount of food, but if they continue to make you feel ill then do go back to your GP. There is no reason why you should persevere if it adversely affects your quality of life, because the gains are not that significant from Metformin to live in misery with it.
Dietary changes are usually much more effective against diabetes than Metformin, so don't feel you have to struggle on with it if you have given it a fair crack and it makes you feel rubbish, but your reaction can settle down after a 2-3 weeks.
Good luck with finding an option that works for you and let us know how you get on.
Really sorry to hear about the health battles you have been fighting and hope ypu are winning against the big C and will soon be winning against diabetes too.
Metformin can cause digestive upset and sometimes it settles down after a while. It is important to start with a low dose and gradually build up, so that your digestive system gets a chance to cope and adjust. It is not clear from you post if the medication was gradually increased or if you were started on the higher dose. If the latter then you might be best going back to the original and starting off on 1 tablet for a week and then upping it to two etc until you are up to the dose prescribed. Some people find Glucophage better but others find it worse. I think the adverse reaction may be to do with the coating and binding agents used rather than the metformin active ingredient itself. It may be that if you go back to the original, that the nausea settles down, particularly if you ensure that you take the tablets mid meal with a substantial amount of food, but if they continue to make you feel ill then do go back to your GP. There is no reason why you should persevere if it adversely affects your quality of life, because the gains are not that significant from Metformin to live in misery with it.
Dietary changes are usually much more effective against diabetes than Metformin, so don't feel you have to struggle on with it if you have given it a fair crack and it makes you feel rubbish, but your reaction can settle down after a 2-3 weeks.
Good luck with finding an option that works for you and let us know how you get on.
Thank you for your reply. I started gradually on metformin from 1 to 4 tablets a day over a month. Once I got to 4 tablets a day I started the nausea. My GP is supportive and told me not to suffer with side effects and try the slow release version. I took 4 a day straight away as I was already taking that dose of normal metformin. It took about 3 days before the upset stomach hit. I think I'll try dropping down to 1 twice a day for a while. My last Hba1c was 54 and my GP was fairly happy with that.
I'll keep you posted.
Gerry
I'll keep you posted.
Gerry
Leadinglights
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You may find testing helpful as it may enable you to make some beneficial dietary changes that will enable you to stay on a lower dose of metformin so your body is less affected by the side effects.
Many do find testing is a crucial part of managing blood glucose levels as the more you can eliminate or reduce the portion size of foods which increase your blood glucose the better.
Many do find testing is a crucial part of managing blood glucose levels as the more you can eliminate or reduce the portion size of foods which increase your blood glucose the better.
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