beta cell protection

yannah · #1 (**permalink**) 02-27-2009, 02:57 PM

here is my question-

my doctor, if my next ac is what he plans it to be wants to take me off metformin. okay, well, I don't know if it will be cuz when I had the undiagnosed UTI, for weeks, my numbers were slightly higher. but anyway. I am not that excited about being diet controlled. here is what I think. I think metformin protects beta cell function. am I right? I have done a little reading on this, and that is what I concluded.

so why would I want to be diet controlled? I don't think I do.

also, in my reading, it turns out, it seems that the actos I used to take is really good at beta cell protection.

anyway, what do we think about preserving beta cells?

then again, why do we even care about AC1? In all the reading I have been doing that number is not a good indicator of much. It is post meal numbers that matter. is that true?

I mean, if it is true, than I am good because my post meal numbers rock, it is the fasting I wish was lower, usually around 100-105 or so.

so i was thinking.....

foxl · #2 (**permalink**) 02-27-2009, 03:28 PM

[quote=yannah;424792]here is my question-

so why would I want to be diet controlled? I don't think I do.

also, in my reading, it turns out, it seems that the actos I used to take is really good at beta cell protection.

anyway, what do we think about preserving beta cells?

QUOTE]

Well ... I thought the thing about actos (which I also am on) was shot down, recently?

Personally, I would rather stay on metformin for another reason, myself ... it has done GREAT things to my appetite!

BlueSky · #3 (**permalink**) 02-27-2009, 03:28 PM

Quote:

Originally Posted by yannah

... why do we even care about AC1? In all the reading I have been doing that number is not a good indicator of much. It is post meal numbers that matter. is that true? .....

The HBA1c is not a good diagnostic tool for diabetes. Fasting and post prandial readings will pick up diabetes before the HBA1c gets into the diabetic range (greater than 6%). But once you have got diabetes, the HBA1c becomes a key indicator of your risk of complications. So it is very important to keep this number as low as possible.

To illustrate this point, look at the graph below. It relates HBA1c to retinopathy risk. As you can see, risk rises steeply as HBA1c goes up.

RayDS · #4 (**permalink**) 03-02-2009, 09:27 AM

You have some very good points. There has been studies that indicate that the med's you are taking preserve beta cells. I can't give you anymore data than that....good luck

BlueSky · #5 (**permalink**) 03-02-2009, 12:43 PM

Quote:

Originally Posted by RayDS

You have some very good points. There has been studies that indicate that the med's you are taking preserve beta cells. I can't give you anymore data than that....good luck

Actos supposedly protects beta cells because it is an insulin sensitizer. Increasing insulin sensitivity reduces the amount of insulin required to achieve normal blood sugar levels. This reduces stress on the beta cells and prolongs their life. Metformin is believed to have a similar effect, mainly through the reduction of hepatic glucose (liver dumps). But I don't think this has been demonstrated in any studies.

The same insulin senisitzing effects can be achieved by reducing carb consumption and getting lots of exercise. The drugs (Actos in particular) also have some nasty side effects. So it it is best to avoid them if possible.

yannah · #6 (**permalink**) 03-02-2009, 01:21 PM

mmm, interesting thoughts blue sky. I was happy to cut the actos and saw no change in my numbers.

AnneInNY · #7 (**permalink**) 03-16-2009, 07:02 AM

Well, I'm new at this but I can tell you the Actos made me hungry as a horse after a 20 mile run. I couldn't stop eating. I did however stop the Actos. I think I'm going to ask the MD for Metformin, as it SEEMS to have fewer side effects, mostly limited to diarrhea surprises but the Actos seems to have WORSE side effects such as turning your cells all to fat to absorb the glucose.

I'm still new at this so take my opinions with a very small grain of salt.

Ategeler · #8 (**permalink**) 03-16-2009, 07:37 AM

I didn't realize this is how it worked. Good to know. The oral meds sometimes confuse me.

rotcoddam · #9 (**permalink**) 03-16-2009, 09:01 AM

A few thoughts:
The a1c is a really good predictor of complications as it gets higher and higher. As it comes down towards normal, the risk of complications gets lower and lower, but a larger and larger percentage of that lower and lower risk becomes explained by wider fluctuations in glucose - i.e., higher peaks after eating.

Bets cell protection is (I think) more of a hypothesis than an established fact - but I might be wrong. The two meds best shown to prevent long term complications of diabetes are metformin and insulin, and when possible those are the only two I prescribe. But lots of people just don't want to start insulin.
As pointed out by someone else, losing weight, especially by cutting carbs, takes a huge load off the pancreas, and may (or may not) help as much as anything to preserve beta cell function. That high fasting glucose is a really tough nut to crack, and it may only come down with significant weight loss or with a night time dose of a medium-acting insulin.

I guess all this may not have helped much...

Dr. J

Quote:

Originally Posted by yannah

here is my question-

my doctor, if my next ac is what he plans it to be wants to take me off metformin. okay, well, I don't know if it will be cuz when I had the undiagnosed UTI, for weeks, my numbers were slightly higher. but anyway. I am not that excited about being diet controlled. here is what I think. I think metformin protects beta cell function. am I right? I have done a little reading on this, and that is what I concluded.

so why would I want to be diet controlled? I don't think I do.

also, in my reading, it turns out, it seems that the actos I used to take is really good at beta cell protection.

anyway, what do we think about preserving beta cells?

then again, why do we even care about AC1? In all the reading I have been doing that number is not a good indicator of much. It is post meal numbers that matter. is that true?

I mean, if it is true, than I am good because my post meal numbers rock, it is the fasting I wish was lower, usually around 100-105 or so.

so i was thinking.....

sumi · #10 (**permalink**) 03-16-2009, 10:05 AM

Yannah,
I'm with you. My doctor also mentioned possibly lowering or stopping my metformin next time as my a1c went from 10.9 to 7.6 in my first two months. So I assume that in May it should be down to 6 or lower. I too am eating about 50 g carbs a day. I've been thinking about this a lot and with my high fasting numbers (110-125), feel more comfortable staying on metformin. Who knows, if a cure is found, our remaining beta cells may be very important. P.S. I wish I could say that the weight was dropping off me- drooping a little maybe, but not dropping.