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GeorgeOttawa

Should I take metformin?

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My most recent FBG is 117, and HBA1C is 5.3%. These numbers have been with me for past 2.5 years. My doctor now asks me to take 500mg Metformin, twice a day. I don't like to take any medication. In your opinion, should I take Metformin? I learned there is a Metformin extended release (ER) version, is Metformin ER better than Metformin? Any opinions are appreciated.

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My most recent FBG is 117, and HBA1C is 5.3%. These numbers have been with me for past 2.5 years. My doctor now asks me to take 500mg Metformin, twice a day. I don't like to take any medication. In your opinion, should I take Metformin? I learned there is a Metformin extended release (ER) version, is Metformin ER better than Metformin? Any opinions are appreciated.

 

In my opinion, I don't see why you would need it.

 

I am not a doctor, but anyone, after seeing those numbers, would probably agree with me.

 

Maybe your doc is trying to pimp meds. I dunno. I can't see a doc suggesting metformin with those kinds of reasonable results over a period of time.

 

Tell him/her to get stuffed, or to explain why he/she is suggesting it.

 

Well, you can say the get stuffed part after he/she gives you a reason. :T

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Thank you, Delphinus. In my Lab report, FBG between 110 and 125 is considered as impaired fasting glucose (pre-diabetes?). My doctor wants me to get my FBG below 110. Since diet and exercise can't do that, my doctor wants me to take metformin to bring my FBG to the target.

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What is the percentage of pre-diabetes patients who take medications, few, 30%, half, 80%, or most?

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Here is my angle: How is your weight? Would you like to lose some?

 

Metformin is helpful in controlling appetite, as long as you get along with it. I LOVE it.

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My most recent FBG is 117, and HBA1C is 5.3%. These numbers have been with me for past 2.5 years. My doctor now asks me to take 500mg Metformin, twice a day. I don't like to take any medication. In your opinion, should I take Metformin? I learned there is a Metformin extended release (ER) version, is Metformin ER better than Metformin? Any opinions are appreciated.

 

Your A1C is good. Your FGB can be just a "bit" lower. That is probably why your doctor suggest Metformin. 500mg is the lowest and it is a $4 generic at most drug store. It is also one of the older drug with a long track record so you should not have to worry about it as compare to many others. Like foxl said, if you can "handle" it, go for it. I went off it after 8 years due to GI problem. It causes one too many incident. :o

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Just on the Metformin ER part, I started it 3 days ago, at the 500 mg dose. No side effects at all, but so far no BG effects either. And no reduction of appetite, I'm sorry to say. I know it takes weeks to become effective, so maybe later I'll see some of those other effects, but taken in the middle of dinner I feel fine with it.

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Thank you, FOXL and aggie168. I am 1.80m (~5'10") tall and my weight is 70kg (~154lbs), so my weight is okay, maybe I need to gain some weight. I know eventually I will have to take medications, but I want to delay this procedure as late as possible. Money is not a concern for my decision on this issue. My doctor is my family doctor, not specialist on diabetes, so I like to get some opinions from this forum.

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Thank you, Abra for your useful information. Please update your Metformin ER effects on the FBG and others later.

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Thank you, FOXL and aggie168. I am 1.80m (~5'10") tall and my weight is 70kg (~154lbs), so my weight is okay, maybe I need to gain some weight. I know eventually I will have to take medications, but I want to delay this procedure as late as possible. Money is not a concern for my decision on this issue. My doctor is my family doctor, not specialist on diabetes, so I like to get some opinions from this forum.

 

Not that there are not slim Type 2's ... but have you had a C-peptide and GAD-65 antibodies? Just in case ...

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Not that there are not slim Type 2's ... but have you had a C-peptide and GAD-65 antibodies? Just in case ...

 

No, I didn't do those tests. What do you mean "Not that there are not slim Type 2's "? You mean a slim person can't develop Type 2 diabetes?

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No, I didn't do those tests. What do you mean "Not that there are not slim Type 2's "? You mean a slim person can't develop Type 2 diabetes?

 

Oh, yes they CAN! It is just that it goes against stereotype -- including "clinical" (or eyeball) diagnosis.

 

I felt that MDs looked at me, I was obese (not very) and so they just assumed I was type 2. Well, I had pre-existing thyroid disease ... autoimmune disease ... and was diagnosed in Diabetic ketoacidosis, and I was just not so sure as they.

 

I nosed around the net, found this place and many, many articles on antibodies in adult-onset Diabetes ... so I figured out what to ask for ... it took me three MD appointments of asking, but I GOT it. Now I am on insulin in the hope of preserving my beta cells for later use!

 

This condition is not rare, either -- there are probably more people with LADA -- adult-onset autoimmune Diabetes, than there are with Type 1 of childhood.

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Metformin can cause GI problems. Metformin ER is less likely to cause those problems.

 

You can ask your doc to refer you to a specialist. Personally, i think 117 is still too high. Of course deciding to take medication is a personal choice and you shouldn't let your doc pressure you into something you're worried about.

 

If I were in your situation, and diet/exercise is not bringing my FG down, I'd be more concerned about getting diabetes which is much more worrisome to me than the effects of metformin, which is probably the safest of the diabetes drugs. Speaking only personally, I wouldn't want to get diabetes one day and then think there was something I could have done about.

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Something I haven't seen yet here is how many carbs are you taking during the day? Are you on a restricted carb diet that would allow your numbers to lower?

 

My numbers were higher than yours but after I started exercising and got my carbs in line with the ADA guidelines my fasting numbers steadily dropped eventually in to the 90's or once in a while lower.

 

I know from being around here a while that evidently their are a number of variations on the problem an some need different treatments than others.

 

Like was mentioned, many pre diabetic people here do prefer to not take drugs. I am in that category. But I have always said that if I had to do so I would. So far its not been something I have to do.

 

I am not really clear on why your numbers on the low end refuse to drop. What kind of numbers are you seeing after eating. Normally the morning number is an indicator of the carb intake during the whole day. If they are low also I am not exactly clear on the reasoning for drugs?

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Thank you Larry H., I am on low carb diet (~80g per day), and walk for 15 ~ 20 minutes after dinner everyday. My after eating numbers are good (I think), normally, < 126 afetr 1 hr, and < 110 after 2 hr.

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I'm a prediabetic with fastings between the 80's to 110. I'm in the medical world and there is so much information about prediatetics developing plaque. I am fighting getting diabetes as much as possible. I have eaten healthy and exercised regularly with little effect on my weight. I was put on Metformin long acting and lost 10 lbs in 3 weeks. I do have some nausea occasionally but can live with it. My endo asked me if I wanted to try Victoza as it can actually protect your insulin making cells in your pancreas. I trust him and started it. My fastings are now in the 70's. I have zero appetite and have to force myself to eat. It's only been a week but I'll see how it goes. George, I'd go see an endo but with your fastings I know mine would treat.

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Thank you, Almond66. After reading your and other replies here, I think I should take metformin. Probably I should go with extended release metformin instead of standard metformin. Maybe after few weeks, if my FBG is not dropping, I will go to see an endo.

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What are advantages/disadvantages of metformin ER over metformin? Thank you.

 

The main advantage seems to be that the metformin ER is less likely to upset your stomach.

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I must be missing something here. It seemed like it used to be that medication was used when other methods failed. Some of the readings you all have are way on the low end. I don't quite understand the reasoning for taking medications at that point. When my doctor originally told me I was type II or pre diabetic he also jumped right on the "lets take medication" bandwagon. I refused and wanted to see what I could do with diet and exercise. So far I am keeping my numbers 20 to 30 points lower in the fasting readings that way and my after meals while some what dependent on what I eat of course, are mostly in what many would call a reasonable level. I see an occasional 150 if I eat something that just won't work, but normally I can keep it under the 140 number which is still at least 20 to 40 points under the post meal suggestions by the ADA. I think finally they lowered it to 160. I guess I just take enough pills already and balk at taking even more, particularly ones with nasty side effects if I don't have too.

Plus there are those studies that show that diet and exercise are three times more likely to prevent the onset of complications than those who take medications. That alone stuck with my mind. If you look at early treatment suggestions by the ADA and others you will still see that report referenced. Why I don't know, but something must be beneficial in keeping one self within a tolerable limit without drugs from what that says.

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I am confused. Are there any criteria for pre-diabetes to take medications? I believe like any other medications, metformin has serious side effects other than GI problem. This is the reason that I hesitate to take any medications.

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Here is one of many sites discussing the ways in which to treat pre diabetic conditions to reduce the progress to type II. It has one section showing a 58% improvement from diet and exercise and another paragraph that shows 31% improvement with Metformin. About half as successful! I don't know why this isn't more accepted here?

 

Prediabetes Treatment and Prediabetes Prevention

 

 

Larry

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Here is one of many sites discussing the ways in which to treat pre diabetic conditions to reduce the progress to type II. It has one section showing a 58% improvement from diet and exercise and another paragraph that shows 31% improvement with Metformin. About half as successful! I don't know why this isn't more accepted here?

 

Prediabetes Treatment and Prediabetes Prevention

 

 

Larry

 

 

No one is refuting that diet and exercise is the most important way to prevent diabetes. It's much more effective than metformin. But at the same time, one doesn't stop exercising and dieting because they're on metformin. You're only adding the benefits of metformin to your arsenal against diabetes, not replacing diet and exercise.

 

I also want to say that for many, taking metformin isn't forever. There are some that use it as a long term solution, but many others use it for the short term and then get off it when their bg is stabilized.

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Thank you, Larry. It is interesting to see this sentence: "Metformin is not currently FDA-approved for use as a prediabetes treatment, but researchers continue to study its potential effectiveness in the prevention of type 2 diabetes."

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