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#1
kultastar

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I was recently diagnosed as Type 2 diabetic. I'm not doing very well. I just started the Metformin. I take 250mg BID since that's all I can tolerate at the present time. I took my sugars/glucometer at 4am and it was 15.6. I'm concerned cause I'm not feel all that great. I can't up my med at this moment so I was wondering what is the benefit of taking insulin versus the Metformin? Are there any benefits if any? Or do I just need to give this more time? I don't want to unnecessarily go to the emergency to just be told there's nothing they can do and for me to give it more time. Help please. :(

#2
patricia52

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Insulin works. It can get you to a good level while you inprove your control. I would discuss the option with my doctor. Used incorrectly insulin can be deadly.
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#3
jwags

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Metformin and Insulin work totally differently. Metformin works in the liver to control glycogen conversion into glucose. This happens when we are not eating. Insuilin is taken at meals to cover the carbs you eat or long acting once or twice a day to control your basal insulin. I have to take 2550 mg of metformin to get decent bgs. If you can't take it, then insulin is your best option.
HbA1c 5.3 3/11 , HbA1c 5/12 6.1
metformin 2550 mg
Moderate carb diet 40-75 carbs a day
3 T of Coconut Oil daily

Vit D, CoQ10, Melatonin, Multi vitamin, zinc, B 12
Chia Seeds , Flaxseeds

Exercise- Tennis - 2 hours/week, Power Walking- 2 miles most days, Hiking in the summer on trails and in the mountains

diagnosed Feb 2007
Age 64

#4
art

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as you ease into the full dose of metformin use insulin for control.

The two together work quite well.
In time you may be able to drop the insulin.

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#5
Hooterville

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You may be able to get by on a once (or split twice) per day basal insulin while you work on tolerating the Metformin and increasing the dose, assuming you will be able to tolerate and increase it over time.

With a basal insulin, you start out on a low dose and wait about 4 days and see how your morning fasting number responds. If you are still too high, you raise the dose by a very small amount. An amount that your doctor will advise you on. You follow this pattern of raising and waiting about 4 days (or whatever schedule your doctor gives you).

For instance. I started on 8 units at bedtime and raised by 2 units every 4 days until I arrived at good morning fasting numbers. Work with your doctor. Raising slowly and by small numbers will prevent you from going low. It takes patience though. It can take a few days to see the effects of a change in basal.

A1c's: 1/11 9.4 ~ 3/11 7.9 ~ 6/11 7.8 ~ 7/11 7.6 ~ 10/11 7.5 ~ 12/11 6.4 ~ 3/12 5.9 ~ 6/12 5.4 ~ 9/12 5.4 ~ 12/12 5.3 ~ 3/13 5.1 ~ 8/13 5.5 ~ 10/13 5.4
Meds: 30 units Lantus - 2,550 mg Metformin
Diet: LCHF ketogenic, 30 to 40 carbs, dabbling in Paleo
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#6
ramon

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I was recently diagnosed as Type 2 diabetic. I'm not doing very well. I just started the Metformin. I take 250mg BID since that's all I can tolerate at the present time. I took my sugars/glucometer at 4am and it was 15.6. I'm concerned cause I'm not feel all that great. I can't up my med at this moment so I was wondering what is the benefit of taking insulin versus the Metformin? Are there any benefits if any? Or do I just need to give this more time? I don't want to unnecessarily go to the emergency to just be told there's nothing they can do and for me to give it more time. Help please. :(


Hello and welcome to the place that can really help you. The worst thing you do is freak out at this critical stage of your life. There is a sensible and safe way to handle this situation one step at a time. How long have you been on met, are you overweight and do you plan to diet? Together we can work it out step by step if you choose to do so. Good luck and whatever you decide make sure you handle this.

#7
Harold

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Metformin may take a couple of weeks before it helps much in the way of control. Until then you will need to eat mostly protein or green leafy veggies or squash type foods. Stay away from grains and tubers or other starchy type foods. Use your meter to see how you react to different foods and stick to those that do not or raise your bg only a little. Adding insulin would help you in the beginning, but it also increases the risk of hypoglycemia and when your glucose level comes down your going to get a taste of that and not like it. However as your body adjusts to the lower normal levels you will feel better than you have on a long time. Sort of like a youth boost in some cases.

#8
Nightstar

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I was recently diagnosed as Type 2 diabetic. I'm not doing very well. I just started the Metformin. I take 250mg BID since that's all I can tolerate at the present time. I took my sugars/glucometer at 4am and it was 15.6. I'm concerned cause I'm not feel all that great. I can't up my med at this moment so I was wondering what is the benefit of taking insulin versus the Metformin? Are there any benefits if any? Or do I just need to give this more time? I don't want to unnecessarily go to the emergency to just be told there's nothing they can do and for me to give it more time. Help please. :(


well, if you do not want your liver stay healthy then take Metformin. If you wish to deal with diabetes and do the best way then start insulin, Levemin is very good. Low dose then increase it till you will take your sugar level under control. Metformin never will lead you to control sugar level. Metformin is good for those who does not have abnormally high level of sugar. They can take Metformin , low carb, or Green Tea, all is good for them. For Diabetics it does not work. You have to control sugar level, and it is possible only with insulin.

Insulin is not deadly. But after Metformin and Glipizide therapy you will need very high dose of insulin. So, then early you start insulin then better and faster you will be able to take control over sugar, learn new skills, and be very good. I do take 245 units, 200 Levemir two shots daily, and Novolog, 15 units 3 times daily. Now I stopped to take Novolog, first week, will see how it works. As you see I am alive, and right now I am back from weekend. I took hike to the Mt.Thouch-me-not, Catskills. Without insulin I really would be death.

The choice is yours.

#9
Harold

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well, if you do not want your liver stay healthy then take Metformin. If you wish to deal with diabetes and do the best way then start insulin, Levemin is very good. Low dose then increase it till you will take your sugar level under control. Metformin never will lead you to control sugar level. Metformin is good for those who does not have abnormally high level of sugar. They can take Metformin , low carb, or Green Tea, all is good for them. For Diabetics it does not work. You have to control sugar level, and it is possible only with insulin.

Insulin is not deadly. But after Metformin and Glipizide therapy you will need very high dose of insulin. So, then early you start insulin then better and faster you will be able to take control over sugar, learn new skills, and be very good. I do take 245 units, 200 Levemir two shots daily, and Novolog, 15 units 3 times daily. Now I stopped to take Novolog, first week, will see how it works. As you see I am alive, and right now I am back from weekend. I took hike to the Mt.Thouch-me-not, Catskills. Without insulin I really would be death.

The choice is yours.

Think many of us would like to see something to back up these claims. Now if they are your opinions from experience say so. Otherwise please give us some sources. Stating opinions as fact is not fair to those new to this. Stating something as your opinion for an alternate approach when others are having problems with standard treatment is okay.

#10
jims_forum

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Think many of us would like to see something to back up these claims. Now if they are your opinions from experience say so. Otherwise please give us some sources. Stating opinions as fact is not fair to those new to this. Stating something as your opinion for an alternate approach when others are having problems with standard treatment is okay.


Harold - I protest these comments as inaccurate and misleading.

Metformin and Insulin have two different roles. I am unaware of any science saying metformin is bad like in the case of avandia/actos where I have seen personnel issues and got off that stuff. Metformin has been the safest of the diabetic drugs ever released.

Metformin is not metabolized at all and leaves as it came in same form. Metformin helps reducing leaky liver excess glucose release adn does this at source. It does not do what Insulin does and that is a hormone signal to the receptors in all the muscle and fat cells that have room to uptake more glucose.

Watching my cgms I used to find my liver was always overflooding my body with glucose causing max insulin resistance and overloading my fat/muscle cells with excess glucose. The metformin stopped that. On my liver extra insulin had no impact nor stop the excess liver glucose release from the storage buffer.

The human body is a complex of multi organs and multi hormones and insulin as a glucose transfer hormone that has varying impacts on all the organs from kidneys, thyroid, stomach, intestines, liver etc.

Metformin will not control excess glucose from the digestion process and that is role of insulin. The beauty of Metformin is that it stops excess glucose at source - the liver when it is supposed not to be releasing excess glucose. The glucose that the metformin stops prevents having to add extra insulin to get it absorbed off by the muscle and fat cells.
James (Jim) W. Snell
30+ years as type 2 diabetic
40 years as Digital Microprocessor System designer
Stroke in 2007 and retired.
Metformin, Humalog Lispro, 1200 calorie Diet and 1.5 to 2 miles walking exercise A1C = 6.4
http://db2jimcaresta.com

#11
ramon

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I was recently diagnosed as Type 2 diabetic. I'm not doing very well. I just started the Metformin. I take 250mg BID since that's all I can tolerate at the present time. I took my sugars/glucometer at 4am and it was 15.6. I'm concerned cause I'm not feel all that great. I can't up my med at this moment so I was wondering what is the benefit of taking insulin versus the Metformin? Are there any benefits if any? Or do I just need to give this more time? I don't want to unnecessarily go to the emergency to just be told there's nothing they can do and for me to give it more time. Help please. :(

I would give the metformin a chance to settle down in your body and even increase the dosage if you can handle it. If you could give us more info such as weight, ht, and diet we might be able to help you better. If you can control this disease with diet, exercise and the help of metformin that would be the way to go. Now this is just my opinion. It takes work and a little time to get on the right track. If you are not satisfied with the results of metformin with diet and moderate exercise then you should very carefully introduce insulin because it can be very deadly. If you do decide to go with the insulin I hope you have someone living with you and they too are educated in its use. Take them to the doctor with you and write down questions before hand and the answers as well cause this thing can be a mind blower and we tend to forget instructions. One step at a time and you will be in control and soon you will have the utmost confidence, its not that hard really.

Please let us know what you decide and we can walk through this together and others will learn from you.

Surviving Diabetes and Cancer Survivor.

WALK SOFTLY AND DRINK LOTS OF ICE TEA

https://www.facebook...ray.barton.9400


#12
jims_forum

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I would give the metformin a chance to settle down in your body and even increase the dosage if you can handle it. If you could give us more info such as weight, ht, and diet we might be able to help you better. If you can control this disease with diet, exercise and the help of metformin that would be the way to go. Now this is just my opinion. It takes work and a little time to get on the right track. If you are not satisfied with the results of metformin with diet and moderate exercise then you should very carefully introduce insulin because it can be very deadly. If you do decide to go with the insulin I hope you have someone living with you and they too are educated in its use. Take them to the doctor with you and write down questions before hand and the answers as well cause this thing can be a mind blower and we tend to forget instructions. One step at a time and you will be in control and soon you will have the utmost confidence, its not that hard really.

Please let us know what you decide and we can walk through this together and others will learn from you.


On my body 250 mg is useless and waste of drugs. As long as my dose is a solid 500mg, the liver pays attention when dose of standard met is up to strength in blood. some may need larger dose.
James (Jim) W. Snell
30+ years as type 2 diabetic
40 years as Digital Microprocessor System designer
Stroke in 2007 and retired.
Metformin, Humalog Lispro, 1200 calorie Diet and 1.5 to 2 miles walking exercise A1C = 6.4
http://db2jimcaresta.com

#13
ramon

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James,
Most of the time the docs will give you a 250mg dose but 2x a day to start. Once in the evening and once in the morning. They adjust accordingly. I'm asking your this question because reading from your website this seems to be right up your alley. My A1c runs around 5.4 so I seem and feel I've got this. I'm doing the low carb thing and as of yesterday I've lost 90lbs and would really like to lose another
100lbs by this time next year. I'm told that humulin R adds weight the more units you use. So what I'm thinking is if I drop the humulin for emergency uses only and start on the metformin can this help me and would it be safe or worth the try.

I will keep on taking the basal levemir but I think or should say hope I can let go of the bolus. Any opinion from you or others would be greatly appreciated.

Thanx in advance, Ray.

Surviving Diabetes and Cancer Survivor.

WALK SOFTLY AND DRINK LOTS OF ICE TEA

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#14
Harold

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Harold - I protest these comments as inaccurate and misleading.

Metformin and Insulin have two different roles. I am unaware of any science saying metformin is bad like in the case of avandia/actos where I have seen personnel issues and got off that stuff. Metformin has been the safest of the diabetic drugs ever released.

Metformin is not metabolized at all and leaves as it came in same form. Metformin helps reducing leaky liver excess glucose release adn does this at source. It does not do what Insulin does and that is a hormone signal to the receptors in all the muscle and fat cells that have room to uptake more glucose.

Watching my cgms I used to find my liver was always overflooding my body with glucose causing max insulin resistance and overloading my fat/muscle cells with excess glucose. The metformin stopped that. On my liver extra insulin had no impact nor stop the excess liver glucose release from the storage buffer.

The human body is a complex of multi organs and multi hormones and insulin as a glucose transfer hormone that has varying impacts on all the organs from kidneys, thyroid, stomach, intestines, liver etc.

Metformin will not control excess glucose from the digestion process and that is role of insulin. The beauty of Metformin is that it stops excess glucose at source - the liver when it is supposed not to be releasing excess glucose. The glucose that the metformin stops prevents having to add extra insulin to get it absorbed off by the muscle and fat cells.


Would you feel/protest the same way if it was Avandia vs. Insulin in Nightstar's post? We have had opposite experiences. I took Avandia for 10 to 11 years and it worked great for me. Took metformin for a year, 500 mg/day, and it tore up my lower intestines. BTW metformin must be metabolized in some form by the body or it would have no affect on glucose levels. Funny thing is both Metformin and Avandia increase insulin sensitivity and inhibit the livers release of glucose, however the active mechanisms are different. Which is why people react differently to them and why medicine is an experiment.

#15
jims_forum

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Harold:
Interesting feedback.

Metformin is not metabolized and signals the liver directly when in the blood system. I hear you about the negative effects for you mention.
Fortunately that is not one of my issues.

Actos was at one point the only thing cramming down my glucose levels but kidneys started down hill and kidney doctor said get off the actos.
Finally got numbers under control and got off actos and kidneys stabalized.

Best wishes and thanx for sharing and commenting.
James (Jim) W. Snell
30+ years as type 2 diabetic
40 years as Digital Microprocessor System designer
Stroke in 2007 and retired.
Metformin, Humalog Lispro, 1200 calorie Diet and 1.5 to 2 miles walking exercise A1C = 6.4
http://db2jimcaresta.com

#16
Lloyd

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well, if you do not want your liver stay healthy then take Metformin.


That has not been my experience. I've taken 850 x 3 (the max dosage) for 18 years, my liver is fine. I've also been on insulin for 7 years.

Taking both and limiting my carbohydrates to 80 a day has worked well for me.

-Lloyd

2014 A1c 5.4 5.6   2013 5.3 4.9 5.2 5.2
2012 5.3 5.2 5.1 5.0
2011 5.0 5.0 5.2 5.0 2010 5.3 5.3 5.3 5.4 5.4
2009 5.4 5.4 5.3 5.2 2008 5.0 5.1 5.2 4.9 4.9
2007 5.3 5.5 5.7<---Pump 6.9 (Mix)
2006 (Lantus) 7.8 8.5 8.7 7.1
2005 8.4 6.9 7.4 2004 6.2 5.6 6.4 6.0 (Pills)


#17
Harold

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Harold:
Interesting feedback.

Metformin is not metabolized and signals the liver directly when in the blood system. I hear you about the negative effects for you mention.
Fortunately that is not one of my issues.

Actos was at one point the only thing cramming down my glucose levels but kidneys started down hill and kidney doctor said get off the actos.
Finally got numbers under control and got off actos and kidneys stabalized.

Best wishes and thanx for sharing and commenting.

This is how weird this is. I went into the hospital early last year and up to this time I had been taking Avandia since DX. The hospital did not have avandia so they gave me Actos. They could have asked for my wife to bring my Avandia, but noooo a lawyer advised them. Well 4 days in hospital and on that day they were planning on letting me go home. Problem was my morning blood test showed my kidneys were only half functioning. So they wisely doubled my IV drip and then the next morning I was swelled up like a balloon and of course they were baffled. Refused the Actos that day, had to remind them endema was a warning sign for Actos, and my blood test showed no decrease in kidney function, but it was not better. The next day cretenine had dropped a little so they let me go home. Since I was swollen up I had to stop the Avandia and they gave me a vial of lantus to take. My doctor did not want me to resume Avandia so I have been on the Lantus since.

#18
ramon

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This is how weird this is. I went into the hospital early last year and up to this time I had been taking Avandia since DX. The hospital did not have avandia so they gave me Actos. They could have asked for my wife to bring my Avandia, but noooo a lawyer advised them. Well 4 days in hospital and on that day they were planning on letting me go home. Problem was my morning blood test showed my kidneys were only half functioning. So they wisely doubled my IV drip and then the next morning I was swelled up like a balloon and of course they were baffled. Refused the Actos that day, had to remind them endema was a warning sign for Actos, and my blood test showed no decrease in kidney function, but it was not better. The next day cretenine had dropped a little so they let me go home. Since I was swollen up I had to stop the Avandia and they gave me a vial of lantus to take. My doctor did not want me to resume Avandia so I have been on the Lantus since.


How do you like the lantus? is it working for you? Have you recorded any changes or notice any physical difference?

Surviving Diabetes and Cancer Survivor.

WALK SOFTLY AND DRINK LOTS OF ICE TEA

https://www.facebook...ray.barton.9400


#19
jerryn

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Hello Jim.
My kidneys are starting down hill... microalbumin is high. I think I have the cause linked to Byetta. microalbumin hit 1800 9 months ago. I told the Doc I bet it's the Byetta, kidney disease does not run in my family. Type 2 diabetes does but we all seem to keep it under control. Anyway I dropped beyetta 6 months later microalbumin dropped to 680, now it's 466.
I'm still scared. I'm on metformin + gliburide. I'm also an engineer. I really don't like having a photo finish running to the bathroom when I pull into the parking lot at work. Sometimes I have a meeting first thing in the morning and I'm the lead guy.
How's your kidneys now.. when you mention stabilize did they improve to normal or did it just stop getting worse ?


BTW I just turned 50 years old. glucose has been good with metformin + gliburide. averaging @ 116.




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