Metformin for type 1s

hi friends! i recently read about type 1s using metformin to help gain some control over numbers and weight loss. any type 1s have experience with this? i have also read about hair loss linked to metformin, is that a common side effect? i have very fine hair to begin with but just curious. I see my endo in a month and will ask more details but if you guys could help me out for now with some advice thatd be great!!


Hi Andrea,

I was on metformin in the 90's, when I was thought to be type 2 because of my age of diagnosis (38). I remember never feeling hungry while I was on it, so I'm sure it helped me keep my weight down. Around the year 2000 I went for my first endo visit, and he changed my diagnosis to type 1, and subsequently took me off metformin, saying I might have to increase my insulin, but wouldn't have to take a pill every day. So I went off it, and got my appetite back. Hmmm, maybe I should go back on it, I could stand to lose some weight now!

I'm type 1 (seemingly with insulin resistance) and taking metformin. My ratio was 1:1-1:3, and my endo wanted me eating a minimum of 120 carbs a day, so my total daily insulin was over 200 units at one point on MDI. This, possibly in combination with other endocrine issues, made me gain over 50lbs in 2-3 months... on an average of 1600calories!

I started metformin at the same time I got a pump, started on symlin, and lowered my carbs to 60-90g per day, so I'm not sure what metformin did on it's own. I can tell you that the combination of all these things drastically changed my insulin needs and control for the better. My ratio is down to 1:5, and my total daily insulin is down to 50-65units.

I take metformin 1000 2x's a day. I was taking it with breakfast and dinner, but I found if I took it at breakfast and right before bed, my morning numbers are much better. I have issues with my waking numbers.

I had hair loss prior to taking metformin, but it doesn't seem worse since I've been on it. My weight has been crazy and random, but I think most people will lose fat when they get to lower their insulin dosages, assuming they exercise the same and eat the same or less calories and carbs.

I am also T1 with insulin resistance. Metformin together with insulin is off-book so needs some out of the box thinking to be prescribed together.

Mainly Metformin works by reducing glucose dumps by your liver. So it doesn't have a direct effect on blood sugar rises caused by food consumption.

*Some* people find that Metformin may help them with their weight. Others find that it makes absolutely no difference. I myself am in the second group. So don't think of it as a weight management technique - but if you are one of the lucky ones, it might have that sort of side-effect.

The main side-effect of Metformin is gastro-intestinal irritation. This can be dramatic. I have first-hand experience of it! Taking the pills with food helps a lot. I have not heard of Metformin being linked to hair loss. I did have terrible hair thinning and loss but it was actually due to undiagnosed T1/blood sugars off the chart.

Hi, I took metformin for a while to help with weight gain (was traveling a lot for my masters). IT killed my stomach, and never did much good for my sugars. My endo recently put me on victoza and it has done wonders, lost 17lbs so fare and my numbers havre gone back to normal. It can make you feel sick when you start but it has worked for me.

Thank you for the replies guys!! i see my endo in a month and hopefully i can give it a try. stay posted!

i would love to be part of group one but weight loss seems impossible for me. symlin never helped me drop pounds. but i try to stay optimistic. i only want to lose about 10, i feel physically uncomfortable! i can definitely stand the gastro issues. i eat a mostly vegan diet, high in veggies and fiber so my stomach can handle a lot lol. i would just love to see some great numbers, and a few pounds lost would be nice. i exercise and eat right and still cant find a way to feel better.

By the way, did your hair grow back? as kid i had very thick hair, now in my 20s i realize that the last few years i have been losing it. i know its common to start losing your hair after a few decades, also very fine hair in my family, but there is a big difference between fine hair and losing hair, i cant decide which boat i am in.

hi there, never even heard of victoza, i am going to bring both meds up to my endo. thanks! congrats on the weight loss and great control!

thanks for the research. I also take symlin. it used to work a lot better for me, idk what happened, but it was great while it lasted. thinking i might need a break before revisiting. we'll see. thanks again.

Have you had a thyroid panel? Hair loss can be due to other things, but it's a classic symptom of being hypothroid. Inability to lose weight is another sign of low thyroid. If you can get thyroid labs, the tests needed are Free T3, Free T4 & Reverse T3. Unfortunately, most doctors only test TSH & that's useless.

Are you eating enough protein as a vegan? Insufficient protein can cause hair loss. Know it's hard to eat enough protein from vegetable sources without also eating a lot of carbs.

I have to be honest. I have seen you work very hard on your diet and losing weight. And perhaps metformin or victoza will help you lose some weight. But you claim to be 10lbs from your "desired" weight. I have to tell you, I look at your picture and I see a pretty young woman at a normal weight. I don't see someone overweight and in need of medication to lose weight. I think you need to be prepared for hard questions from your doctor about why you think you need these medications to lose 10lbs. He may think you are at a perfectly healthy weight.

I inquired about this once when I had gained a few pounds and my endo was very against it. She said that metformin can be very hard on the kidneys and because T1s are obviously at a high risk of developing kidney damage anyway, she didn't think it was worth the risk (especially considering I wasn't really overweight, maybe just 10 pounds or so over my ideal weight).

At some point in dealing with T1, you have NOT worry about your weight and just worry about your overall health. A few pounds over what you consider "ideal" may be normal for your body. Sometimes, because T1 causes such significant weight loss at its onset or when it's out of control, some of us get used to being a little underweight (and let's face it, as women we get lots of positive feedback when we lose weight, but little when we gain weight, even if that weight gain is associated with better health).

So, you need to ask yourself, "What is healthy for MY body?" If your BGs are in control, you're eating well, and you don't have any other issues, accept your body for what it is.

I am taking 500mg of Metformin every day in addition to Lantus and Humalog. I'm a LADA Type 1, so I have some insulin resistance. I have noticed that on the days in which I do not take it, my BGs are typically somewhat higher. I have also heard that it helps keeps weight off, but never heard anything about it causing hair loss. Did your endo suggest you take it?

IR is not a typical symptom of LADA. But anyone with Type 1 is subject to develop it especially if they follow the typical recommended amounts of carbs!

I agree with you on the carbs..

Here's where I'm coming from with the IR being LADA..

According to John Walsh, whose opinion I trust, people with LADA, like other Type 1's have little or no resistance to insulin. ("Using Insulin" page 40). And just from the anecdotal info on here, most of us take insulin doses similar to other Type 1's (while people with IR typically take significantly higher doses.)Type 1 is primarily a condition of insulin deficiency, where Type 2 is characterized by resistance. But there are certainly exceptions to all rules with D! I just saw your TDD in your other post, you take less than 20 units a day. That is not a dose of someone with insulin resistance.That's a dose of someone who is insulin sensitive. What makes you think you have IR?

Hello Zoe, Metformin will influence the insulin receptor that it true. Thus the affinity to insulin will improve. For T1 this does not help much but it also influences the production rate of the liver for glucose. This will have an interesting effect for T1 too. They will need less basal insulin for this lower rate of the liver. But the reactivity of the liver will be moderated down too. This has the potential to help T1 diabetics that have a very sensitive or reactive liver. Those with very high release rates after waking up and putting the first foot to the floor. Those who react with huge spikes to physical activity. Metformin has a good safety record but the side effects can be unpleasant (bloating etc). Still I would explore it to see how it can help me if my endo would suggest it to me. It just takes one or two weeks to see the benefits and downsides.

I developed some insulin resistance and was using really high basal rates at night...approaching 3 u/hour at for part of the night, in order to keep my BG down. My endo said this was fine, but if we wanted to attack the root of the problem - gluconeogenesis by the liver - I could try metformin. I am now taking 500 mg Metformin ER
in the morning and the evening. It has cut my TDD by about 25% and has reduced spiking at meals (it slows digestion too). You have to ramp up slowly to get used to it to avoid the stomach side effects.

My endo has also said she is willing to let me try symlin or Victoza (typically a type 2 drug, now being tested in type 1s) if I wsanted to... but right now , the metformin is working fine and the warnings on symlin and victoza are a little scary regarding potential side effects.

If you do take metformin, you will have to make adjustments in your basal rates, I:C ratios, and ISF factor. Once I retuned everything, things have been relatively stable.

It *is* possible to have insulin resistance with type 1.

By the way, my weight dropped about 5 pounds since taking the metformin. I have a normal BMI for my height (6'0, 170 lbs).

I've been taking Metformin since the day I was diagnosed about 3 years ago (as my primary thought I was Type 2 due to my age). Even when the endo determined it was LADA, he kept me on metformin. Endo felt that even if I didn't have insulin resistance, it would help with sensitivity and allow less insulin to be used. Currently, I only need 2-3 units of basal, plus boluses ranging 1:10 to 1:30, depending on the time of day. Probably still honeymooning a bit, though. I wouldn't choose it specifically for weight loss, but if you think it will help with your BG, it might be worth asking about. Actually, it looks like you've already been to the appt - what did you end up deciding to do?

Thanks, Holger, I wasn't aware of those uses for Metformin in Type 1's.

What I was questioning, though, is why diabeetusista believed she had Insulin Resistance.