Hi
I am on Metformin 2 x 500mg per day. Was always promised , get yourself fit and we’ll then you will be able to get of meds. Worked hard, fit and last 6 Results were below 5.7 ? doctor says on for life now. Have anyone of you tried jus reducing and finally getting of this med.
Doctors here in NZ do not actively help you to find an avenue to better yourself. Where I live only one doctor, who just barks at you, seriously found this forum to best help to getting results.
This is a decision about what your health goal is going to be. I think this is a very personal decision, it isn't something that a doctor should dictate to you. It is best made in consultation with your doctor. Sadly, many doctors just tell you what you should do rather than asking what your goal is.
So the real question is, what is your goal? While an A1c of 5.7% is a great achievement, many of us struggle getting our A1c down to that level, it isn't non-diabetic. Bernstein actually believes you should attain an A1c below 5% and would likely yell at you about your diet, increase your metformin and maybe even put you on insulin. Most doctors in the US would tell you are fine and let you drop the metformin, particularly if you can still keep your below 5.7% (the threshold for prediabetes diagnosis).
But I have to tell you, here in the US, most of my doctors have always just be happy to have my Ac1 < 7% and they would not want me to drop medication if I was doing well. It is actually good that your doctor wants to keep your blood sugar even better controlled.
My suggestion is that you do two things. If you really want to go off meds, next doctors visit, ask your doctor to make a deal with you. You go off meds, promising to be diligent about your diet and exercise and as long as your A1c remains below (insert target here), then you will continue to stay off meds. But when your blood sugar rises, you will agree to more aggressive treatment. And that is the second thing I ask you to think about and accept. Diabetes is really progressive. Sure maybe some of us can make a few lifestyle changes and be ok, but for the majority of us, it will get worse and you need to accept that in the near future you will need medication and you should use that medication promptly, not when your A1c gets really high.
I'm in a similar situation. T2, only on Metformin, though my A1C has been 6.2. I have had no problems tolerating Metformmin, but I do wonder about going on a reduced dose. I have thought about doing some pill-splitting & watching the results.
How bad could it be to try such an experiment?
I think we all grow older and even if we do everything right our diabetes will get more pronounced. Maybe not dramatically, but we do get more insulin resistant with age, we slow down, we lose muscle mass. Yes, if you have an A1c of 6.5%, an average blood sugar of 140 mg/dl, then you will be killing off your beta cells and it gets really progressive. But aging also marches on.
All told, I have to just applaud what you have done. Getting down to an A1c of 5.7%, really getting the diet and exercise working, that is an accomplishment. And I suspect that with some effort, you could actually get off medication. But I just don't believe that you just "heal." You still have diabetes and everything works against us getting better. And eventually, you may have to go back on medication. But that is ok. All that really matters is that you control your diabetes. Diabetes doesn't kill us, uncontrolled blood sugars kill us.
Metformin is a hard one to remove. The stopping excess liver glucose takes a minimum level of metformin from a pill to have effect. Under that level it doesn't do anything.
For me that is around 500 to 700 mg dose. I found no success dropping metformin. Insulin on the other hand, I have great success getting the levels down.
So for me - Metformin NO and Insulin yes.
great job in getting your A1C down to 5.7 Mike. I was in a similiar situation. Dr had me on metformin for approx 6 months. I really didnt want to take it but we made a deal that if I was able to get my a1c down into the 5's and keep it there I could get off of meds. I concur with Brian, next appointment get an agreement with your Dr. When I was able to get off of Metformin my Doc was happy for me but he also mentioned that I would probably be back on it within 5 years. I have not forgot that statement. It's been 4 years and I really want to shove that in his face next year. :)
Keep studying, researching, being your own advocate.
I quit taking mine (metformin 500 mg twice a day), changed my diet, quit listening to the PA and other "experts" (been an ICU nurse for the past 20+ years, and know all their scare tactics and misinformation). I walk at least 3 times a week, can't run or jog due to a severe back injury, but running is not necessary anyway. Even with metformin my morning blood sugar was always between 145-160. I was on 150 mg a day of blood pressure medication. Today, I take between 25 and 50 mg a day of blood pressure med., no metformin for the past 3 months or so. Compared to my metformin (and prior) days, I have a lot more energy, am losing weight, and my morning blood sugar is between 112 and 124, but I'm working on making those numbers even better.
Just my opinion, but if the doc tells you all about the anti-inflammatory properties of metformin, the diet I am on is also known to be anti-inflammatory. It may get boring after a while, but won't kill you. Good luck to you :-)