i am furious about this. When i first found i was diabetic (a1c 5.9, but morning fbg 130 to 140 regularly) no doctor in my area would give me access to any meds at all..."wait til you have an a1c of 7.0" they said.
but by the time a person has an a1c of 7.0 they usually have diabetic complications to some degree. the ADA recommends metformin for prediabetes, and at the very least, that patients have a right to choose.
But doctors dont give choices...and they withhold meds and the right to choose, especially depending on where you live.
There are virtually no cases of harm caused by metformin in the history of the drug...there is no reason to limit its availability or even to require a script for it.
I urge everyone to to write to the FDA and leave the choice to consumers.
I'm guessing you're talking about this press release?
I can appreciate the pickle that you are in, but also think that those who are selling "cinnamon snake oil" to cure diabetes need to get their products off the market. Kudos to the FDA for calling out those who aren't labeling their product correctly and who aren't listing all of the ingredients. This is the first step to clarity and truth in advertising.
The US needs to find another way to deal with the unreasonable and rising cost of medical care. I agree that consumers should have a choice. However that choice needs to include all of the facts. The FDA seems to be calling out those who are not properly identifying what is in their products.
i'm not talking about cinimum snake oil, i'm talking about metformin...it is the safest drug goin with no reports of harm far as i know (the news release mentioned this but i will be reseaching starting tommorrow).
it's nice to talk about rising cost of health care and snake oil, etc., but tell that to those that need medication and can't get it, both uninformed general docotors (they are legion) and no health care at all...i am not talking about all meds...i'm talking about metformin and certainly the risk of harm of talking metformin without a script for 5 years is less the risk of harm of not taking anything if your a1c is between 6 and 6.5 (you can check the ada guidelines) sorry if i'm sounding brusque no rudenss meant got a pet emergency on the other line (i'm and animal welfare advocate and i'm multitasking tonite) sorry for bad spelling etc.
But metformin is available from FDA approved sources in the US for as little as $4/month at Walmart. The real problem is the ADA and other guidelines which advocate only treating diabetes when you really, really, really have it. Unfortunately, many first line primary care doctors believe all this stuff and will deny you treatment until you are really far gone. I urge you to just find a doctor who is forward thinking and will work with you to aggressively diagnose and treat your condition. There are doctors who don't believe the ADA line, you just have to find them.
It's not avialable if you don't has a script....unless you go offshore. that was how i got metformin.... People for the most part do not have the ability to "just go find an forward thinking doctor" That's ludicriss. Few people have the finacial means to do that, and are frequently constrained by insurance company policy besides.
You are correct about doctors being unwilling to prescribe however....i would like to dialogue with you about your experiences in this area...are you avialable?
I’m no expert on all the different health insurance policies-- but even in rural Alaska… In a town small enough that I actually know the doctors all personally, I am able to pick the one I consider (based on my experience and others’) to be the most “forward thinking”. How does your insurance trap you with one particular doctor that you don’t like?
I have a medicare supplemental insurance, they have a book i can select from 10 doctors. Not one of those doctors would allow me to have a prescription for metformin when my a1c was 5.9.
I read the ADA backwards and forwards...i knew my risk for complications was very high without something. Also, altho an a1c of 5.9 is not diagnostic of diabetes in and of itself, my morning sugars were always 130 t0 140 before metformin, and that *is*...i spent an entire year on a strict diet!! steam cabbage, things like that...i could not drink a glass of tomato juice!!! i lost 60 pounds, my a1c still 5.9 and climbed to 6.1, if i starved my morning sugar went higher due to liver, if i ate to much, it went higher. if your liver is overreleasing glycogen into your blood no dietarymeasures will help.
but no doctor would give me metformin or send me to an educator...as if i needed one...i have a graduate degree in excercise physiology, i do understand diabetes.
Finally i resolved to get metformin somehow..that ended up being getting it offshore. the next doctor i met i told him i was on metformin already, but i didn't tell him i got it illegally. He didn't even blink about signing the script...i think these general doctors are uninformed and care more about liability and if its a pain in the ■■■ for them.
I can only pick doctors off that list. cost of self pay here is about 180 per visit...i live on disability...i can't do that.... i'm stuck.
Now i'm on insulin doing better than ever, but i got that for free also, now the VA that is supposed to provide me with scripts, won't rovide me with insulin either (I am a veteran but i won't use our VA..they are even worse than civilian doctors. they won't do ANYTHING til you are too far gone to make a difference. I run 15 to 25 miles weekly and lift weights a min of 10 hours a week besides, but without insulin it makes no difference. I have a good nurse practitioner now who says i was right all along, but now the problem is i need insulin and i can't affordto buy it and the VA won't give it to me. When i run out of the insulin i was given (a freinds diabetic mom died and gave me her unopened, non-expired insulin) i will be back to square one.
I feel very bitter. i know the medicine...i know the risk factors for various demographic groups...i have a right to choose...i'm not even trying to choose some odd offthewall treatment plan...what i want to choose is right there in the first 24 pages of the ADA guidelines, but no doctors here will support it. they are all in the stone age.....if medication is made more inaccessable people will be more enslaved to bad doctors..
what makes it worse is that metformin has the lowest risk of adverse occurances than any other med...there is no **reason** to limit it...
The FDA is saying they want to make sure people get the medical advise they need, but it isn't the avialibility of medicines that are stopping people from using doctors...its people's ability to afford doctors.
To tell sick people who will rapidly deteriorate that they should contendedly wait years til all the problems with the medical sysstem are worked out is heartless and ridiculaous. the system is saying "we can't help you but we won't allow you to try to help yourself either... sorry...you have to die...in the future it will be better for those that come after you" its moronic!!!
Domperidone is a drug that is not FDA approved (approved everywhere else in the world) that you can get through an offshore pharmacy. I sure pray they don't start messing with that.
I am always available. You can post here in discussions or send me a private message. Insurance cannot override a doctors recommendation on treatment, especially for a $4/month drug. You may not get cooperation from your approved list of 10 doctors, but most people can choose their doctor. Once you have started metformin treatment, it will be "accepted" by most doctors, even those on your limited list.
There are some doctors but they are few and far between. Not all of us live in or near a city, and many have to use doctors within their plan.
They should not start messing around with **any** approved diabetes drugs, including insulins. They should do their homework. I began researching this issue just today, so i only have some info so far, but they themselves state they have no records whatever of adverse occurances of people taking metfromin without prescription but, they go on to say, they "want to ensure" that people seek medical advice.
I have a huge amount of date (anecdotal at this point i admit), of over 300 personal interviews i've done..the main reason diabetics and prediabetes don't get medical care is that they have no health care and/or health care not consistant with ADA guidelines....as in my own situation where doctors refused to prescribe in accordance with ADA guidelines and refused to explain their reasoning.
Which is to say, its unavailability of medical care, not availability of metformin driving this problem, so therefore (in my opinion which i believe will be supported by evidance as it is gathered), taking this very safe drug away not only does not solve anything it actually makes life worse for many diabetics. The reason I myself have so few complications is i treated myself early and agressively with metformin, after neither weight loss, nor exercise changed my fasting blood sugars. I was reading in the 2013 ADA guidelines just earlier this month that while type II's may experience remission with diet and exercise changes, the type II's that are helped by this tend to be IGT, and IFG are not much helped (not sure where that was but was in first 50 of the the document. Within the week i will have a petition about this whole this on the care2 platform, and i'm hoping I will be able to win support for freedom on choice by some in this forum
yes, what you say that once treatment is started most doctors will accept...because there is more liability in disagreeing with another doctor...i am slowly learning the ropes, and that was how i got started...got metformon offshore and i did not offer any info on how i got started with it..the doctor just assumed.
On the other point though, i disagree, though i am open to being proved wrong. I think most folks are in some kind of HMO or insurance plan that limits them because they have there own doctors that are "enrolled" with the hma company...i think the the insurers do this to negotiate reimbursement rates. I think only very few patients are "self Insured" or "cash payers". I **think** but i'm not certain. It would be nice if others commented on their perception of the matter.
I will however be starting a cre2 petition on this matter within a week...that won't be a solution, but it will be the opening volley that i hope will encourage public discourse and awareness of the issues. we will see.... I'm new at this.
That is my experienc too...i hope we get more comments. I'd honestly like to know if my own perceptions are accurate.
For me, getting on metformin was pretty easy, but I went through hell getting a doctor to put me on insulin. I had been aggressive with low carbing with metformin, and got the "if you A1C is below 7, you're doing great." I was LADA/T1.5 and crashing.
What does LADA/1.5 stand for?
It took some doing for me to get insulin as well...it helps to know your ADA really well. My a1c was creeping up, and i am something of an athlete...and i look like one (at 59, lol). but i know my ADA guidelines fairly well too...and ADA says 1) insulin may be appropriate 2) if you have few comorbidities and havn't been a diabetic very long, its worth while managing your a1c more agressively **and** patient preferances should be considered. Its funny...you can tell the doc the very same thing as it says in the ADA and he won't pay attention, but if you write it in a letter with citations of page and paragraph where the ada says the same thing, its hard for the doctor to say 'no' without looking bad...but, on the other had, the Veterans Adminsitration won't give me insulin...so i am in limbo. I need insulin and have know idea what i'll do when i run out. i can't afford it even though my civilian doc prescribed it, i have no prescription coverage. Because i am fairly well controlled on insulin, they test me and i don't test like a diabeteic raging out of control, but i tried going off insulin and within a month i was easily getting over 200. i have no idea whats next...
I had to get Metformin without a prescription online when I first decided I needed it. My doctor would not prescribe it because he was afraid my blood sugar would be too low. I honestly don't think he understood the difference between Metformin and sulfonylureas. Once I got the Metformin myself and had taken it for a year, I switched doctors within the HMO. I told the new doctor the truth, that I was getting Metformin online, and why. She gave me a prescription. The only thing I regret about ordering it that way is all the junk email I get now.
I agree with you and will be happy to sign your petition when you do it. Is there a way you can get insulin with some assistance/help? I think there are sources listed here to help people who can't afford it to get it.
What is igt & igf?
'IGT' is impaired glucose tolerance, 'IGFf' is bad typing....sorry should have been 'IFG', impaired fasting glucose.
IGF is found by the 2hour glucose tolerance test. You drink a measured amount (75 gm i think) and they test your BG after two hours. If above 140, you are diabetic by definition.
A person with IFG might do ok on IGT...I did...my problem was high fasting glucose every morning. I had had high morning glucose if i ate too much or if i ate too little (not going to talk about 'dawn phenomena'just now.)
IFG is a combination of a pancreous not making insulin and/or insulin resistance on the body PLUS a liver that is insulin resistant too; in a healthy person, the liver stops releasing glucose into the blood in response to high insulin. But in the IFG person, the liver keeps on putting out more and more glucose. Turns out i am like that. metfromin helps suppress the liver releasing insulin....
Thank ou for support. We diabetics need to do the best we can on ourselves...eating, working out, etc., but as a group we don't foucs enough on obstacles put in front of us by the medical establisment. I hope to see us raising awareness and taking action...we deserve better than we get most of the time in my opinion.
I am working on my own insulin problem....taking a tiny rest after calling congressman and a bunch of carrying on trying to compell the Veterans Administration to give me insulin...I get tire thinking about it *sigh*
I'm working on my typing also. funky notebook keyboard plus how much other writing i do each day...i get sloppy about typos on forums and less formal venues...I'll try harder....
Yes, general practice doctors *in* *general* are not well-informed about diabetes, in my (limited experience) not only do they not keep up with the ADA, they know less about diabetes than i do.
I see I am not the only one with that problem.....we have to do something about this. I have been a community orgaizer, lobbiest, and grass roots organizer for a few years now...ecology issues, stuff like that... What little expertise I have acquired I see i need to turn to this issue, because I see my experience of not getting early aggressive treatment despite ADA's recommendation for that, ...my experience in the area is not unique at all.
I find myself wondering if that is because the board of the ADA is pretty physicians, and they stick together to protect their domain.
I asked an endcrinologist a few months ago why i don't get have any input into the treatment plan (that this particular idiot was trying to force on me...no meds at all til A1C of 7), and she said it was because she has been to school and I havn't. I responded "But i'm the one that bears the consequences!" She was unmoved. I got the hell out of there. In fact we never even went thru the "welcome to my practice health history" I had filled out...she said she knew she could not work with me....but i still had to pay for the visit. I would have taken it to small claims court just to raise hell, but i had enough hell in my life at that moment, and sometimes you gotta pick your battles...ha ha ha
Yes I see what you mean, metformin is very good for stopping that and it doesn't seem to have a lot of bad side effects. You're welcome :) Don't give up, I'm sure you're going to succeed. I totally agree, our meds should all be otc and then we can consult with a good doc for guidance when needed.Please send me a link for the petition.