GP is halving my Metformin.

Posted , 6 users are following.

I was diagnosed type 2, 3 years ago with an HbA1c of 60. ( 7.6% ).

I was prescribed Metformin, 1000mg a day, taken 500 mg at breakfast and 500 mg at dinner.

Since 2016, by paring carbs to the bone and exercising, it steadily fell to 41 ( 5.9%) at my blood test last December.

The nurse said I should reduce the Metformin to 500mg, taken with dinner. I wasn't keen, so since January I have been cutting my 500mg tablet in half at breakfast and taking 500mg at dinner. So I have been having three quarters of what I took for 3 years. ie 750mg.

My last blood test, last week, showed that my HbA1c has gone up to 42 (6%). An increase of 1 or .1% in 3 months.

Now my GP has said I must only take 500mg a day. As my levels rose in 3 months by reducing my dose by a quarter, I am expecting that reducing the dose to half, they will rise further.

My question is, isn't it better to be as close to a "normal" level as possible? Why does it seem that I am being punished for all my dedicated efforts?

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  • Posted

    It is better to follow you docter and nurses instructions, I am sure many of us will probably wondered if we should mess around with medication,. not a good idea. Talk to your medical team, go armed with a list of all the questions you want to ask.

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    • Posted

      Hi Josephine, thankyou for replying. Just wish I had your faith in the medics. Unfortunately, due to mis diagnoses and previous medical blunders at the hands of the NHS, I have learnt to question everything.

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  • Posted

    I agree with you. Although I question if 250 mg of Metformin will have any major impact. Still, the objective is to get the BG numbers into non diabetic range.

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    • Posted

      Hi Jane, thankyou for replying. I thought so too. I shall do as I'm told and stick with the half dose and see what has happened at my next blood test in June. Then, I might be having a conversation with the GP if the level has gone badly wrong!

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    • Posted

      Ruth, the other thing to keep in mind is that some GPs are remarkably uninformed about T2. Further, some GPs are more likely to prescribe meds than others.

      Self testing daily can give you an indicator of how you are doing while you are waiting for an A1C. Although self testing is not as accurate as an A1C test, it does provide directional value. Something to consider if you are not already doing so.

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    • Posted

      Just to be clear, I expect Jane is talking about daily (or more frequent) self-testing of the blood glucose (BG) number.

      It is also possible to self-test A1C, but it's much more expensive. A blood glucose test is under fifty cents, I think the home A1C tests are like twenty dollars.

      You can usually get a fair estimate of A1C from the BG test, especially from a series of them over days. For that matter sometimes the BG number is more significant than the A1C, and for full cases both are needed to guide treatment.

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    • Posted

      Hi Jane, no I never have self tested with the strips. You are so right about some GPs being uninformed about type 2. Mine is one of them. It was me who first spotted that my A1c was 60 and pointed it out to him, when I got results of a routine blood test! If not, he probably wouldn't have noticed at all. The advice I have received has been negligable and the diabetic nurse at the practice is pretty useless too. They have never advised me/taught me about self testing with the monitor and strips. I have learned what little I know from reading and from forums like this. I do get blood tests done privately from time to time but generally I just wing it, keep carbs to a minimum and hope I'm doing ok. I will see what June's blood test shows and if there is no significant increase, maybe I'll try and wean myself off Metformin completely. Thankyou for your advice and sharing your knowledge. x

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    • Posted

      Hi Jx, thankyou for your advice. I never have tested with the monitor and strips, just tend to wing it and hope I'm doing the right thing. My GP hasn't given me much information and the diabetic nurse at the practice isn't much use either. I'm in the UK and the NHS is a bit hit and miss. Revered by some but in my experience, you get a cut price service. I'd rather pay for a service and get a decent one.

      I will see what my blood test shows in June and them maybe try and come off Metformin altogether if there is no significant increase.

      Thankyou for all your help.x

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    • Posted

      Ruth, I suggest self testing with strips. Here is why. Self testing (fasting in the morning, before and after meals, and at night) is extremely useful to learn how your body processes carbs. You can learn what foods are triggers, how your BG trends over time of day, etc. Everyone is different and everyone responds to food differently. At the beginning you test quite alot but after you get to know yourself you can back off the frequency. I also use self testing as a general barometer on how I am doing, at least in terms of trends. I record my numbers in a log and have found it to be a fairly accurate assessment of my A1C. It is not very hard to do and not very expensive. I am needle phobic and did not like it at first but got used to it very fast. If you are borderline or "pre-diabetic" now is the time to manage it. Anyway thats just my 2 cents worth. 😃

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    • Posted

      HI Jane, thankyou for your continued help. SO much better than the medicos! I'm needle phobic too but i guess you get used to it. I will definitely take your advice on board and look into getting all the kit.x

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  • Posted

    I think it's worth a try.

    I'm currently at 500 and 500, and I'm just looking for a solid week of good BG readings and I might try skipping the morning dose.

    Note that a morning cup of green tea is helpful along the same lines as a small dose of metformin.

    The 0.1% change in your A1C is within the error range, it is far from certain that it shows a trend.

    But if the numbers do go bad, they're not likely to go very far, and then you can just return to the previous dosage.

    However, final note, my doctors don't seem to feel that 500/500 is much of a dose and generic metformin is one of the cheapest drugs out there, with virtually no known drawbacks (once you're acclimated to it, of course!), so I am a bit surprised that they would suggest this. It seems minor all around. Who knows, maybe you can have the same numbers without any metformin - especially if you stay on the green tea. And of COURSE on a good diet, with exercise!

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    • Posted

      Most medical literature suggests than any Metformin dose under 2000 mg/day has little to no effect. Personally I disagree with this because 500 mg/day has a positive impact when administered with diet and exercise. Yet, 250 mg is a very small change one way or the other.

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    • Posted

      Jane, had not heard that about the dosing. But the max dose is only about 2500 per day. Hmm.

      Well, if I have a slow week, I'm even more eager to try reducing to 500 per day, or even zero.

      Thanks.

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    • Posted

      Hi JX, thankyou for replying. I agree, with you, it does seem a bit petty to reduce the dose and by such a small amount that it could have negligible effect.

      I will definitely try your green tea suggestion and see what my blood test in June reveals.

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    • Posted

      Ruth, it sounds like you don't do blood glucose tests at home? Maybe your numbers were never so high that you started doing that?

      You can get the kit yourself - or if you know somebody who has one, you can use theirs, there's no contamination with the disposable strips. Then you could tell the same day how things are going.

      You can buy the kit for cash, my local chain had a special - buy 100 strips, get the meter free, though you probably also want the spring-loaded finger-sticker and the "lances", but about $40 cash would buy the whole thing and enough tests for 3x a day for a month.

      If you've already learned to count carbs, and knocked your diet down to the keto range, I'd be surprised to hear you weren't also doing this, but just in case, it is something you can do on your own.

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    • Posted

      In general, I agree that the less meds the better. No meds is my preference. Yet, Metformin seems to have some positive effects beyond impact on diabetes. 500 mg of Metformin is a minimal dose. It is unlikely that a 250 mg dosage change (+ or -) would have a significant impact.

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