Type 1 & Metformin - Trial

[Flower3333]

I went for my yearly blood test for my diabetes at my local hospital this morning. The gentleman taking my blood said that he was also a type one diabetic and he’s doing a trial where he takes his long acting insulin but doesn’t take any short acting insulin but he takes Metformin instead.

He has been a type one diabetic for 12 years. I didn’t get any further details.

Has anyone heard of this before? I’ve previously heard about type one diabetics taking metformin due to insulin resistance but not instead of short acting insulin.

 

[DaveB]

To me it sounds like a rather pointless trial. I take Metformin with my insulin partly to keep my nurse happy, partly for it's other protective effects (cancer?) and less so for it's very small effect on BS. Yes, Met can help with insulin resistance but that's not my problems with a BMI of 21 and low body fat measure. If you have excess weight when a T1 then the solution is to eat fewer carbs

 

[rebrascora]

I haven't heard of anything about this. I was on Metformin when first diagnosed because I was assumed to be Type 2 initially and even eating low carb and taking Metformin and in my honey moon period right through the summer, I still needed bolus insulin.
Out of curiosity was he a bigger guy who might struggle with insulin resistance or did he look quite lean and fit. Did he mention following a low carb diet or increased exercise? Just trying to figure out the logic of it. Have to say, I would much prefer to inject insulin than keep taking the Metformin, even through the gastric effects had subsided mostly.... You just never knew when you were going to get a spasm. I don't miss it!

 

[Flower3333]

I haven't heard of anything about this. I was on Metformin when first diagnosed because I was assumed to be Type 2 initially and even eating low carb and taking Metformin and in my honey moon period right through the summer, I still needed bolus insulin.
Out of curiosity was he a bigger guy who might struggle with insulin resistance or did he look quite lean and fit. Did he mention following a low carb diet or increased exercise? Just trying to figure out the logic of it. Have to say, I would much prefer to inject insulin than keep taking the Metformin, even through the gastric effects had subsided mostly.... You just never knew when you were going to get a spasm. I don't miss it!

He looked young, lean and fit. I wish I’d asked more details but I wasn’t expecting to have the conversation.

 

[Bruce Stephens]

Out of curiosity was he a bigger guy who might struggle with insulin resistance or did he look quite lean and fit. Did he mention following a low carb diet or increased exercise?

I was wondering if it was metformin plus a (very) low carb diet. (And basal insulin, obviously.) Or maybe just for people who still produce quite a bit of natural insulin.

 

[grovesy]

I have heard and know Type 1 on Metformin but to aid Insulin Restitance not to replace bolus Insulin.

 

[rebrascora]

It might work if he was on a very low carb diet, just using basal insulin to cover liver output and perhaps glucose from protein breakdown. I am not sure I understand the purpose of the Metformin in a lean fit person unless it is to suppress liver output a bit but can't really see how that would replace bolus insulin. If it was the other way around and Metformin was being used to replace basal insulin in a very fit person, then maybe, but their basal needs would have to be very low to start with. I wonder if he was still in his honeymoon period and that was why they were just using Metformin and basal?

Which area was this in.... Just wondering if it might be a local trial or if Mike @everydayupsanddowns might have heard of it and know what it is about?

 

[Bruce Stephens]

I am not sure I understand the purpose of the Metformin in a lean fit person unless it is to suppress liver output a bit but can't really see how that would replace bolus insulin.

I'm guessing with a low carb diet then Metformin plus exercise (plus the basal) might be enough during the day? But we're all guessing. (I looked in a few trial registries and couldn't see anything relevant, but it's entirely possible I missed it.)

 

[rebrascora]

I am doing quite a lot of exercise several times a day with low carb and whilst I am only using a few units of Fiasp a day, I'm not sure I could manage without it as I have had to decrease basal to prevent night time hypos from the exercise, which means I need the odd unit of correction of Fiasp through the day to keep my levels from going too high.

I would be really interested in seeing what the trial is all about though.

 

[Robin]

Well, I tried it and it didn’t work! When I was misdiagnosed as Type 2, I was on metformin, gliclazide, basal insulin, and put myself on quite a low carb diet (though not as low as Keto) and I couldn’t get my HbA1c below 9% in old money (about 75). At which point the hospital thought to do GAD antibody tests, which proved positive, and they immediately took me off the Metformin and Glic, and added bolus insulin to the basal. HbA1c promptly dropped to 6.5 or 48.

 

[Flower3333]

It might work if he was on a very low carb diet, just using basal insulin to cover liver output and perhaps glucose from protein breakdown. I am not sure I understand the purpose of the Metformin in a lean fit person unless it is to suppress liver output a bit but can't really see how that would replace bolus insulin. If it was the other way around and Metformin was being used to replace basal insulin in a very fit person, then maybe, but their basal needs would have to be very low to start with. I wonder if he was still in his honeymoon period and that was why they were just using Metformin and basal?

Which area was this in.... Just wondering if it might be a local trial or if Mike @everydayupsanddowns might have heard of it and know what it is about?

I had my blood test done at Stoke Mandeville hospital but the gentleman said he was from Milton Keynes.

 

[grovesy]

Mind, the trail could be anywhere as some of the trails, as along as you can get to the trail center you can enter the trail.

 

[trophywench]

... or even a Trial if you don't fancy trekking!

Wouldn't concern yourself about it, if I were you. We will simply all be able to say Oooh, that's what that bloke was on about then - if we ever hear any more about it!