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amjon

Started Metformin

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amjon

I've had a crazy time lately. In December my daughter died at 27 weeks, so I was induced to deliver. I became pregnant again Easter and miscarried 5 weeks ago. In between My fasting BS was WAY higher than I have ever had (it's always been in the 60s-70s and was 90s-100s). I told the OB I was concerned, but told everything was fine and not to worry about it. I did some fingerprick tests and got 90s-115 fasting and 140-160 after eating (which I know is too high). I told the OB and MFM and they both told me it was fine and would have no impact on pregnancy, but MFM recommended GTT. I did the GTT and had 1 hour of 134 (didn't eat after and crashed at 3 hours). The OB said it was normal, but we had a MMC (that actually died right around then). I asked for Thyroid testing and total t4 came back high, so he referred me to the endocrinologist. The first thing he said to me was that he thought I was insulin resistant and wasn't the last bit concerned there was a thyroid problem. He put me on Metformin and ordered some tests. I'm so glad the OB referred me (even if it's for a reason besides what was the true problem). He's having me start with just 500 once a day, then add one more pill in until I get to 4. A couple of nights ago I had the WORST stomach cramps (as bad as labor) for about 30 minutes. The doctor was closed, so I called in the morning. They told me to stops the meds until I came in 3 weeks later, but I told them I needed something as I may be pregnant and don't want to lose another baby. They called in the same thing (but in name brand) and told me to go to the ER if I had the pain again, but didn't order any type of blood test. Has anyone had anything like that happen on Metformin?

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Lizzie G

Hi,

 

I'm sorry to hear about your stillbirth and miscarriages. I get that you want reasons for these things as once you know the reasons, you can stop them happening again - i would be exactly the same in your shoes. But, to be honest, you talk about having a MMC around the time of a GTT where your blood sugar peaked at 134...that is not an abnormal number, and certainly not dangerous in any way to the baby (ok so it's higher than you want your blood sugar to be running ALL the time, but absolutely safe and normal for after a meal), its a number that is within the guidelines for after a meal during pregnancy, which are based on normal non-diabetic numbers. None of the numbers you speak of are in any way high enough to have caused miscarriages or your stillbirth. Yes Im not a doctor, but having been a type 1 for many years and had a type 1 pregnancy I have read an awful lot of papers, studies etc and I am pretty sure that any endocrinologist would echo my view that your terrible losses were not caused by something diabetes related. I'm not sure why you would be testing your blood sugar as it doesnt look like you are diabetic, but one piece of advice to you which i hope doesnt sound condescending: you are directing the doctors attentions towards blood sugar being a cause for your MCs, and that could well be diverting them away from running other tests which might be more likely to uncover the real cause (which could actually be random bad luck, it happens, i have several friends who have had several tragic losses, tests have not shed any light on the situation, and then they have gone on to have normal pregnancies).

 

I can't remember what you said your thyroid result was, but an endo knows what to worry about and what is ok, and you need to trust this opinion otherwise you are going to struggle. either that or get another doctor if you doubt this one is competent?

 

re the metformin i wouldnt know, however, there are mixed opinions about whether it should be taken in pregnancy (i believe many type 2s switch to insulin) and im surprised you have been prescribed it by a doctor that is aware you are trying to get pregnant? for the level of insulin resistance you describe, i am pretty sure that 30 minutes of vigorous exercise each day, and avoiding processed foods and stodgy fatty carby meals would help - i certainly need a lot less insulin myself when taking regular exercise and eating a wholesome diet. you may well be doing those things, but if you're not i would suggest you get yourself moving and look carefully at your diet rather than kicking your pancreas with metformin.

 

Good luck with everything.

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amjon
Hi,

 

I'm sorry to hear about your stillbirth and miscarriages. I get that you want reasons for these things as once you know the reasons, you can stop them happening again - i would be exactly the same in your shoes. But, to be honest, you talk about having a MMC around the time of a GTT where your blood sugar peaked at 134...that is not an abnormal number, and certainly not dangerous in any way to the baby (ok so it's higher than you want your blood sugar to be running ALL the time, but absolutely safe and normal for after a meal), its a number that is within the guidelines for after a meal during pregnancy, which are based on normal non-diabetic numbers. None of the numbers you speak of are in any way high enough to have caused miscarriages or your stillbirth. Yes Im not a doctor, but having been a type 1 for many years and had a type 1 pregnancy I have read an awful lot of papers, studies etc and I am pretty sure that any endocrinologist would echo my view that your terrible losses were not caused by something diabetes related. I'm not sure why you would be testing your blood sugar as it doesnt look like you are diabetic, but one piece of advice to you which i hope doesnt sound condescending: you are directing the doctors attentions towards blood sugar being a cause for your MCs, and that could well be diverting them away from running other tests which might be more likely to uncover the real cause (which could actually be random bad luck, it happens, i have several friends who have had several tragic losses, tests have not shed any light on the situation, and then they have gone on to have normal pregnancies).

 

I can't remember what you said your thyroid result was, but an endo knows what to worry about and what is ok, and you need to trust this opinion otherwise you are going to struggle. either that or get another doctor if you doubt this one is competent?

 

re the metformin i wouldnt know, however, there are mixed opinions about whether it should be taken in pregnancy (i believe many type 2s switch to insulin) and im surprised you have been prescribed it by a doctor that is aware you are trying to get pregnant? for the level of insulin resistance you describe, i am pretty sure that 30 minutes of vigorous exercise each day, and avoiding processed foods and stodgy fatty carby meals would help - i certainly need a lot less insulin myself when taking regular exercise and eating a wholesome diet. you may well be doing those things, but if you're not i would suggest you get yourself moving and look carefully at your diet rather than kicking your pancreas with metformin.

 

Good luck with everything.

It WAS an endo that told me he thinks my BS may have had something to do with my losses. He's also the one that brought up BS as an issue before I even said a word. He had my 1 hour GTT and I told him about the numbers I got and the previous 5 hour GTT I had. I've tried the diet for years (only way to keep from getting the crashing lows) and it wasn't really helping, so the endo prescribed Metformin. He said it's been shown to help prevent miscarriages. He said my insulin is probably already too high (hence why I go from 160s to 80s or lower in about an hour), so I doubt MORE insulin would help. The Metformin helps your body to use the insulin it has and that seems to be the problem I have. I've had plenty of other testing, trust me I'm not ruling anything out as a possible cause just because we think it may be this one. I've had several autoimmune/ clotting factor tests; all which came back normal. If I see something else that may be a cause, I would look into it. I've asked the doctor if there is anything else we should look at, but he says we've done just about every test that would tell us anything.

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Lizzie G

sorry, i didnt mean to offend, the way i read your post sounded like it had been you that was thinking it was a blood sugar issue. however, i do stick to what i said, in saying that the numbers you reported would not cause issues in early pregnancy, i dont know whether this endo thinks they have been going super high at other times, which could cause issues, but the ranges you described, really really would not (they are on the high-ish end of normal), im glad you are getting all the antibody etc tests. im so sorry you are going through all this, whatever the cause, it is a painful place to be and im thinking of you x

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