Hi, I’ve been type 2 for 18 months and reduced my hb1ac from 116 to 47. On 2000 mg Metformin and just stopped pioglitazone. My weight was 9 stone 4 on diagnosis and reduced to 8 stone before now getting back to 9 stone 4. So I feel cutting calories isn’t a priority. Since reducing medication I feel sick every morning and have an upset stomach after evening meal and I’m struggling to have a quality of life. Doc wants me to take empagliflozin but I worry about even more side effects. Anyone else in a similar position?
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Type 2, struggling with medication
- Thread starter AnnnieMac
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Leadinglights
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Welcome to the forum. A couple of things occur to me about the medication, metformin is known to cause stomach problems in some people but if you have only just started to get those symptoms it could be the brand of metformin you have been given is different and the coating or additives can vary and that can cause a problem. Otherwise it may be an idea to discuss moving to slow release or dropping down the amount as you have now reduced your HbA1C to what would actually be a acceptable level.
You mention cutting calories but if it is blood glucose you are wanting to reduce then keeping an eye on the CARBOHYDRATES rather than calories would help with maintaining the 47 or reducing further.
If you are down at 47, additional medication seems a bit odd and looking at the carbs in your diet may be a better option. Keeping to 130g or less per day could be an option. This link may give you ideas for that approach. https://lowcarbfreshwell.com/
Jodee
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Hi Annie, I have found the metformin upsets my bowel if I take 3 a day 500mg*. I am on empagliflozin lowest dose, and I am ok on that, but if I was offered the higher dose I would be inclined to say no that that having read all the information and from a letter I got from the GP surgery about certain probs and when to act.
*I have reduced my metformin dose to twice daily, and sometimes I forget so I have it once daily with the empagliflozin.
Can I say you have done really well to reduce down to 47 from 116 - a great achievement, Well done.
saffron15
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When I started on metformin it bunged me up then when I got to 3 then 4 it was looser. However the following week I was put on a SGLT2 and metformin reduced to 2. By December my BG had reduced from 69 to 44. I'm now on 1 metformin. I am on slow release. Try and change if not. Empaglifozin is an SGLT2. I'm on dapaglifozin. It warns you may get thrush I haven't and you could get ketoacidosis but are likely to feel unwell and use a ketostix I've only tested twice since I started, my urine was in normal range. If you start empaglifozin they are likely to reduce your metformin.SGLT2is good for cardiovascular health too. I have high blood pressure but you mustn't go very low carb on it.
Have a good chat with your doctor. Reducing metformin seems the next step.
Have a good chat with your doctor. Reducing metformin seems the next step.
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Well done on your terrific HbA1c reduction @AnnnieMac - and good to hear your weight has gone back up again.
As I understand it the ‘flozins aren’t commonly associated with stomach upset, aside from their risk of DKA, which is a rare but very serious side effect which can be indicated be stomach pain, nausea, breathing difficulty, and fruity/prear drop breath.
Metformin does have an established reputation for stomach upset (though most people can take it without problems, or any stomach problems settle down fairly quickly).
As others have said, the slower release formulations (eg Glucophage or SR versions) are usually kinder on the tum. Do discuss your worries with your GP or nurse - they should be able to develop a plan with you that takes your worries into account.
As I understand it the ‘flozins aren’t commonly associated with stomach upset, aside from their risk of DKA, which is a rare but very serious side effect which can be indicated be stomach pain, nausea, breathing difficulty, and fruity/prear drop breath.
Metformin does have an established reputation for stomach upset (though most people can take it without problems, or any stomach problems settle down fairly quickly).
As others have said, the slower release formulations (eg Glucophage or SR versions) are usually kinder on the tum. Do discuss your worries with your GP or nurse - they should be able to develop a plan with you that takes your worries into account.
debs248
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Is that just empagliflozin or all SGLT2is? I've been told by my GP that the diabetes team will want to put me on a 'flozin once my HbA1c drops below 70 but not which one.
I'm currently aiming for <130g carbs daily but it's often around 50-60. Is this counted as very low carb? I've never heard that you shouldn't eat too few carbs with SGLT2is before, only with sulphonylureas. Unlike sulphonylureas, SGLT2is don't need to be taken with food.
Leadinglights
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I know that some people do have quite low carb 70-100g per day but not at the keto level which definitely is not recommended, the risk is something called euglycemic DKA which applies with SGLT2s.
Leadinglights
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