metformin for seniors over 70?

Sherlock · #1 (**permalink**) 11-10-2009, 05:36 AM

My dad is 82 and has had Type 2 for about 10 years. His blood sugar is all over the place and doesn't seem to relate to anything he eats or doesn't eat.

He was put on metformin for about a month and his blood sugar was great.

Then his doc took him off it and said people over 70 shouldn't take metformin. His blood sugar is again very high no matter what he eats or doesn't eat.

His doc is a geriatric "specialist" at the VA (it's free for him there) and he refuses to go see my endocrinologist. There's just no talking him into anything and he won't listen to me (and I have very well controlled Type 2 so it's not like I don't know what I'm talking about). Even my endo listens to me when I tell her about some new study I read. The only thing that ticks me off is that she thinks 180 after one hour and 140 after two hours is "tight control" (I go for way less than 140 after one hour and under 110 after two hours).

His doc tells him to test BS before eating and no other time. Sometimes before meals it's as high as 200. His doc is not concerned. I think his doc is guilty of malpractice and if not that, then certainly ignorance and negiligence.

Why can't people over 70 take metformin? It worked so well for my dad (and works great for me too).

Thanks in advance for any help .

dbaratta · #2 (**permalink**) 11-10-2009, 05:44 AM

[quote=Sherlock;

His doc tells him to test BS before eating and no other time. Sometimes before meals it's as high as 200. His doc is not concerned. I think his doc is guilty of malpractice and if not that, then certainly ignorance and negiligence.

Why can't people over 70 take metformin? It worked so well for my dad (and works great for me too).

Thanks in advance for any help .[/QUOTE]

My question to your doc is why did he put him on in the first place if he didn't want him to take it. ugh! Met can be hard on the kidneys after time. Maybe he thinks your dad is at risk.

Cormac_Doyle · #3 (**permalink**) 11-10-2009, 06:00 AM

Very often, Physicians (particularly non-endocrinologist phyisicians) working with elderly patients will not aim for very tight control.

(Note that i do not agree with the assessment below)
This is for several stated reasons, but most generically as:

Patient's overall "quality of life" is better served by allowing a freer/more relaxed diet and activity regimen with a minimally intrusive medical regimen

To break this down further:

1. The patient will probably be less Hypo-aware; thus it is dangerous to aim for tight control.

2. 1 or two finger-prick tests per day is more than adequate for a T2 diabetic: the main aim is to avoid hypo's. Compliance in any group of patients is low. Geriatric patients are notorious for having poor compliance (due to them forgetting, or deliberately refusing medications/treatments). T2 diabetics are also similarly slandered. Add the two together, and many doctors are happy with 1 or 2 finger prick tests a week ...

3. Tight control is unnecessary, as avoiding "long term" side effects is not important (worrying about possible nephrotoxicity or neurological damage in 3-4 years is not important if the patient's statistical mortality/morbidity variance falls within this timeframe). This is what happens when accountants control the doctors ...

Finally

4. General Practicioners are not specialists in Diabetes care, and may not understand the full implications of poor control, or may be working from an outdated definition of poor control.

jambo101 · #4 (**permalink**) 11-10-2009, 07:17 AM

My Dad is 85 and is on Metformin,Glyburide and Lantus,his BS is right on and he's happy and healthy.
If the doctor told my Dad to drop the meds he'd be looking for a second opinion real fast.

gettingby · #5 (**permalink**) 11-10-2009, 07:28 AM

I knew a gentleman on here that was on Lantus, Met, and Glypizide and he had wonderful numbers and A1C's. He was in his late 60's.

As long as they keep a watch on his kidneys, I don't see what the problem is.

bebe38 · #6 (**permalink**) 11-10-2009, 08:00 AM

My brother-in-laws Dad was on metformin and he lived into his late 90s.

bebe38 · #7 (**permalink**) 11-10-2009, 08:19 AM

Sherlock, my Daddy used the VA for all of his doctors/hospital stays. I see that you are in Richmond VA, so I looked up the VA hospital there; they do have an Diabetes care unit there. You don't have to keep seeing the same doctor once you are enrolled Daddy used a few different departments and his main doctor always got the reports from all of the other doctors. I don't know if anything has changed or not Daddy's been gone for 2 years now; but you didn't have to have a referral from your main doctor to make an appointment with another department.

Here's the link for the listing of departments and the phone numbers to make appointments.
http://http://www.richmond.va.gov/pa...pointments.asp

I hope that this will help some. Oh and you don't have to use your local VA either, Daddy had a friend who didn't like the one near him so he came down to the one in Durham NC for his monthly treatments.

Beth.