I would use the word "remission" instead of "reversal".
Where were you when I wrote it? lol
Excellent point, that is more in line with what I “meant”. Just poor word choice on my part I guess.
THANKS!
I will hop in and respond.
First off, I agree that the words remission, cure etc tend to offer too much false hope and may in reality inappropriate.
In my case and as I see it is:
Getting the conditions that appear to be causing the problem - wearing out body are critical to stop on going body damage.
Getting the damage slowed down/stopped and preserving what is left operating is key critical.
ANy change made in diet, meds , exercise will only show immediate affect in the fast blood glucose BG and its averages.
Actual improvement in body will take 3 to 6 months of continuous operation that way.
My examples are priceless. It took one year to find solution to liver riots on metformin although I had been using for years.
Initally after getting BG down working, it took 6 months to finally see body panic over BG going under 70 and doing Liver dump. It seemed I had reserves of glucose stacked all over my body for 6 months.
AFter figuring out proper metformin doses and timing, it took my body 6 months to suddenly in one month generate a whole bunch of super lows and I was first cutting stralix in half, then boot altogether and then focusing on the dam
75/25 and getting that high intenisty crap out of my system ( 26 units in am for a few years) and going to the humalog lispro 4 units in am; 4 at lunch and 4 at dinner and initially 1/2 unit at midnight. The half unit at midnight no longer needed and yanked.
I did find that 15 units of lantus most helpful as basil insulin nad CGMS confirms dose correct as numbers at midnight to am flat.
My response today is:
- one needs to give ones body the best possible chance.
- That means regular hearty exercise - 1-2 miles walking or equivalent.
- Control carbs intake and insure not too much.
- Get medical problems checked, fixed where possible and monitor regular research to watch progress and thinking.
- Keep up the faith and hang in there and give 6 months to year to see how body is actually performing.
- one must actively monitor this crap and take readings, the nitwits that assume one finger prick or 4 if you are on insulin
is sufficient and absolutely ludicrous and disgraceful. - If you are in good health you probably do not need CGMS but as type 2 who had monstrous problems, absolutely essential to watch and track BG activity 24/7 to see what is really ticking behind the secret curtain.
Thank you all for writing and sharing. Good luck in your quest and hopefully better health and at minimum at least a few more days standing on green side of the grass and enjoying sunshine.
Hmm… the timing of Metformin is crucial. I had thought that because it builds up in the system, the timing didn’t matter. I now cut the one pill in half and take it with meals. I figured it out by using the meter. Who knew that the timing of the pill could make so much difference?
BTW the first thing I learned on this site was to eat a Metformin sandwich…food, pill,food. That strategy all but stopped the GI issues. Amazing!
NO don’t CUT the metformin. It says right on the bottle not to break the tablets. I think if you do it makes it absorb too quickly, i.e. NOW.
They say the timing doesn’t matter because most people have the ER kind, but even with that kind I have found it does matter. It helps to take morning and night if you take more than one pill…
My doctor likes me to take both Metformin pills that make up my dosage at night. He says taking them together means that they last for the whole 24 hours in an even dose. I don’t get any side effects from the drug so he is probably right.
Just wanted to observe that regular hearty exercise is not possible for all Type 2’s; many have arthritis and fibromyalgia which make this too painful. Type 2 control has to be individualized for the person, and what works for you may not work for everyone else.
Let me add more:
I presently take doses of 500mg standard Metformin as follows:
one hour before each meal so as to be up in strengh in blood as digestion ends and BG heads back down.
Timing dependent on your body/gut/liver. For me that is 2.5 hours up to strength, 2 hours on and 1/2 over the cliff/niagrar falls. My gut takes 40 to 60 mins for gut to start outputting sugar, my gut usually lasts 1.5 to 2.5 hours on proper meal and sugars from fats come off about 6 hours after meal ingestion.
The reason for this timing is that when the BG heads back down after digestion end, if there is a bump, extar snack following right behind and attempts to push BG back up; ( BG can be from 140 to 210 etc) Dam liver can decide to do a sympathetic dump and ram your BG up and for me that would be 278 to 311 or higher.
Any time metformin up to strength in blood, one would see a small disturbance in BG from liver but still at llevel it was tracking. I have sat on CGMS and met presence and not and confirmed results. I have not had spurious liver dump in weeks and a1c recently 6.4 and low points are around 120-122.BG
I can watch on CGMS as each pill comes up, BG starts to fall as liver leakage cut off.
I take one at 10:00 pm and one at 12:00am and that cuts off the dawn effect from 12:30 midnight through to 5:30 am contiguously. After 5:30 I watch my liver come out of barn and try and pump BG up. I take my breakfast humalog 4 units at 5:30 followed by metformin pills, vitamin heart pills by 6:10 and this covers me real well till lunch.
I can adjust my met pill dose to match eating time and always target 1 hour before eating.
One big dose of metformin useless - been there done that and needed to kill some pill jockey’s over that.
STandard Metformin for me works best, ER not and hate Teva but most standard generic’s work well.
Doses of 250 milligram not large enough.
Both Salk Institute and researcher at John Hopkins have released info that suggests Metformin works directly
on liver turning off the make sugar switch to put liver in fasting.
John Hopkins researcher indicates that dose size of metformin to whack switch may vary on individual but they had figured out way to simply test for drug dose size.
As far as I am concerned, some good folks in medicine are NOT knowledgeable on this issue at all. Their binnocculars are pointed in wrong direction.
Also, you have to watch what you eat and drugs you take as they will override the metformin and cause liver to boot out the glucose. Been there - done that. MSG , some food additives and some antibiodics. If you bump into those dogs, you need to up insulin and it will usually tast 4 to 6 hours and new dose of metformin to stop leakage. Oh yes hard booze will also override met and liver will boot glucose so I do not drink when met up to strength.
Meformin is way more powerfull than advertised, be carefull.
One needs to check with your Doctor, have a CGMS and supervise closely. I do not want tight control so as to ensure a little slop and excess glucose when liver cut off.
Basically what this indicates is that ones fifo buffer - liver is unreliable and buggering up glucose control.
I have been buying 1000 mg pills and cutting in half for years. I also had 500 mg pills I did not have to cut.
For me I am unaware of any issue but it may affect others
Good point and answer would be or equivalent by means you can do and Doctor approves.
Yes neat Ladies.
First off after eating ones needs to rest for 1/2 hour so as not to race food into gut.
Secondly walking does help agitate gut and speed up things - more BG.
Exercise enough - you will drive it down.
I have consistently on liver dumps and bg too high went marching 2 miles or more and it does come down
excepting a liver dump.
Whoops! Thanks Chris. I forgot to say that while I did change the timing of the Metformin on my own, I soon saw a new GP who okayed it. I only did it on my own because all the pills I was taking were causing my numbers to rise (A1C 10.1) and I had developed neuropathy.
The good news is that the new doc is a Type 2 who believes in low carb and exercise. The bad news is that he works part time at the clinic because he plans to retire soon.
While my numbers are now normal during the day I still have the Dawn Effect. I took the full Metformin morning and night for a few years as the endo suggested but there was never any change…often 11 in the morning. When I changed the dose and timing, I no longer felt sick so I could drink a glass of wine in the evening. Now I’m starting to see normal numbers when I wake up (4 out of 7 days) and those 11s are a thing of the past.
Hopefully anyone changing the timing or dosing of meds can do so under the supervision of a good doctor. Thanks for pointing this out Chris! 
Cutting metformin pills in half would only be detrimental if you were taking the timed release variety, usually called Metformin ER.
BTW when I was taking the sulfonylurea my numbers were 13-18 all day and all night. The new GP said that the sulfonylurea had caused the high numbers and the resulting neuropathy. It is true that one size does not fit all when it comes to Type 2.
That is interesting, because, of course, the sulfs are SUPPOSED to lower BGs by stimulating the pancreas to produce more insulin. They are no longer considered to be first-lline treatment for Type 2, because they cause weight gain and metformin works a lot better for most people.
Not sure I would trust what a GP says – it’s more likely that the high BGs were the cause of the neuropathy, but the important thing is that you get the treatment that works for you – the sulfs were obviously NOT working!
Hi Natalie: I stopped the sulf because I believed I was allergic to it. The GP said that the problem was that the sulf was not necessary which is why the numbers had gone up with each pill. This makes sense to me because my numbers are normal now. The neuropathy has almost healed (still have a toe without full sensation) and my kidney and liver numbers have returned to normal. I haven’t been tested for C-peptide but, after 3 months, I’m pretty sure my pancreas is still working…at least for now. I figure the sulfs just forced out more of the same insulin which my body was having problems with already.
The endo said he had to ramp up the pills because the disease was progressing. He told me that I should eat more fruits and veggies. He consistently ignored all my meter readings and logs. The GP told me to eat low carb and exercise. He also said that if the numbers went up again he would prescribe a small dose of insulin. He reviewed all my files from the endo and actually looked at all my logs. He asked me to come in every 2 weeks until he was sure that I was okay. For the first time in almost 4 years I feel like I can trust a doctor again. It’s too bad that he plans to retire soon. 
There is an interesting article posted on Dlife called “Metformin and Exercise Combinations Less Effective For Glucose Control”. Sorry… I don’t know how to do the “link” thing but it is listed with the other articles at the bottom of the TuD Homepage.
Heres' the link Peetie mentioned. Can't really say it jibes with my experience though.
Not being a turkey but why?
I was led to believe that the whole pill was a special blend of special slow release fillers.
Why does cutting pill in half have a problem? Sounds mor elike a pill company excuse
to prevent saving money buying bigger pill and cut in 1/2
useless. Couldn’t disagree more from direct experience.
What hack wrote this?
First off there discussion doesn’t even cover how it works on me.
Second, the more I exercise, BG goes down and stays lower longer irregardless of the
metformin I take.
This must be one of those margerine studies where butter is bad for you and transfat marg is good.
Cutting an ER pill causes the drug to be absorbed too quickly in the body. The reasoning for this warning has nothing to do with cost. Any kind of extended release pill has a special coating on the outside that takes longer to breakdown/digest, which causes the medicine to be absorbed by the digestive tract more slowly. This makes the drug to have a longer, more steady affect on the body.
Cutting it would allow the digestive tract to absorb the drug more quickly (too quickly), which could potentially be very dangerous/fatal if levels of the drug become too high in the blood stream.