I was wondering if there was anyone out there with type 1 and on metformin. Obviously insulin as well! My glucose levels and weight have been slowly creeping up the last year despite diet, exercise, and vigilant testing. I did some research and was initially going to try Symlin, but it was so expensive! So I decided to give Metformin a shot. I have seen some blogs/websites that discuss people in a similar situation to me who has success with Metformin.
So far I am on a 500 mg twice a day. A little bit of GI upset but nothing like the horror stories I have read. I do notice my post-prandial numbers are much better already! And I am less hungry. I felt like before I could eat 24/7 but now I feel satisfied for longer.
I would love to hear stories of anyone’s successes or failures with managing type 1 diabetes with insulin and metformin.
I'm Type 1 (LADA) but fit the clinical presentation of a typical Type 2. Overweight, hypertension, etc. This caused me years and years of misdiagnosis.
I've been on Metformin for years as it is one of the preeminent treatments choice for Type 2. For me it has been extremely helpful, even more so since switching from MDI to the pump. I have little to no side effects any more, if I ever did I cannot recall.
There is a huge difference with post-prandial spikes when I'm not taking it - on the order of 60-100 points! (I've had an opportunity to test this again recently after some procedures requiring that I stop taking it for a few days.) It makes a huge difference for me. Interestingly enough, although I suppose expected, it does almost nothing to help with basal insulin needs.
I take Metformin, i am up to 2500 mg a day, and i can see a huge difference than without it!!! I can tell if i wake up later on the weekends and i don't take it, and i eat and take my insulin, i have a much HIGHER pp, and then i realize oh yeah metformin!!! I have PCOS and cushings so i have plenty of insulin resistance with my T1D, but i couldn't imagine life without it! It also is such a harmless drug in comparison and does so many good things in the way of the body with different things. Since moving to Alaska i have had every doctor and endo ask why in the world as a T1D i am taking a T2D medication and i go through the explanation and then tell them to educate themselves on it! Congrats on starting and see results!! THe GI upset usually always goes away within 3-6 weeks of being on the medication! Take it with food helps more. A lot of people find it to work best if you take with your first bite :) Good luck and if you have any questions feel free to ask!
I'm Type 1 (for the past 25 years) and on a t:slim pump, Dexcom AND Metformin. I asked my endocrinologist to put me on the Metformin in August because despite exercising a ton and eating a limited carb diet, I was unable to lose weight. My a1C when I started the Met (500 ER 2x per day) was 6.5% but I know for a fact my a1c has improved since then just based on how my Dex has been looking. I'm thinking it's closer to 6% now. I had really limited GI issues with Metformin- a touch of nausea here and there if I didn't eat a lot with the dose, but that's it. Not vomiting, diarrhea or any of the other horror stories you read about. I honestly wonder if most people follow the instructions to make sure to take it with food. Biggest changes for me were postprandial bloods and my 4AM bloods- both were lower. I find that I don't spike as much and that I am barely hungry anymore, like you mentioned. HOWEVER, this does not seem to have translated to much weight loss, if any. I think I seriously lost 1-2 pounds and that's it. Bad things about being on the the Met that I have noticed are that you have to be REALLY careful with Hypos because it is difficult to get them up as quickly as before. When I'm low now, I turn off my pump for 45 minutes AND have a tablespoon of honey. Of course, this varies depending on how much physical activity I'm doing. My TDDs were hovering around 26 units to 32 units daily. Now I'm consistently around 20-24 units. Another negative about the Metformin is that it magnifies the hypos that can be caused by consuming alcohol. Before using Metformin, if I had beer or wine with dinner, I knew to expect a possible drop in the middle of the night, so I had to monitor and maybe have a snack before bed. Right when I started Metformin, I had a couple of crazy lows after drinking with dinner that were the most insane lows I've ever had. They actually caused serious confusion along with the usual weakness/sweating which was not a symptom I had ever experienced before and I had great difficulty bringing my blood sugar up. I think one time I consumed half of a container of rooftop organic honey while lying in a pool of my own sweat in bed. Thanks Brooklyn rooftop honey! Thank God for CGMs though- at least I was alarmed to the situation before it got worse. Honestly, if I was not using Dex or any CGM, I wouldn't use Metformin. I think the first month can be tough because you can have more hypos than you might be ready for. I don't have as many hypos now but it's because I have completely adjusted my basal rates. Hope that helps. Feel free to message me if you need more info.
I love it and believe it's one of the best medications out there. They should just put it in the water, if you ask me. I take Extended Release at bedtime. It helps with dawn phenomenon and allows me to use less insulin overall. The ER formulation results in absolutely no GI side effects for me.
Interesting, I've always wondered about this. Do people with minimal or no insulin-resistance still find Metformin helpful? I'm a lean, athletic Type 1 in a very drawn-out, decade-plus honeymoon, with minimal insulin-resistance (have had an oral glucose tolerance test with insulin levels). My regimen works well, so not sure how seriously I'd actually consider this, but I've wondered about whether it should be part of treatment protocols more generally for a while.
Metformin was a medicine my new endo referred to as something I could try first- not insulin. I don't think I am insulin resistant since I can get hypo symptoms if I exercise too strenuously, particularly if I had elevated glucose before. I wouldn't want to increase the chance of having hypoglycemic symptoms; although I'n not in danger of going too low since I am not on any meds and my body recovers. It's just rather unpleasant. Just how would Metformin benefit a person with type 1 or early LADA in my case?
Actually lows such as you describe are found in both T2 and LADA. It is called reactive hypoglycemia and occurs as your insulin production wanes. Metformin has three main actions, it improves your insulin sensitivity, it reduces the amount of glucose produced by your liver and it impedes the absorption of carbs in your digestion. All of these effects may help you whether you are T2 or LADA. And in the end whether you are T2 or LADA, when you can't control your blood sugar adequately you should move aggressively to use more powerful treatment including insulin.
Thanks Brian...I was a little concerned when I read the earlier post about metformin causing magnified lows, but I imagine the insulin use is what resulted in the low...not Metformin. This post has been helpful! My 30-day average of 120 on this diet is creeping up and now is around 123. I am leaning toward asking doc for a trial of Metformin if my A1C went back up from 5.5 to 5.9 since switching from low carb to his suggested Mediterranean diet. I'm scheduled for an A1C in Jan. so I will make the request then. I don't want to wait till I see him again in April...I think that's too long.
I am T1 and used 500 mg/day for several years. It brought my TDD down from about 75u to about 50u/day. Just had to go off it though because if your eGFR (kidney function) test is abnormal (can't recall but maybe 30 or less), then the company does not recommend continuing Met as it will only make the kidney function worse.
I can recommend it as long as your kidneys are good. I have not read the other posts so this may be a repeat of what others may have said.
Oh, and it reduces total daily insulin dosage, especially good for those on higher insulin amts.
Just returned home from an appointment with my endo. Based on the remarks made in this thread and my relative insulin resistance from 3 a.m. to 1 p.m., I asked my doctor what she thought about prescribing Metformin off-label to a T1D. She was fine with it and thought it would help me. She said overweight T1Ds do benefit from it. My body mass index is just over 25, the lower threshold for being overweight.
I'll start tonight on 1x/day 1000mg extended release. She mentioned a titrated dose to begin on so maybe it'll be less in the beginning.
I'll post my results. I'm hoping to get better BG control with less insulin and maybe lose a few pounds. I always resist starting any new chronic drugs but I think this one is worth a try.
Thank you everyone for your comments! I gave Metformin a shot for about 2 months, but it did not work well for me. I was having severe lows despite cutting back my insulin a great deal and the lows took longer to come back up.
It actually had the opposite GI effect after I was on it for a month or so, it constipated me. I felt so full and bloated all the time. I did not like it. And also no weight loss.
I gave it a shot, but it didn't work well for me. I am currently looking into Invokana. It seems promising.
Would love to hear about what happens with the Invokana. Keep us posted! I'm getting my liver levels checked and then maybe going up on the Metformin. I agree with you about feeling full all the time though...I am ALWAYS full and never hungry...still can't lose a pound though. Stumped!
I stopped the Metformin after six days. Here's the summary I posted in the TuD group, Flatliners Club:
I recently experimented with adding Metformin to my diabetes routine. I've read accounts online from T1Ds who said it helped them. I was experiencing increasing insulin resistance in the 3:00 a.m. to noon timeframe and I hoped that Metformin could moderate that. My doctor agreed to give it a try.
I used it for six days and my BG control got worse, much worse. My immediate BG lines started to soar (250 mg/dl peak) from the 2:00 a.m. to 8:00 a.m. I increased my basal profile to compensate but I was not making any progress.
Now I realize that a six-day experiment with any change is not usually enough but I couldn't bear to watch my very good to excellent control degrade to poor. I came to the conclusion that my previous regimen, without Metformin, was a much better plan for me. I realized that I was trying to make a very good situation perfect or "gilding the lily."
So, I dumped the Metformin dose and it took me five days to return to my former patterns.
It didn't work out for me. I am not technically insulin resistant at a total daily dose of 40 units of insulin. The textbook definition of the threshold of insulin resistance is a total daily insulin dose of > 0.5 units/kilogram of body weight. I am right at 0.5 units/kg.
My restored control is back in a good range. My latest weekly time in range (65-140) is 81%, standard deviation of 33, average of 104 mg/dl, and time low is 6%. This meets two of my four weekly goals.
Diabetes is tough to control and we're all dealt different hands to play. Using Metformin to control BGs is another tool available to us. Good luck to all!
I was still taking 2000 mg of Metformin when I started insulin (LADA, after a 13 year misdiagnosis of T2). Since I'm thin and am pretty insulin sensitive, I figured I wouldn't see much of a change going off it.
However, with the Metformin, my numbers were great on only 7 units of insulin daily (4 Lantus, 3 Novolog) and I could eat 25-30 carbs for lunch and dinner on a single unit of Novolog. Without it, I'm up to about 11-13 units (6 Lantus, 5-7 Novolog) and can eat about 20 carbs on TWO units of Novolog. I also have a greater incidence of unexpected highs without it.
Hi, Jessica–My take on Metformin is mixed. It does moderate spikes but I did cut my dose From 1000 mg to 500 mg twice a day way back because of exercise lows. I also lost more weight than I could spare (considering how much I lost when I was DKA last year). I may go off it entirely in the new year and adjust basal/bolus accordingly 'cos as it stands I can’t miss a meal or snack ever! And the CGM I started using a few weeks ago has made a been a big help in avoiding exercise lows. Glad Invokana is working for you. CatLady
