Metformin adjunctuve therapy with insulin for T1

[MarkMunday]

I have for some time been keen to try using Metformin to reduce the production of glucose by the liver. I suspect that this is happening big time and have been looking for a way to deal with it.

I discussed this with the endo on my annual check-up yesterday. He doesn't think it will work. But, after some discussion, he agreed to try it out anyway. I did a google search on it and found evidence that Metformin has been used successfully with T1s. Here is a link :

http://www.attract.wales.nhs.uk/question_answers.cfm?question_id=1415

I started taking Metformin yesterday. And I expect it to take a while to make a difference. I will post my feedback. And I am interested in any opinions you may have on this.

Cheers,

Mark

[jen_slc]

I think I remember this coming up when we were discussing morning and exercise-induced liver dumps leading to high BG. Definitely keep us posted, I'd really like to know if it has an effect. :top: I'm having to take more and more insulin to cover a 9 gram piece of bread in the morning (1, 2, 3, 4 units), and sometimes then I still spike. And just last night I went from 110 to 270 after the gym. Felt like dying. There's got to be something that can control this!

[am1977]

I agree :dito:...it sounds like an interesting concept :hmmmm: Please let us know how things progress :top:

[bel4_20]

Well?... Type 1 here and i was put on 1500mg a day of it and so far I can say it works pretty good....prefect?..no but it works well during the day, now overnight when i'm not taking it my readings do sore the good ol' morning liver dump.

[gettingby]

This does sound like a pretty interesting concept. Please keep us updated, Mark.

[sydneya]

I am not Type 1, but I still read the type I posting. The reason is there is sooooo much info here. Mark is one of the several people that is an inspiration to me because he does a good job taking control of his disease. He doesn't leave it all to the doctor, which I believe is the way to go. Know your own body and go with it.
It'll be interesting to here more post on this from you, Mark.

[dbc]

I've been on Metformin for the past 6 months and yes, it does work.

But my case may be a bit misleading - I'm T1, LADA, diagnosed 18months ago when my A1c was only 7.5, and I've been in the honeymoon phase since, still not on insulin yet as I still have some beta cell insulin capacity. I've been pretty careful to avoid overloading the pancreas by sticking to a low carb diet.

Two months ago the endo increased the metformin to 2x1000mg daily, and my fasting bs came down to around 5.6 - 6.1. Unfortunately I showed all the side-effects in the book (nausea, diarrhoea, metallic taste in the mouth), after sticking it out for a month with no improvement, I've had to drop back to 2x500mg daily. Fasting bs are edging up to 7.0 - 7.5 again. Maybe the honeymoon is coming to and end.....

Next checkup is January, will let you know what transpires.

Dave

[Peter Lee]

I've been on Metformin for the past 6 months and yes, it does work.

Two months ago the endo increased the metformin to 2x1000mg daily, and my fasting bs came down to around 5.6 - 6.1. Unfortunately I showed all the side-effects in the book (nausea, diarrhoea, metallic taste in the mouth), after sticking it out for a month with no improvement, I've had to drop back to 2x500mg daily. Fasting bs are edging up to 7.0 - 7.5 again. Maybe the honeymoon is coming to and end.....

Dave
I had the same experience with Metformin and found that I had to put up with some pretty bad side effects for about four months before they started to subside. Now I have no side effects except sometimes bad gas.

[MarkMunday]

I've been on Metformin for the past 6 months and yes, it does work.

But my case may be a bit misleading - I'm T1, LADA, diagnosed 18months ago when my A1c was only 7.5, and I've been in the honeymoon phase since, still not on insulin yet as I still have some beta cell insulin capacity. I've been pretty careful to avoid overloading the pancreas by sticking to a low carb diet.

Two months ago the endo increased the metformin to 2x1000mg daily, and my fasting bs came down to around 5.6 - 6.1. Unfortunately I showed all the side-effects in the book (nausea, diarrhoea, metallic taste in the mouth), after sticking it out for a month with no improvement, I've had to drop back to 2x500mg daily. Fasting bs are edging up to 7.0 - 7.5 again. Maybe the honeymoon is coming to and end.....

Next checkup is January, will let you know what transpires.

Dave
Dave,

Thats interesting. I am trying to establish if there are people who aren't insulin resistant but respond to Metformin. And it sounds like you could be on of them. After you started taking Metformin, how long did it take to see a difference?

Any reason why you aren't using insulin in conjunction with the Metformin? It would improve your control and prolong the life of those remaining bete cells.

Cheers,

Mark

[dbc]

Dave,

Thats interesting. I am trying to establish if there are people who aren't insulin resistant but respond to Metformin. And it sounds like you could be on of them. After you started taking Metformin, how long did it take to see a difference?

Any reason why you aren't using insulin in conjunction with the Metformin? It would improve your control and prolong the life of those remaining bete cells.

Cheers,

Mark


I'm pretty sure I'm not insulin resistant - my understanding is insulin resistance is associated with overweight? - but then, has any research been done on this aspect of T1 diabetes?.... At diagnosis I was just inside the upper level of BMI. Since changing my eating habits to low carbing I lost about 12kg in 8 months or so, have since picked up about 2Kg and seem to have stabilised there. So I'm not overweight.

My fasting levels dropped within 2-3 weeks of starting on the pills - initially I was 2x500mg daily. After three months on metformin my A1c dropped from 6.5 to 6.0. Another three months and the A1c had crept back up to 6.4, presumably due to slow progression of LADA, so the metformin dose was upped to 2 x 1000mg daily. I saw and immediate drop in my fasting bs levels, from around 6.5 to around 5.6 - 6.0, but I battled with the side effects and gave up after a month, went back to 2x500mg daily.

WHy am I not on insulin yet? This is an issue I discuss with the Dr every time I see him. He's reasoning goes as follows:
1. My A1c is still reasonable, and I'm not on any medication that boosts insulin production, (therefore I'm can't be having excessive highs and lows which could still give a reasonable A1c average)
2. It follows that my highs can't be too excessive.
3. If the highs are not excessive, he's concerned about insulin therapy resulting in hypo episodes.

From everything I've read, I am keen to start insulin sooner rather than later - the Dr is being conservative, I guess. I'm going to push this issue hard again in January, especially since I reacted so badly to the higher metformin dose (although, from Peter's post above, maybe I wimped out too soon! but it was not pleasant!!)

cheers
Dave