Type 1's on Metformin?


I know this has been asked before, but I didn’t see any answers.

I’m going to experiment with it and report back in a couple of months… but I want to see if any other T1’s have tried Metformin.

I’m trying to see if it will shorten the amount of time between when I bolus and when I can eat ( I currently have to wait a minimum of 30 minutes before eating and it gets quite annoying - if I eat too soon I have a lengthy period of High BG).

So, any T1’s on Metformin? How did it change your control? Good/bad/otherwise?

My doctor put me on metformin because I was gaining weight from the insulin. She explained that it helps you stop gaining weight. She did not explain anything else about it and it wasn’t until I picked it up from the pharmacy that I learned more about it. The side effects were a little much for me so I stopped. I decided I would be better off just exercising and watching my calorie intake. That has been this type 1’s experience with metformin.

Your goal to reduce the bolus/eat time seems a bit specific to me for Metformin but good luck with it.
I, and many other Type 1s, take Metformin due to having insulin resistance. I was in the 75u TDD range when I was put on it. Now I am back to the neighborhood of 50 to 60 u TDD and have A1cs in the 6.2 to 6.7 range consistently. That is a good improvement for me.
Have you tried the dual wave bolus for meals? Everyone has a different ratio but one trial could be to take 1/3 as the normal bolus and 2/3 over the next 30 to 60 minutes depending on the type of food (carb vs fat). Or even 1/2 and 1/2 though I never do that split. And is your basal rate correct? I use either the dual or square wave for every meal.

I’d like to know too. Read about using it for T1 in the teenage years for help with the highs caused by growth hormone in “Pumping Insulin” 4th edition. Wtih my teenage son we found pre-bolusing helps too, and yes its real annoying to him too. Though I’m not sure I would want to add a drug to his life, so I didn’t ask his Dr. about it last Friday. What I did ask was about Symlin, I know there a members here that use it, it replaces the hormone amylin that was also lost when the beta cells were destroyed. Its job was to “slow digestion of foods and by suppressing an abnormal release of glucagon that causes glucose to be released by the liver. Amylin uses both these actions to reduce glucose spiking after meals.” “Use of Symlin, a modified form of amylin, can dramatically improve blood sugar control and reduce glucose variability in anyone whose insulin production in limited. When prescribed and given as an injection before meals, postmeal blood sugars become easier to control. Symlin decreases glucagon secretion, deceases appetite, delays gastric emptying and reduces sleepiness after eating. Less hunger is experienced after meals, enabling many people who are overweight to lose weight, yet normal weight individuals lose none. Symlin is undergoing studies seeking approval by the FDA as a weight loss drug.”

Here’s where his endo stood on it; Its not approved for children and prescriped only for Type 2s (But that maybe just be their policy)

The book “Pump Insulin” John Walsh, is an amazingly educating book even for those on MDI, I highly recommend it! :slight_smile:

I have been wondering about this, thanks for asking! Please do report back what your results are!! I am LADA and even though I am very active and thin I still have some insulin resistance and I was thinking in the future when I am forced onto high doses of insulin if adding Metformin would help.

So is your son now using Symlin?

I should have been more specific… it is exactly for the same reason as you… i have insulin resistance (and when my BS gets high I have EXTREME insulin resistance) I’m on TDD of 90-100 units of Novolog and it’s ridiculous.

As for square/extended bolusing, I would need the opposite (need the insulin ALL upfront and with at least a 30 min lead time… my basal rate is 100% right on.)

I do use the square bolus for high protein meals (I actually try the TAG method and it works quite well)…

Thank you for your feedback, I’m glad to hear your TDD went down by about 25% or so… that’s very reassuring!

I tried Symlin… be careful with the lows… it does a great job of curbing appetite and it did allow me to take insulin immediately before eating, but it threw such a wrench in my timing that it made it quite difficult to manage… your experience may vary, but with the lows it would take 3 hours or more of “nursing” a low that simply would not respond to glucose or food and would eventually rebound to a high and got me into a rollercoaster cycle.

I’m glad to be off the symlin, but then again, I was taking a high dose (60mcg 3-4 times per day).

I will let you know how the metformin goes (it’s only 2 pills a day and I believe there’s an extended release version as well)…

Hi LiL MaMa, haven’t been on the forums in a while, its good to be back. No, his Doc said its not approved for children yet. I’m all for hormone replacement for what he lost but leary about drugs, though I know Metaformin is what helps type 2s.

Absolutely will report back!

You know, the irony is that when I exercise regularly my body seems to take care of all these problems all by itself and the insulin resistance is drastically decreased…

There’s no substitute for regular exercise, but unfortunately I let work/life get in the way sometimes and hopefully the Metformin will fill some of that gap!

Thanks Rye… you’re right on with the exercise and food intake!

I exercise for an hour and half 7 days a week, which helps me with post meal spikes and allows me to take low doses of insulin but heaven forbid I miss a workout after a meal! lol

I hope you don’t mind me asking, but have you tried limiting the carbs? Having elevated blood sugars alone can “cause” insulin resistance, and if you go way high from your meals, that can be an issue. Reducing the carbs may cut down on those highs and combat the IR.

I don’t use Metformin myself, but its main effect is to inhibit gluconeogenesis. As such, it seems like it’s a particularly powerful tool when combined with low carbing.

Low carbing, as a T1, often results in my total dose going up, because I end up taking insulin to cover the proteins hours after the meal. But combine low carbing with Metformin (inhibiting those proteins etc. from turning into a rise in bg’s hours after the meal) and it looks like a potent combination.

The wikipedia page implies that T2’s have unusually high rates of gluconeogensis when not on Metformin. Wonder if the same is true for T1’s. Makes me question other measurements (e.g. “glycemic index”) which seem to correspond poorly to my reality, too.

So no real answers from me, just a lot of random thoughts :slight_smile:

While one action of metformin is to reduce the amount of glucose your liver produces, a primary effect is also the increased the uptake of glucose into your cells (decreased insulin resistance). For T1s, these effects can be just as signficant for a T2.

Hey rye, can I ask what the side effects were? I’m in the same position as you, with my weight increasing due to the insulin, and have thought that it might be something worth asking my doctor about.

I take Metformin but I was prescribed to it at the same time I was prescribed insulin so I’m not sure what effect it has over and above my insulin. I go to a free clinic, not a specialist, so they just try different things to see what works… It doesn’t seem to be hurting anything. It’s free from the pharmacy I go to and I haven’t noticed any side effects so I doubt I’ll stop taking it any time soon.

I was misdiagnosed as a T2 and metformin worked for me for a few months. But it ultimately stopped working at all. In fact, that was a big reason why a doctor finally had me get GAD65 testing. So, based on that experience, I would think that it would work if you had insulin resistance in addition to Type 1 but not if you don’t. Of course, I’m basing this thought on nothing other than what happened to me and at that time I was mighty sick due to the misdiagnosis in the first place.

I’m a T1 and was on metformin for about a year. I became very insulin resistant after my pregnancy and the amount of insulin I was taking was ridiculous. I was also struggling to lose the baby weight without any luck. I was on 2000mg/day (1000mg with breakfast and 1000mg with dinner). It helped me lose weight and helped a great deal with the insulin resistance. I’ve lost 30lbs (with a weight loss program) in the past 6 month and am now off the metformin. In my case it was a win-win.

I was on Metformin last spring 2010. I’m Type 1 since 1998. I went on it due to high insulin resistance. I had insulin resistance to the extent that my doctors thought I had gastroparesis. I went on Metformin (1 pill per day at first) in the morning for a few weeks. Then I increased my dosage to one pill in the morning, one pill at dinner. My numbers improved quite a bit because my body was finally USING the insulin I was injecting.

I had to threaten my endocronologist to prescribe Metformin to me. He kept saying that it was a Type 2 drug and that I wasn’t eligible. I told him I would keep taking the insulin, but also wanted to take Metformin.

I was on Metformin a total of 3 months before it seemed like my body was kick-started and re-booted. My A1c has dropped 2% since coming off of Metformin and I seriously credit my experience with Metformin for the short 3 months that I was taking it for my tight A1c control. After I give birth (I’m currently 5 months pregnant) I will likely go back on Metformin for a few months to help get my insulin intake back down to what it was before becoming pregnant.

My endo prescribed me 2 tablets per day right from the start, but I believe it was smart to ease into it. Watch your numbers as they will likely go low until you lower your insulin intake. You may even need to lower your basal. I know I did. I posted a blog on TuD about Metformin and Type 1 last year.

One side effect was… if you take one pill too many… you WILL pay the price. I was soooo sick because I took 2 at dinnertime when I forgot that I already took one that morning. Oh boy. A few hours later it was like my intestines were pouring out of my body. I swear I lost 15 pounds that night.

Good luck! I recommend it.