What can I expect from metformin and are there alternatives ?

[Taffyboyslim]

I am on 3 x 500 slow release .....is this a normal dose for someone with my readings ? ......79

Will it , together with dietary changes , lower my readings ?

How long might it take ?

Is metformin the gold standard treatment and at what point do they add or replace things ?

Thank you

 

[NotWorriedAtAll]

I was put on two 500 and not slow release in the beginning.
I think it is the first thing they always try with type 2.
I changed my diet a LOT quite quickly and stopped taking them after a few months. My numbers have been fine ever since without any other meds. I was better without them but lots of people do well with them. I cut carbs so much they were pointless for me. I had one hba1c of 42 in that year and then took myself off metformin and also had 42 for the next hba1c also. It held at 42 until this summer's 40.

So with metformin and dietary changes I was back down to pre-diabetic numbers within 3 months.

 

[Windy]

Hi, I was on 2 non-slow release metformin at the start, when my HbA1c was 83, like NotWorriedAtAll says, it's the first thing that they give you for T2. It can give you bad guts, but the slow release version is meant to be better. I had my dose reduced to 1 metformin at a medication review after six months. It's not meant to be massively good at lowering your BG levels, I read somewhere it's only a percentage or two reduction in BG.
It's a tool in the GP's armoury to address higher BG. A combination of a bit of weight loss, going out for walks (or other exercise to burn off the glucose in your muscles), and dietary changes will also play a part. GP should do a review with you when your current prescription runs out, mine was a phone appointment. I asked for the dose to be reduced, and he was happy as my HbA1c had reduced. There's alternative medications if you don't get on with metformin. Don't be afraid to go back to your GP and ask them if you're one of the unlucky ones that have a bad experience with it.
Sarah

 

[Taffyboyslim]

Hi, I was on 2 non-slow release metformin at the start, when my HbA1c was 83, like NotWorriedAtAll says, it's the first thing that they give you for T2. It can give you bad guts, but the slow release version is meant to be better. I had my dose reduced to 1 metformin at a medication review after six months. It's not meant to be massively good at lowering your BG levels, I read somewhere it's only a percentage or two reduction in BG.
It's a tool in the GP's armoury to address higher BG. A combination of a bit of weight loss, going out for walks (or other exercise to burn off the glucose in your muscles), and dietary changes will also play a part. GP should do a review with you when your current prescription runs out, mine was a phone appointment. I asked for the dose to be reduced, and he was happy as my HbA1c had reduced. There's alternative medications if you don't get on with metformin. Don't be afraid to go back to your GP and ask them if you're one of the unlucky ones that have a bad experience with it.
Sarah

Thank you Sarah

 

[Bruce Stephens]

Is metformin the gold standard treatment and at what point do they add or replace things ?

The NICE guidelines are available for everyone to read: https://www.nice.org.uk/guidance/ng28/chapter/Recommendations#drug-treatment

Metformin is the recommended first drug (most of the time). I think because it's cheap and generally well tolerated, so no reason not to try it. There are certainly many others should metformin not suit you. (I see NICE recommends standard release metformin so it's interesting you've been given slow release from the beginning. (Not a wrong decision, but it's interesting.))

 

[gll]

Metformin does 2 things
1) helps your body to use the insulin you make more effectively
2) tells your liver to chill out on the dumping of so much glucose back into your blood

Its cheap and if tolerated, most people stay on metformin even if they progress down the routes of other drugs.

As for dosage, it seems to vary from place to place. I had a higher diagnosis a1c (91) and was only put on 2 x 500mg. No idea what the reasoning is as to who gets put on what.

There is a set pathway for T2s to go down medication wise and it generally depends on if you can tolerate the medication and is it effective enough (along with dietary/lifestyle changes). Within each medication, there are usually different dosages to work through as well.
https://forum.diabetes.org.uk/boards/threads/nice-sign-flowchart-for-t2-medication.99813/
The link above is a post on here with various links, inc t2 pathways as flowcharts if you were interested in how and when you would have new regimes introduced.

 

[harbottle]

My hba1c was 83 and I was started on 1000mg doses, 500mg in the morning 500mg in the evening. No side effects. I also went low carb and lost a lot of weight in three months so I have no idea how much the Metformin contributed to the lower HBA1c after 3 months - a small amount, perhaps, but the lifestyle change make much more difference. It was cut to 1 500mg tablet after 3 months, and more recently my GP said we could stop it and 'see what happens.' (It went up to 39) I said I'd rather wait. The drug is thought to have a lot of other benefits as well, but it's mainly used for T2 diabetes.

 

[Taffyboyslim]

I am certainly not going to rush things

 

[Taffyboyslim]

Doctor was lovely . Explained 3 x 500 mg dose was because sugars were high and they want to try their best to help me get it down .

 

[Barrowman]

They started me on 2 x 500mg Metformin when I was diagnosed three months ago - they disagreed with my stomach so it was changed to Foxiga, unfortunately, that did have pretty much the same effect.

Now on the third attempt, they prescribed Gliclazide and I'm pleased to say that works fine for me, with no side effects whatsoever and it's just one a day.

So there are plenty of options out there if you find your present medication is not right for you.

 

[Taffyboyslim]

They started me on 2 x 500mg Metformin when I was diagnosed three months ago - they disagreed with my stomach so it was changed to Foxiga, unfortunately, that did have pretty much the same effect.

Now on the third attempt, they prescribed Gliclazide and I'm pleased to say that works fine for me, with no side effects whatsoever and it's just one a day.

So there are plenty of options out there if you find your present medication is not right for you.

Thank you , I have my second blood test at the end of August so I am sure we will get on top of things

 

[palas]

This is an interesting thread. I'm on 2 x 1000g Sukkarto SR (slow release, which is metformin). At my last review I mentioned that I had recurrent sudden diarrhoea and have had to have bloodtests and send in a sample! I had a letter through saying that the general surgical dept of my local hospital want a telephone appointment in September. Reading through this thread I'm now wondering whether it's just the metformin causing these problems. I've been on it for 10 years now.

I shall talk to my diabetic nurse when she comes back from holiday. Thanks for reminding me that MF affects you this way.

 

[Drummer]

Oh yes - my whole life fell apart when prescribed Metformin and Atorvastatin.
I could not go out of the house after taking the tablets, on some days I could not go far from the toilet.
When I stopped taking them I was prepared to find no improvement in my test levels - but I was eating low carb, and found I was no longer diabetic.