My husband is a type 1( LADA?) and has been on insulin for 35 years. He has been gaining weight steadily all that time(What a surprise!) and has serious complications, Eyes, Chacot feet, beginnings of nephropathy. He’s reached about 250 pounds and is taking mega doses of insulin.
I’m a low carb type 2 and I’ve got his carbs and insulin down a bit and a big improvement in A1c ( down to single figures)
At last, he’s agreed he needs to lose some of that weight. his stomach is struggling to get out of his shirts and with those feet, he can hardly walk. I was sitting oposite him last night for dinner and a thought hit me. Those huge doses of insulin,(60 units Glargine and 15 units actrapid with each carb containing meal. They havent ever told him to calculate a correct dose and he doesn’t want to listen to me on this) could be down to insulin resistance. Could Metformin help? I’ve looked it up and it has been done safely, but I want the opinion of the experts. I often feel I’m battling the medics for my husband’s life. They’ve had most of his health. The care is deplorable here in the UK. It’s “take so much insulin and eat up to it and don’t follow a faddy, low carb diet”
I haven’t heard of Type 1 diabetics taking 60 units of basal insulin and 15 U rapid acting with a meal. With those high doses of insulin, it sounds like your husband definitely has insulin resistance. I wonder about his diagnosis as a Type 1. I know that in England, people are called Type 1 if they are insulin dependent, even if they started as a Type 2. Is this the case with your husband? If so, I would imagine Metformin could be very helpful.
My husband was diagnosed about 35 years ago and it definitely wasn’t type 2. I suspect LADA. He was in his late 20s a the time. Still the doses and his weight have gone up and up over those years.
Thanks. I exercise quite a lot, but I can’t get my husband to join in. He genuinely cannot walk far. In fact has a blue parking badge. (to allow parking near entrances) However, I have a set of small weights. perhaps I could get him to try those while sitting. I’d NEVER get him to the gym,
I’m an overweight Type 1 (diagnosed when I was 3 back in 1979) - I was thin until I piled on the pounds during my teenage years when I stopped exercising and have struggled with my weight ever since. I’m complication free (luckily!) but despite changing my diet and exercising 3 times a week I haven’t managed to lose any weight. At my last diabetes check-up the doctor suggested that I try using Metformin to reduce my insulin dosage and help my weight loss - I’m also in the UK (looked after at the Derby Royal Infirmary) and had never heard of Metformin until this doctor suggested it.
Unfortunately, the doctor forgot to tell my GP about this Metformin plan so now I’m in a situation where I want to start using it, but can’t get hold of my diabetes doctor to start me on it! I might just make an appointment to see him to discuss this.
I don’t think it’s fair to say “the care is deplorable here in the UK”. I’ve had nothing but good experiences - I know it’s the luck of the draw, but I think we should be grateful that we don’t have to pay for any of our treatment here (although we do pay National Insurance I know!). Nothing’s perfect, but the care we get here is better than plenty of other places trust me!
What about a bike or a stationary bike? Might be lower impact on the feet? I am T1 LADA and was told to stop taking metformin. It sounds as if your husband was told to take X units of insulin then eat to cover that amount… In the states we are usually given an insulin/carb ratio… meaning we eat carbs then cover them with insulin. Seems much easier that way and we can choose the amount of carbs we want or need. It sounds to me as if he is gaining weight from over eating to “feed” the insulin dose…and perhaps the weight has added some insulin resistance. I would assume diet and exercise would help. Just my 2 cents~ This site,
Diabetes Mall, has some good info and you can also get the book “Using Insulin” from here. Another good source of info is Diabetes Self Management
Look at it this way; Carbs produce glucose which is a necessary Fuel for your body, and the insulin helps your body use that fuel…if your not using the “fuel” ie. (by exercise or activity) it gets stored (as fat) until it’s needed. You wouldn’t keep adding “fuel” to a car that just sits in the garage…
Good luck and please keep us posted.
When I was first diagnosed with diabetes they put me on Metformin andsince my diagnosis came from my PCP they got it wrong! I was actually Type 1 and Metformin did nothing for me and I mean nothing. If Metformin does work for an individual I would say they are more likely Type 2.
I’m so glad you’re getting good care. West Berks thinks they’re good, but from what I’ve learned in the last couple of years, they’re pretty pathetic. Still on the high carb megadose Insulin regime and calling low carb “a faddy diet” I’m a type 2 and only really see a nurse. I’ve never seen the consultant’s team, except when they’ve seen my type 1 husband.
One of my walking group members recently used an unrepeatable adjective about our local diabetologist and one of my near neighbours, was a stable, overweight, type 2 until a hospital stay, since when she’s gone unstable, been put on insulin and gained so much weight that she can’t walk at all. To my mind that shouldn’t happen. they treat one symptom at a time and never look at the broader picture,(most of them )
To Kristy, you’ve got it right. Eating up to the insulin is what I have to train my husband out of. I cook a low carb meal and he does himself some microwave rice. I think he’s scared they might be right that he needs carbs.
My Doctor told me Metformin will reduce glucose production by the liver and help a person’s arteries and reduce insulin resistance. It will also help with appetite, but I suspect it does that by lowering the pp spikes. Also, I have heard of t1’s developing insulin resistance, so your husband has precedence. Consequently, metformin is not going to eliminate his need for insulin, but it may reduce the amount that he needs. Since metformin is relatively free of side affects (other than diahrea) I believe it would be worth talking to a doctor about adding it, and I would try to find an educator to train the both of you on carb counting and insulin dosage.
peace
danny
There were tons of articles out about a year or so ago about the growing problem they’re calling “double diabetes”… when a type 1 gets fat, has the gene whammy of type 2 in the family as well or even has another problem that causes very high insulin need (like ongoing corticosteroid therapy for lupus or RA, polycystic ovaries, etc). Metformin can certainly help then (not a lot, but a little). In our case it would just decrease the total daily insulin by a bit, which in turn can help with things such as fat storage and appetite control. High insulin levels can also hurt cholesterol, triglycerides, blood pressure, etc, so if diet and exercise can’t do it alone, Metformin really is an option as an adjunct therapy. Of course if you’re a relatively thin type 1 without aggravating factors, of course it won’t do a thing for you.
It’s weird - I’ve heard lots of people on here have been told that low-carb is a “faddy diet” by their diabetes specialists but I’ve never heard that myself. I suppose doctors (like other professionals) go with the trend of the day for recommending diets but I suppose the best bet is just to go with what works for you (ie. what results in the best HBA1c result) and ignore the “latest doctor-recommended-diet-trend”.
In my opinion it’s simple: carbohydrates in a meal=rise in blood sugar so reducing the amount of carbohydrates means less high blood sugar spikes and a lower insulin dosage.
Like I said though, just go with what works for you and if your HBA1c result is good then you’re doing things right and you don’t need any dietary advice from someone (ie. your doctor) who doesn’t live with the condition 24 hours a day.
Ran across this article today, which could be helpful:
Thanks for that. It’s just what I was looking for and what I suspected mightt happen/
.
Hana
I didn’t expect Metformin to take away the need for insulin in a T1, but to reduce the size of dose needed. I’m on it myself and know its side effects, although I never had them.
i have type one they started me on metformin my doctor told me it would not work for me because i dont make insulin you need to take a test c-pepcide it will tell you
As I’ve written, I was thinking it might help my type1 husband who has become insulin resistant and very overweight. It would have to be supplementary to insulin; to help overcome the resistance. I know it doesn’t work for type 1s on its own.
Dear Hana.
Him and I could be twins. I developped mine only (sarcasm) 11 years ago but it feels like 35 years. Time does not fly when you are having no fun. Now weight 250 also up from 210 before starting insulin. I do 1 hour of exercise a day. But being Slovak this is an inadequate amount, 7 hours per day would be better… Met 8 Slovak ladies in Nice, 100% of the sample were very obese.
In desperation I tried Metformin although my body does not like the drug, no diarreah, but ended up feeling dead after 3 weeks of 500 mg 3 times per day. Did not really notice that it reduced my hunger. Insulin dosage was only slightly reduced. Blood sugar control was a bit easier. I am not an expert dont know what type of diabetes I have and take about 40 IU Lantus and 30 IU novorapid per day. Trying a low carb diet now also in desperation. Not sure that is the solution since the fat turns into glucose and stored in the liver and later the liver spews out prodigious amounts of glucose. My guess is try the Metformin. Met a very mild diabetic at a PhD students thesis review of how to loose weight with diabetes. 3 of the 4 diabetics there including myself very grotesquely obese but the mild one was slim. I asked him if he walked on the road to Damascus and was struct by a light? He said no. Then I asked him if he had a lot of moral fibre ( A Bomber Command concept) ? He said no. Then at a lost of what to ask as a futher question. He volunteered that the miracle was Metformin.
Mr and Mrs. Rudinski’s only ate sauerkraut with a small amount of meat and lived healthy into their 90’s. Mr. Rudinski was the inventor of the wire shopping cart. So lack of money was not the reason for this diet. Working with wire was a Slovak tradition. As a young man He had a factory in 1917 in Petrograd during the October revolution.
I’m a Czech, born in Prague, but only lived there until aged 2. Now in England.Married to T1 for 37 years and constantly looking out for him. He’d have been long gone if he’d had to depend on the medics. Ironially developed T2 myself. It runs in the family, Am over weight, but have lost 15Kg on low carb and Metformin. Have to be careful with that mid European cooking, but have managed to modify many recipes. Have given up Knedliky though. Making Hovezi Gulas tomorrow for 13. Offering baked potatoes and a variety of vegetables to go with. Have taken up serious walking. Health Walk groups are a common feature of this area,
Dear Hana.
It was a shame that Czechoslovakia broke up. My Slovak friend Ethela Milanova even ceased to communicate with her sister over this issue.
Medical care her in Canada is also very poor, you are basically on your own for diabetes. But the system did put my Humpty Dumpty back together again when our son had his pelvis broken is an auto crash. We do not have a two tier system like Britain yet although our politicans would love it. My British Doctor friend said the people should resist that.
The beef gulash is a good idea my wife makes Swedish kalops which is kind of similar minus the paprika which I am allowed to add to my portion only.
The knedliky and baked patatoes I am not sure about. This may have been good for the male when we cut hay by hand for 10 hours per day back home. My mother used to make knedliky to go with wild hare and a white flour dill sauce. This was in the late 1960’s. Now my blood sugar skyrockets just thinking about it.
Your husband is very lucky that you take care of him. My wife does nothing to help and made a torte with sweet cream and covered in very sweet marzipan for our wedding anniversary. I had one slice and BG out of control for 30 hours. He and I should be on a strict sauerkraut only diet.
Trying like you a low carb diet does help the blood sugar somewhat. That’s great that you lost 15 Kg.
Walking here has been difficult in the last 3 weeks. Minus 25 to 30 C. Today my son, dog and I went for a 3 Km walk it was a relatively balmy -12C. Tommorow a heat wave with -2C we will go ice fishing for rainbow trout. I wonder if eating mostly fish would be very good for the cholesterol.