more questions about the long term

[snrumph]

Hello,

I know there have been lots of threads regarding the use of drugs/no drugs in control of diabetes. I am only 3 weeks in since my diagnosis and have been doing pretty well without dipping in to the metformin the doc gave me.

After talking with another (better) doctor, I was told that studies have shown that patients on medication have better long term success than those using diet and exercise alone. He also told me that I should be taking the meds regardless of whether my sugar is under control - that the disfunctional state of the pancreas requires permanent assistance by way of meds.

Have others received similar advice? There seems to be a wide range of opinions between docs and patients. It is also confusing to read about people being taken off their meds. Seems to conflict with this line of thinking...

Thanks.

[mommaterra]

Keeping in mind that I am ON metformin, I can tell you that the biggest factor in your diabetes is you -- learning how your body responds to different foods, getting educated (reading a lot of the more technical stuff, too) and then deciding how you want to approach your disease and what your priorities are. And then you can see where, or if, drugs come into play. At least that's been my approach.

I have had no negative effects from metformin, but I plan to stay on it only if it truly works and only so long as I really need it. In six weeks I came down from the 240s to 120s, but kinda stuck there, even with VERY low carbing and exercise, which I have no problems continuing. But I exercised three hours a day, initially, to get even to here, and I don't expect that to be a popular first choice, either!

For me, if I can get down into the 90s and stay there without drugs (which I did before), I will discontinue the metformin. That's MY line, and yours, like everyone else's, will be a little different. I endure the effects of my choices, and so I choose the options for my diabetes based on the best information I have, including consulting with my doc. But he, probably to his chagrin, doesn't call the shots. I can do so much better than the 'industry average' patient in the comparison (who likely has a fasting BG of 180+ and a PP BG significantly higher). --diana

[wiseguy]

This has also been a confusing concept for me. To my way of thinking, how could it be better to achieve something with drugs that you can achieve just as well without drugs. I too am just recently diagnosed (about four weeks now) and my doctor tried to prescribe Metformin for me. I had previously done some research and decided that I would try to control my BG levels with diet, exercise, and some supplements that are known to be helpful. The doctor didn't agree, but he could not come up with a convincing enough argument to change my mind. At this point I have been keeping my fasting numbers below 100 and after meal numbers have not exceeded 140. I think I will improve on these as time goes by.

If and when the time comes that I can no longer control my BG levels this way, I will not hesitate to do whatever it takes to retain control. But as long as I can do it without drugs, I will.

[rwmetcalf]

I have a goal of getting off the meds, as well. I have been re-thinking whether or not I will actually go off the meds or not once I get to where I feel I can. Here is why: The metformin helps me be more insulin sensitive and this in turn takes some of the load off of my pancreas in terms of producing insulin. Since my pancreas is already partly shot, anything to help take the load off is welcome. We have easy access to meters to tell us how our BG levels are, but we do not have easy access to a means to test our insulin, except for periodic blood tests and then we have to ask for the tests (usually). If our insulin sensitivity gets worse and we aren't monitoring our insulin levels very often, we could be doing more harm to the pancreas by overworking it before we notice a BG level rise.

I think for me, just getting to the goal will be good. I have not heard that diabetics become immune or resistant over time to metformin. If that is the case, I may reconsider my position, again.

Anybody know if we get to the point where our body stops responding to metformin? The answer is probably one of those YMMV type answers.....:smile:

Regards,
Roger

[Bibleteacher]

dear wiseguy

I can not tell you what to do in your particular situation, since I do not know all the facts and even if I did, how you control diabetes is mostly a personal decision.

My decision has been to go without drugs.
but that is my personal decision.
of course I have to work a little harder than other diabetics to keep myself under control, but I feel comfortable with my decision.

I have a philosophical bias against drugs, besides the fact that I do not want to deal with the side effects.

[Dan Gato]

I wish the old-timers would provide their opinion here, based on their experience of many years.

Metformin helps me & I don't have side effects, for now.
But who is to know what will happen in 2027, 20 yrs from now.

At the moment of diagnosis some beta cells had already died on each one of us. for the T2's the challenge is to keep the remaining beta cells producing our own insulin, if you don't help your pancreas with meds now.
then in the future you may have to use outside insulin sooner than later.

Medicine has come a long way, & thanks to the docs life expentancy has increased. people used to die of diabetes like 6 months or a year after diagnosis.
In my case I'm helped by the docs & the meds prescribed to me.
My meter & strips are creation of the new technology & new stuff is on the way to help the human kind suffering many diseases.

[snrumph]

"Metformin helps me & I don't have side effects, for now. But who is to know what will happen in 2027, 20 yrs from now. At the moment of diagnosis some beta cells had already died on each one of us. for the T2's the challenge is to keep the remaining beta cells producing our own insulin, if you don't help your pancreas with meds now. then in the future you may have to use outside insulin sooner than later."

My concern exactly. At my age I could be on this drug for longer than I've been alive - which scares me a little. At the same time it could improve my long term prognosis. I realize taking meds like everything else we do is a personal decision, but I am trying to take my personal feelings out of this and make a decision based on good science. Lots of good information on the net nowadays, but it's still not easy.

I wish the old-timers would provide their opinion here, based on their experience of many years.

I second that. Though I have a feeling that most of the type II's that use this board, myself included, are newly diagnosed and once they get their lives back to normal stop coming around. I've love to hear from someone who's been on meds for 20 years. I figure if I make it that long, the'll have tiny injectable robots that repair your body and give you superpowers. Of course, I thought we'd all be living on moon colonies by now...

[wiseguy]

I've love to hear from someone who's been on meds for 20 years. I figure if I make it that long, the'll have tiny injectable robots that repair your body and give you superpowers.
My father was diagnosed at age 37 and controlled his BG with meds until his late sixties before going on insulin. He is now 82 and still going strong. I don't know about "injectable robots" but I would like to avoid needing insulin at least until the insulin patch is perfected.

[princesslinda]

I'm T2, diagnosed 5 months ago, on metformin 500 mg 2 times a day. This has really helped bring my levels under control. Like the rest of you, I do wonder how long this medicine will continue to be effective. I would like to go off it at some point, but do worry about my poor pancreas if I should go off it. I think if I could get to a "normal" weight, I'd perhaps be able to control things for awhile without it. That being said, i'll do whatever it takes to make sure I suffer as little complications as I can.

I also feel that in the future there will be even more things to help diabetics (esp. since the #'s are on the rise) and there will be something for us even if we can't be sure the metformin will help indefinitely.

I think so much of it is up to the individual. Most of the diabetics i've been around have started on metformin and then went on to other medications, in part because they didn't stick to their diet and metformin alone is harder to help keep levels low if you don't stick to a rigorous diet and exercise program. Sometimes I wonder how long I can keep it up myself...when I look at the age I am now (42) and think...can I DO this 35 more years...but really what choice do I have.

[orpy]

This discussion brings to mind my own ongoing question:

How many years do you let pass with less than ideal numbers? Since diagnosis, I've tried exercise and diet, then drugs...the last time that I had an acceptable A1C (6.2) was 2 years ago. Currently, it's 6.6 yet after reading Bernstein's book, I realize that I'm nowhere close to having a normal A1C. My physician and endo seem to be okay with this so far. I'm feeling like I'd like to get closer to an acceptable BS.

So, my question is: should I start demanding more meds? Should I wait while they futz around with my meds or should I just demand insulin? I may have asked this before but I'm still befuddled. (I'm a perfect weight and medium active). I eat as low carb as can be.

[princesslinda]

Orpy:
I wonder the same thing....my A1c was 6.2 and the doc was thrilled...I was too until I read the optimal levels in the Bernstein book...not sure WHAT i'll have to do to get those levels. Unfortunately, i'm quite overweight, so maybe losing weight would make me less insulin resistent and that in turn might lower me more.

I can't imagine eating much less than I do now myself. Have you seen an endo? I wonder if they push for lower levels than regular docs? Also, my regular doc said anything under 7 is good control, yet from what I read here, in the 5's should be where we all are. It can get discouraging can't it?

[orpy]

dear wiseguy

I can not tell you what to do in your particular situation, since I do not know all the facts and even if I did, how you control diabetes is mostly a personal decision.

My decision has been to go without drugs.
but that is my personal decision.
of course I have to work a little harder than other diabetics to keep myself under control, but I feel comfortable with my decision.

I have a philosophical bias against drugs, besides the fact that I do not want to deal with the side effects.

Bibleteacher,

What is your secret if you don't mind me asking? How does a diabetic achieve an A1C such as you have without meds? I'd love to know...

[lewsterr]

My father had Type 2, and eventually had to go on insulin. Over time, he developed neuropathy in both legs (had no feeling below the knees....try walking when you can't feel the floor beneath you) and, because of the diabetes, became blind immediately after starting chemotherapy. Although he took great care in trying to control his BG through meds, diet, and exercise, the disease eventually took its toll. He died 5 years ago. I have learned from my father that you don't play around with diabetes. Take the meds and test regularly. The thought of living with a neuropathy like he had and blindness is frightening.

[orpy]

dear wiseguy

I can not tell you what to do in your particular situation, since I do not know all the facts and even if I did, how you control diabetes is mostly a personal decision.

My decision has been to go without drugs.
but that is my personal decision.
of course I have to work a little harder than other diabetics to keep myself under control, but I feel comfortable with my decision.

I have a philosophical bias against drugs, besides the fact that I do not want to deal with the side effects.

Bibleteacher,

What is your secret if you don't mind me asking? How does a diabetic achieve an A1C such as you have without meds? I'd love to know...

Bibleteacher,

I did go back and saw some of your previous posts so I have an idea of how you did it...so I guess this has been addressed previously.

Orpy:
I wonder the same thing....my A1c was 6.2 and the doc was thrilled...I was too until I read the optimal levels in the Bernstein book...not sure WHAT i'll have to do to get those levels. Unfortunately, i'm quite overweight, so maybe losing weight would make me less insulin resistent and that in turn might lower me more.

I can't imagine eating much less than I do now myself. Have you seen an endo? I wonder if they push for lower levels than regular docs? Also, my regular doc said anything under 7 is good control, yet from what I read here, in the 5's should be where we all are. It can get discouraging can't it?

Yes, it's confusing and discouraging. I DO see an endo (or let's say, his nurse practitioner). I don't believe I can eat a whole lot less than I do. It was funny, when I DID achieve the 6.2, they got upset because they said I was starving myself (they actually tried referring me to an eating-disorder therapist)! Now, I'm back to an acceptable weight, yet now my numbers are less controlled. I have to admit that reading Bernstein's book made me very dissatisfied with my A1C...Anyway, hang in there.

[princesslinda]

Lew:
Sounds like you and I have both seen more than we ever wanted to as far as diabetic complications...my mom had an amputation, severe retinopathy and eventually renal failure. Like you, I, too, will do whatever it takes to avoid this. I really hope that the researchers keep coming up with medications to take the place of others we may become immune to.

[lewsterr]

Linda,

I suppose you have to see the horrible toll it takes in a loved one to realize the seriousness and importance of taking every precaution possible. Your mom endured more than her fair share of complications.

I'm beginning to wonder if, in these classes they offer for diabetes, they should show movies interviewing people with complications from diabetes...basically using scare tactics. Most people who are newly diagnosed probably don't realize the seriousness of the disease. What may seem like nothing more than a game of keeping the BG within range can lead to life threatening complications. Needless to say, I don't have to tell you about that.

[princesslinda]

Hey Lew:
You make a good point...though think if everyone saw only the complications at first, it would be much easier to just "throw in the towel" and feel that trying for control is futile. I think what's helped me the most is seeing all the folks on this forum who are living their lives as normally as possible with diabetes and are NOT having lots of horrible complications. This forum has made diabetes more tolerable for me. I was so seriously depressed, I wasn't sure I even wanted to keep going right after my diagnosis...I still have those days, but this place has given me hope.

My mom brought her complications on by living for 20 years as if she didn't have diabetes, eating what she wanted, when she wanted. She always said she' d rather have quality over quantity....and she didn't really have much of either. I want BOTH!

[lewsterr]

Linda, I agree. You are sooooo right!