Re: metformin

teedee wrote: 
I have just started taking metformin to see if im type 2 - my doc had
originally put me on insulatard was taking only 6mmol at night before
bed time.  Was taking it for nearling 8 months and on a diet of 1000
calories a day with some exercise - cycling one hour in evenings and
walking for an hour at lunch breaks. I still couldnt loose even a lb -
i feel so hungry all the time and the 1000 calorie diet is not working
for me.  Im 10stone 6lb and 5 foot 2inches.
My fasting blood was 8.4 and after taking gtt was 11.4 doc said i was
type 1 diabetic.  But i have my doubts my dad was type 2 and so was his
sis.

How long does it take for metformin to take effect, This morning i was
7.7 i have only started to take it for 2 days now will it take a wee
while to take effect.  I just want to loose 1 stone as i find it very
difficult to breathe as if i have asthma feelings.  Im 34.


Either you misunderstand what is happening, or your doc is woefully inept at modern diabetes diagnosis and treatment. One is not Type-1 simply because they use insulin.

Type-1 and Type-2 diabetes are two completely separate conditions that happen to share the symptom of high BG. It is impossible to diagnose Type-1 without antibody tests. It is possible to *infer* a diagnosis of Type-1 by a c-peptide test that comes back low. A GTT only shows how your body handles a glucose challenge over time. If the results are abnormal, it doesn't tell you why.

Taking Insultard (NPH) only before bed can be a valid treatment for a Type-2 with Dawn Phenomenon, but it usually is a lousy treatment for a Type-1, as it tends to be of too short a duration in the body. BTW, blood glucose (BG) is measured in mmol/l or mg/dl. Insulin is measured in units. I assume your nightly shot of Insultard was 6 units.

If your doc truly believes that you are Type-1, putting you on metformin alone is a dangerous course. There is no valid treatment for type-1 that does not include insulin injections. Some Type-1 patients also take metformin.

The fact that you are exercising is wonderful, and will pay dividends over time. But you also need to address diet. Your needs as a diabetic are different than the non-diabetic population. While total calories is important to weight gain or loss, your blood glucose measurements are more closely related to carbohydrate consumption.

Many find it more difficult to lose weight while injecting insulin, as insulin promotes the storage of fat. Metformin users often find that the drug causes them to lose weight, but this is due to limiting the body's ability to create glucose, which the insulin helps store.

There are some rules of thumb that deal with calorie needs. A person with a normal Basal Metabolic Rate (BMR) will tend to lose weight if their diet provides 10 or fewer calories per pound of body weight. Most will maintain body weight on 12 calories/pound. Most will tend to gain weight at 15 cal/lb. This *does* vary by person. As a person who weighs 146 lb., you "should" need right around 1800 cal/day to remain at that weight. The fact that you exercise regularly should require even more calories to maintain your weight.

This leads me to believe that there may be some other things happening. Despite concientious exercise, there may be some reason that your BMR is low. A common cause is hypothyroid. Has your doc done any thyroid tests?

Metformin takes a while to build up its action on your system. Most find that it doesn't "kick in" for 4-6 weeks. Because it is famous for causing tummy problems, most start at 500mg/day for a while, and then increase the dose. The published "theraputic" dose is 1500mg/day. That is the amount that shows clinical results. Some do fine with less.

Successful diabetes control relies on three components: diet, exercise, and meds, if necessary. It looks like you are doing great with the exercise part. You might want to address the dietary component, and you certainly need more information and guidance from a competent doctor on selecting the proper med regimen, and that will be determined by proper Type-1 or Type-2 diagnosis.

Jim
.

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