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Uff Da

Metformin ER - Please help me design an experiment

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Uff Da

I've been on Metformin ER since diagnosed with diabetes in October 2011. I take 500 mg 4 times daily. Yes, I know it is extended release and I shouldn't have to do that, but I have such a bad memory and end up missing pills and having late irregular meals that I thought my frequent bad behavior might be evened out a bit that way.

 

Metformin is basically a type 2 drug. After a year and a half of treating me as a type 2, my doctor finally referred me to an endocrinologist. Antibody tests indicate I'm a 1.5. I still make "some" of my own insulin, but since the blood test was not a fasting test, how much is in question as there is no reference range unless the test was fasting. The endo put me on Lantus and Humalog, and because of the distance I live from his office, he is turning me back over to my PCP for further follow-up. In his letter to my PCP, he states, "I told her she could stay on metformin."

 

Note the operative word could. Not should. I had asked my PCP a year and a half ago to let me experiment with dropping the metformin, as I didn't see that it had done any good. At that time she said no, with an excuse that amounted to "everybody's doing it." But at that time, though she never gave me a type, I expect she thought I was a type 2. So before I see her next time in July, I'd like to do my own experiment and wonder if some of you would help.

 

I did a web search to learn why some doctors prescribe metformin off-label to type 1s. Most reasons don't apply to me. I'm underweight, not overweight. I only take 6-7 units Lantus daily, so I don't need to reduce a very large dose. The ONLY reason I can see that might apply to me is that it could limit the amount of glucose secreted by the liver. So how do I know if my liver secrets too much glucose? What should I be looking for? How do I differentiate a high BG from the liver from that from insufficient supply of insulin?

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I've been on Metformin ER since diagnosed with diabetes in October 2011. I take 500 mg 4 times daily. Yes, I know it is extended release and I shouldn't have to do that, but I have such a bad memory and end up missing pills and having late irregular meals that I thought my frequent bad behavior might be evened out a bit that way.

 

Metformin is basically a type 2 drug. After a year and a half of treating me as a type 2, my doctor finally referred me to an endocrinologist. Antibody tests indicate I'm a 1.5. I still make "some" of my own insulin, but since the blood test was not a fasting test, how much is in question as there is no reference range unless the test was fasting. The endo put me on Lantus and Humalog, and because of the distance I live from his office, he is turning me back over to my PCP for further follow-up. In his letter to my PCP, he states, "I told her she could stay on metformin."

 

Note the operative word could. Not should. I had asked my PCP a year and a half ago to let me experiment with dropping the metformin, as I didn't see that it had done any good. At that time she said no, with an excuse that amounted to "everybody's doing it." But at that time, though she never gave me a type, I expect she thought I was a type 2. So before I see her next time in July, I'd like to do my own experiment and wonder if some of you would help.

 

I did a web search to learn why some doctors prescribe metformin off-label to type 1s. Most reasons don't apply to me. I'm underweight, not overweight. I only take 6-7 units Lantus daily, so I don't need to reduce a very large dose. The ONLY reason I can see that might apply to me is that it could limit the amount of glucose secreted by the liver. So how do I know if my liver secrets too much glucose? What should I be looking for? How do I differentiate a high BG from the liver from that from insufficient supply of insulin?

 

There is a misconception here. Metformin is a drug that stops excess liver glucose release when it shouldn't. Yes it is thought of as a type 2 drug but in reality it is a liver drug and if you have excess liver glucose release type 1 and/or type 2, metformin can help either.

 

Type 2's seem to have a predominance of liver leakage. Up till now the approach as best I understand it from a type 1 perspective - since on insulin just add more to transfer the excess glucose( to the skeletal muscles). There is no free lunch as excess glucose sent to skeletal muscles need to be burned off by extra exercise. Using metformin does actually reduce the insulin required to get the excess liver glucose transferred out as metformin cuts off the excess glucose release at source.. Been there - done that!

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