Metformin and type 1?

It took a few days before I started to notice a difference. My dose is also low at only 500 mg/day. After a few days, I lowered my basal by 1 unit, and I noticed I was more responsive to bolus insulin.

It’s now been 2 months, and my daily basal needs have lowered by an additional 3-4 units (current dose is 20-21 units/day, varies based on activity level and monthly cycle…prior dose was 25-26 units/day). I’ve had a lot going on in the last two months, so I hesitate to give Metformin all the credit for that. However, prior to starting Metformin, my basal dose kept increasing by around 1 unit every 3-4 months. So, at the very least, I can say that the pattern has reversed.

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Thanks, @katers87! That’s helpful.

I’m 2 doses in (500mg/day right now) and excited that I haven’t had any GI side effects. I’m taking the ER version and have been taking it with food and Immodium. Hoping the side effects stay at bay.

My insulin needs have been going up these past couple days, but that is due to where I am in my hormonal cycle. I’m guessing that in a week or two when I’m at the other end of my cycle and the Metformin starts to kick in, I’ll probably have a fairly abrupt drop in insulin needs. Will be carrying extra fruit snacks with me!

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Hello Tim,

I am a type 1 diabetic and I have been using Metformin and insulin for years. My only issue was that Metformin made me nauseas for the first few weeks and then it went away. I take very little insulin (I’m told) compared to most diabetics and I have been a diabetic for 30 plus years. Thanks

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I also take 500 mg Metformin twice a day. It helps my body metabolize my FIASP fast acting insulin faster. I’m about 60 years of age and have been a Type I diabetic since age 23. I use Tujeo and FIASP as by slow and fast acting insulins.

I have found that Metformin does NOT decrease my insulin requirements (I take as much insulin as I did before starting Metformin about 2 years ago), but it makes my body metabolize my insulin faster…

Let us know how it works out after you try it!

Will do. I have the pills just haven’t had the “nows the perfect day to start” moment yet

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Thank you everyone for all the responses. My next question is how did all of you go about getting a prescription for metformin as a type 1? I went into my doctor with around 10 studies off pubmed showing benefits of metformin in type 1 diabetes and he still shut me down…

I just asked, and pointed out how much my mealtime insulin doses had increased over last couple years… he said he didn’t particularly think it’d help as I have no signs of “metabolic syndrome” or something like that but said I can give it a shot if I want

I showed my evening spike patterns to my doctor and explained that the spikes were occurring even when I dosed aggressively.

He said he was willing to prescribe it but told me that he didn’t think it would help and thought it would cause lows. I explained that I could lower my basal if it caused lows, but that I’d like to give it a try to see if it’d help. So he wrote a prescription.

Do you have an endo? You might call their office and ask them to prescribe it, they should be more up to date on it being used.

My endo who was a type 1 offered it to me if I wanted it, I just turned it down because I had had side effects before.

Yes I have an endo appointment this Thursday. I’m bringing in all my studies I can find on pubmed. Hopefully she is willing to think outside of the box and help me out.

It might be helpful to provide personal documentation of your insulin resistance/need for increased insulin sensitivity. A situation specific to you that shows how you personally would benefit from Metformin may be more persuasive than studies.

Good point I will give that a try as well. Thank you

I would consider a new endo or at least a second opinion.
My previous endo said I could not go on the pump until I had a better A1c, not true.

I am T1 (38 years) on metformin for almost 4 months. I take the extended release version, 1000 mg at breakfast and 500 at dinner. It has cut my mealtime bolus needs down by about 30%, and it seems like my insulin acts faster (especially with a post-bolus walk), and my blood sugar curve is smoother—fewer spikes (although sometimes spikes do happen still, for various reasons). My correction blouses seem to be a lot smaller too, but I made some other changes that may have helped those too. I tried to get my dosage up to 2500 mg/day, but had nausea at anything over 1500/day, so that’s where I am. I gradually increased the dosage, per specific instructions from my Dr., and I think that helped my body get used to the medication. I haven’t had an A1c test yet, but according to my calculations, my A1c is about 6.2 (from 6.5 pre-metformin). Here are the instructions my doctor gave me when I first started:

“Week #1: Please take 1 pill with dinner every night.

Week #2: If there are no stomach issues (diarrhea, abdominal pain, nausea), please take 1 pill with breakfast and 1 pill with dinner.

Week #3: If there are no stomach issues (diarrhea, abdominal pain, nausea), please take 1 pill with breakfast and 2 pills with dinner.

Week #4: If there are no stomach issues (diarrhea, abdominal pain, nausea), please take 2 pills with breakfast and 2 pills with dinner.

Our goal is to get you on the highest dose of Metformin that you can tolerate. Most patients can tolerate 4 pills per day, but some develop abdominal symptoms with 2 or 3 pills.”

Hope this helps!

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@Cat99 I love the instructions the doctor gave you! Especially including the word, please!

So many times the rx says to take as directed, yet the directions either weren’t presented, clear, or remembered.

Thank you for sharing!

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