Metformin for pre-diabetics with good control

[Montana1]

I really don't know what to do here. I will be going on vacation for 3 months to a tropical country. I am managing my bs with diet and exercise. A1c as of yesterday 5.5
My problem is that I know I won't be having as much control there as I do at home. I am trying to jump the gun here and start Metformin ER before I go. So I am planning on being on it just for the time I am gone and continue to manage with diet and exercise when I get back. What are the pros and cons of taking this medication? I've read that it can help lower cholesterol (my cholesterol is a bit high) also that it might help reverse fatty liver which I have, loose weight and I am trying hard to loose at least 25 lbs. So pros I can see. What are the cons? I don't see many, apart from the initial side effects. Am I missing something? that will prevent me from taking this medicine?
Another question, will my body in a sense get used to metformin? so much that it will be harder for me to control with diet and exercise when going off it? Please... some words of wisdom will be appreciated.
Montana

[Ronin]

Hi Montana!

I'm a bit confused. Your A1c numbers indicate that you are capable of control, while at the same time you are saying that you "know" you will not be able to exercise control while away from home.

Any medication has it's own set of problems. For starters, you do not know how your body will react. You could wind up having serious hypoglycemic reactions, and in a foreign country, while on vacation, that can be very dangerous. The likelihood of a hypo-incident while not on medication is unlikely.

I have the feeling that you rely on external controls from friends and family to keep you on "the-straight-and-narrow" and those controls will not be available when you are away.

Do you know any of the people you will be with during the three months? If so, develop them as part of your external control system. You will need somebody to watch you closely if you start taking meds, so why not somebody to assist you while you are away?

I cannot speak to the specifics of any medication because I am not on, nor have I been on, any of them. However, my friends, who do take medications, have had some serious incidents.

Figure out what is most important to you and make sure you have a friend on the trip who will assist you regardless of the path you chose.

[xMenace]

you do not know how your body will react. You could wind up having serious hypoglycemic reactions, and in a foreign country, while on vacation, that can be very dangerous.

The chances of a hypo from met is pretty remote, and the chances of a serious one are pretty much nil. But Ronin is right on the first part. Met is known to have issues, especially for people with any cariovascular problems. You don't want anything like that. You should have a good chat with your doctor or endo about it.

It will probably give you lots of gas. Taking it the week of your trip might make the plane ride a bit uncomfortable for all ;) It can take a few weeks to build up and work fully too.

I agree that your A1C is pretty darned good. You can probably get by pretty well with no meds at all. Being a bit high for three months won't hurt much if at all. You just don't want to go over 250ish.

[Montana1]

Thanks for your imput Ronin and xmenace. Ronin, I did talk with my doctor about it and she thinks it is a good ida to be on it for that amount of time. No, I don't need family to be on "the-stright-and-narrow" If anything I would not have any control if It was up to my family their attitue is that of "it is not that bad" this food or that food won't really hurt you... here, have a piece of cake. As far as having the side effects, I have 2-3 weeks before leaving. I rather take it now rather than started there. As far a having bad reaction my doctor assured me that in the many years of her practicing medicine she has not had people with too many problems. I just wanted to know anyone else's opinion before taking it. Thank you for your responses.
Montana

[susique333]

Im recently on Metformin and there are some bowel issues in the beginning. I read the PDR on Metformin and if I recall correctly its 50% (give or take a few percent) that have gut issues initally. I still make sure when I leave the house that I have my route planned in the event there is a need for a sudden stop. It does seem to be lessening. Metformin Side Effects (http://diabetes.emedtv.com/metformin/metformin-side-effects.html)

[wiseguy]

Bottom line is that you need to learn to maintain control no matter where you are and not to depend on drugs to do it for you.

[MJB]

With an A1c of 5.5 I would be in no hurry to start taking drugs for diabetes. Just say no to the triple fudge layer cake, etc. :D

[Harold]

I know there is a huge following for the "No drugs for me" in the type 2 and pre-diabetes crowd. However in the study, that brought about the whole pre-diabetes concept, it was shown with a proper diet and exercise regime along with oral medication it was possible to reverse the onset of diabetes in a respectable percentage of the study group. BTW Diet and exercise alone did not have any where near the same results. Why anyone would pass up the opportunity while they have a chance of taking oral meds for the short term vs. taking them for life makes no sense to me. :confused:

[Montana1]

Harold,
That is the same thing I have been reading, that treatment with this trio is the most beneficial to reverse and/or delay onset of T-2 diabetes. I have second guessed all this articles, thus coming here and asking for advice or input on this. Surely I was not catching something since so many people were so against taking the oral meds. As I do more reading, I have noticed that the benefits might outweigh the drawbacks for people like my self, who are not only pre-diabetic, but with elevated cholesterol, triglycerides, fatty liver.....
Thank you Harold,
Montana

[Harold]

Montan, Your Welcomed! Been something I have been wanting to ask for a long time.

[Ronin]

Hi Harold!

Your response to the question is interesting: "...it was shown with a proper diet and exercise regime along with oral medication it was possible to reverse the onset of diabetes in a respectable percentage of the study group. BTW Diet and exercise alone did not have any where near the same results."

I was not aware that a short period of oral medication could reverse the onset of Type-2 diabetes allowing the person to stop the drugs at some time and then resume the typical modern high carbohydrate diet. Or, perhaps they really can't return to a high carb diet after all.

There is also the question of what is the appropriate drug. Looking at my profile, A1c's in the low 5% range, Fasting C-Peptide of 1.3 (low end of "normal). What oral medications should I be taking to prevent the onset of diabetes?

[Harold]

Hi Ronin,

This has been awhile since I read it, but it seems like they used metformin for the most part. Some may have used a combination of met and a sulfonrea. Think they may even had some on avandia. However it seemed that the insulin sensitizers where the effective ones.

Have no idea what the age range was or their physical condition, as in BMI, was to be considered for the study. Do remember the the summation stressing the combination of diet, exercise, and the oral meds. I would think even post the study they would have to eat properly as in not overloading the body with carbs/calories in anyone meal to avoid another onset of diabetes. I was trying to take in all of my days worth of calories in one meal and had been doing so for a couple of decades or more.

Would this help someone who's genetic time as come I have no idea. Worth a shot though if your game. Talk to your doctor and see what he thinks.