Type 2 when to come off metformin

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MadWayne

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Relationship to Diabetes
Type 2
My GP confirmed diabetes type 2 in October 2023.

Put on metformin, but got my suspicions before diagnosis so took some steps to lose weight responsibly.

By the time it was confirmed on the second blood test done of the symptoms had already subsided.

Currently on 2gmet a day.
Started at 96mmol/mol second blood test 90mmol/mol.

My last 1AC was 38mmol/mol

So from around11% to 5.6%, pretty pleased in just over 3months, lost a few stone in weight due to better diet and exercise.

The metformin side affects feeling cold in hands feet nose at times has been so bad it was scary.

So now my blood sugar is in the normal range should the GP be training me off metformin?

If I look at data in metformin and reducing blood sugar it doesn’t make such an impact as my results currently show. Studies I have read say 2% max over 29 weeks on a dosage of around 2.5g.

So much would appear to be to my new regime.
If I continue my new regime and my issues with metformin side affects shouldn’t my go look at reducing my metformin at least.

My other blood results appear to be good.

Waiting to hear from the GP, so for now taking the metformin as not been asked to come off.

But seems to me we should be able to reduce the dose if nothing else.
 
So posted on general message board few minutes ago.

I was diagnosed type two in October 2023 and suspected before then.

My latest bloods 3/4months after diagnosis are now in normal range.

I want off the metformin asap.

Gone from 11%. 96mmmol/mol to 5.6% 38mmol/mol,

So now normal, but meformin alone isn’t responsible it’s gym/swim 3 times a week and better diet change not dieting to lose weight specifically and whilst I can say I have had chocolate it’s been 4g of buttons when I have them. Easiest way to limit and feel like you’re having more than one.

Lost plenty of weight and lighter now than I was 14 years ago, yes it’s a lot of weight in 3/4months

Now the weight loss is much slower which isn’t a bad thing as it’s a lifestyle change.

But just when should I be weaned off metformin
 
Hi. Welcome to the forum and many congratulations on your amazing progress with weight loss and hbA1c reduction.
What dose of Metformin are you on and have you discussed reducing it with your nurse or GP?
I personally think that you could start reducing it now unless there is some particular health reason for remaining on it. Health care professionals can sometimes be a bit skeptical of how effective lifestyle changes are or can be maintained and assume the medication is doing most of the work or will be needed when diet and exercise lapse, so they can be reluctant to decrease or stop medication but ultimately it is up to you, whether you take them or not. The important thing is that there isn't some other medical reason to keep taking the medication, so discussing it with your health care professional is important. If they can't give you a valid reason to continue taking them then I would suggest you reduce them slowly and see what your levels do.
 
breakfast 1g teatime 1g
The health care professionals are not accessible due to the gate keeper.

I want to speak to them, although given that I have been suffering from some side effects which they said were not known, but are stated as side effects on NHS website amongst other sources as well the medication documentation. Seems crazy.

I am only aware of it for blood sugar control and it isn’t exactly compatible with another medication I may take from time to time.

The gate keeper, isn’t a medical professional.
Nor am I.
I see little point in staying on the same level of medication and by all means state it’s been reduced due to progress and assumes I continue on maintaining or lowering slightly the blood sugar slightly at the next blood test.

Which is 3months away at the earliest I could do it myself or pay for a test monthly to monitor it moving up or down.

There are studies suggesting that metformin alone over 29 weeks at 2.5g a day would only reduce by 1.5%, so most reasonable suspect for the drop being so large in a short period of time is the combined lifestyle changes and some due to the metformin.

Now my understanding of hb1AC is a measure of blood sugar attached to the blood cells, as the bloods life cycle is 3 months the test should be done every 3 months.

However the chemistry would also suggest that high blood sugar could increase the hb1AC faster than its lost if you like.

Due to the exercise regime my blood cells are likely to be recycled more regularly

I can see from the blood tests done, that I have doubled the level of a chemical can’t recall the name at the minute think it began with an Rib…, that is related to the recycling of blood.

Most of the other levels were the same as previous bar one which was lower this is marking liver function I believe so probably a lot better than things have been.

I agree that it’s my choice, but it should be done via consultation and agreement. Side effects alone are reason enough to take me off it medically and as things are now in specification/ normal range there surely has to be a stronger case for a reduction at least.
Not a fan of medication unless absolutely necessary and not for any longer than necessary.

I read some articles about how you might see drops in blood sugar, worked out the likely outcome over the period between the blood tests.

And it wasn’t a million miles away, but then again I can remove sugar from my tea/coffee and cut out the biscuits and chocolate that are the like sources of my added sugar.

I can reduce my carbs on the plate and control that intake.

These are things I have done and to be fair, it appears to have worked, eat lots of fruit which I said if my blood sugar was high this time round would be the source of it being high, as no sugar added to drinks, or processed sugar and no the aways.

That said did have half a pizza sweet potatoes chips and salad, so changing from a whole pizza garlic bread and chips and no salad. Which was probably highest carb meal I have had.

I don’t want to gamble, but I am happy to take educated punts and listen to reason.

Looks like the 111 appointment made hasn’t materialised with the GP but time yet.

hopefully it will get addressed sooner rather than later in a controlled way.
 
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Hello MadWayne
I have been taken off of Metformin this month after an HbA1c test at the end of December showed a drop from 88 to 37 after 3 months of strict dieting and weight loss. I started Metformin in early Oct after the initial diagnosis on 1x500g rising weekly to 4x500g. But as the diet was working I briefly got up to 3x500g per day but then dropped back to 2 per day and then 1 per day at the end. All done in and after discussion with my GP.
If your preference is to stop taking Metformin then make this clear to your GP or diabetic specialist nurse at your surgery and pursue it with them.
Good luck.
 
I stopped taking Metformin as it made me so ill - but I don't do high carb even on days when I eat a few more carbs than normal.
Metformin can have really unpleasant side effects. Combined with Atorvastatin it was so bad I was becoming suicidal in just a few weeks, so I stopped it. Seven years later I am still convinced that it was the only decision to make at the time as I never needed the tablets in the first place.
 
The meds were a joke, started them and booked an appointment with doctor was on them a week.

When the doctor read the instructions they had to read it more than once and we got the numbers tidied up to how many.

It was one of the bizzarist instructions for meds I have seen,

It seems sensible for it to be monitored and reduced and removed.

Your lighter than me and I am 5 9 and 16stone so obese category, but the blood results were similar if not starting in a worse place.

I can’t get past the gate keeper, they used to be an excellent practice but now it’s so shocking I looked at leaving before Christmas,

As I do have an appointment, i will probably have to send them formal request and complaint.

Stating what I was told by the diabetic nurse and regarding the results.

At the time I was getting the med schedule clarified I discussed exercise that I was taking already in anticipation of it being diabetes and the doctor said I shouldn’t do swimming I should walk. Really think I should change surgeries because they don’t want to listen to your concerns at all.its a shame 10/11 years ago couldn’t fault them appointments drop of an hat, listened and things worked well.

This started because they took a blood test they didn’t make me aware of, I had a shoulder conplaint they have closed this done as resolved and it isn’t. So also need to raise that too. Sent a message from nhs app asking why it was closed down and looks like it’s not been actioned.
 
Thanks for everyone’s replies it’s appreciated

Glad things have worked out and no surprises you wanted off the meds.
 
MadWayne said:
Thanks for everyone’s replies it’s appreciated

Glad things have worked out and no surprises you wanted off the meds.
Click to expand...
I am a little confused about what you are still eating as you mention sugar i tea/coffee, lots of fruit, pizza, chips, sweet potatoes which are all going to add to your carb intake as they are all high carb foods.
If those are still on your menu the the metformin may be doing quite a bit. But a strategy could be to reduce the medication gradually but look to reducing your carbs.
Also a home blood glucose monitor would be beneficial so you could keep a good check on day to day readings or check the effect of meals especially if they are high in carbs.
 
I can see how that was unclear.

They were my main sources of sugars and they are probably sugars in the worst possible form.
They were the easy stops, mainly as coffee I find hard to drink without sugar i dont drink it as much now, maybe once a month, but with tea i sometimes had sugar and others I didn't so that was easy to remove and whilst i never had a lot of sugar in my tea, i did have a fair few brews a day.

Chocolate and biscuits were a problem if we had them in, open a packet and regardless of size it got consumed, salted peanuts also a vice of the past, now I have 30g max a day of mixed nuts unsalted, they were easy stops/changes. When visiting others I am able to resist the temptations but have to tell them if they are being pushy about the diabetes and that makes them think twice.

Fruit I eat a lot of fruit and still eat the same as I have always done, so my body seems to think that's okay, the metformin I have no doubts would have helped but the numbers would suggest that it certainly isn't the metformin doing all the work as the studies show there performance.

High carb ,meals are avoided most of the time now and when they are in play its reduced portions and with a side of veg, it would be interesting to see daily blood sugars more so if i came off the metformin as my average ie 1ac is in normal range from a very high value, As that average includes Christmas period, didn't go mad but did have more than normal Christmas week but maintained weight, the main control was carbs over Christmas.

Also if having a high carb meal try and fit it in on an exercise day as better chance of it being burned up or at least that's my theory.

I will be having half a bottle of red wine tonight with the wife but dont have that often either and to be fair half a bottle less than once a week/ fortnight is better than a couple a week between us.

I guess I went a stray on the chocolate and fairly confident that I have opted for a lifestyle change rather than a strict diet, have done them many moons ago for getting married and the like which is short term pain for short term gain.

Lifestyle change so make it sustainable and hence weaning off the metformin seems more sensible approach than stopping completely but need to have the docs opinion before embarking down that road.

If i was being tested once a month it would show up if the sugar average was going up or down and an earlier intervention could be taken if average blood sugars increasing. fairly sure if i dont lose the lifestyle focus I will be okay.
But thinking and knowing, I could do hb1ac at boots for £20 but not sure what the standard is apparently it takes 7 minutes.

if its a good standard of test I could get it checked at that price to see which way its going.
 
MadWayne said:
I can see how that was unclear.

They were my main sources of sugars and they are probably sugars in the worst possible form.
They were the easy stops, mainly as coffee I find hard to drink without sugar i dont drink it as much now, maybe once a month, but with tea i sometimes had sugar and others I didn't so that was easy to remove and whilst i never had a lot of sugar in my tea, i did have a fair few brews a day.

Chocolate and biscuits were a problem if we had them in, open a packet and regardless of size it got consumed, salted peanuts also a vice of the past, now I have 30g max a day of mixed nuts unsalted, they were easy stops/changes. When visiting others I am able to resist the temptations but have to tell them if they are being pushy about the diabetes and that makes them think twice.

Fruit I eat a lot of fruit and still eat the same as I have always done, so my body seems to think that's okay, the metformin I have no doubts would have helped but the numbers would suggest that it certainly isn't the metformin doing all the work as the studies show there performance.

High carb ,meals are avoided most of the time now and when they are in play its reduced portions and with a side of veg, it would be interesting to see daily blood sugars more so if i came off the metformin as my average ie 1ac is in normal range from a very high value, As that average includes Christmas period, didn't go mad but did have more than normal Christmas week but maintained weight, the main control was carbs over Christmas.

Also if having a high carb meal try and fit it in on an exercise day as better chance of it being burned up or at least that's my theory.

I will be having half a bottle of red wine tonight with the wife but dont have that often either and to be fair half a bottle less than once a week/ fortnight is better than a couple a week between us.

I guess I went a stray on the chocolate and fairly confident that I have opted for a lifestyle change rather than a strict diet, have done them many moons ago for getting married and the like which is short term pain for short term gain.

Lifestyle change so make it sustainable and hence weaning off the metformin seems more sensible approach than stopping completely but need to have the docs opinion before embarking down that road.

If i was being tested once a month it would show up if the sugar average was going up or down and an earlier intervention could be taken if average blood sugars increasing. fairly sure if i dont lose the lifestyle focus I will be okay.
But thinking and knowing, I could do hb1ac at boots for £20 but not sure what the standard is apparently it takes 7 minutes.

if its a good standard of test I could get it checked at that price to see which way its going.
Click to expand...
 
On the other hand £20 would buy you a home testing blood glucose monitor and enough strips to test every day for nearly 2 months and you could then also test if you felt unwell or wanted to test the effect of particular meals.
 
Well done on your terrific HbA1c reduction @MadWayne - great to see your weight loss and the changes to your menu have had such a big impact.

We have several member who have managed to reduce or come off metformin, so it certainly can happen. @Martin.A was one if I remember correctly.
 
seen one in very similar circumstances.

Just a shame can’t get hold of a doc or the diabetic nurse to discuss.

Hopefully get it down and taking less meds will help reduce side effects.
 
MadWayne said:
not sure why I would need to or want to.
Click to expand...
It is something that people find gives them the control over managing their condition rather than waiting for the periodic HbA1C during which time things ca go awry.
Many people make their dietary choices based on what their monitor tells them.
 
My issue is the metformin and its side effects.

Happy to take it if it’s absolutely necessary and not convinced it is now.

I am reluctant to adjust my meds without speaking with doc first but can’t get past the gate keeper.

Indeed the gatekeeeper says doc Has reviewed and said no further action.

Now given the same gatekeeper technology got told me an earlier result was satisfactory when asking about the Hb1Ac test I thought I was going for.

But turns out the pharmacist requested a cholesterol test and they changed the date I had booked in for Hb1Ac and changed it to cholesterol.

At least that’s the way I see the events.

Now I have my results on nhs app I can see them so don’t have to get the gatekeeper and confusion
 
Leadinglights said:
It is something that people find gives them the control over managing their condition rather than waiting for the periodic HbA1C during which time things ca go awry.
Many people make their dietary choices based on what their monitor tells them.
Click to expand...
Fair enough I would like to think my diet isn’t going to change massively now or exercise.

Due to a few things a few people cercus’s sessions were missed around Christmas.

The removal of metformin it may be wise to have some sort of monitoring but would imagine it will take a while for the metformin to deminish that’s something I need to look into thinking about it.
 
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