As you may have read from my page and/ore posts, I was diagnosed Type 2 in Jan 2011.
I have done the diet / exercise thing, which took me a long way (A1C from 11.2 down to below 9!).
Then I added metformin 1/2 tab twice a day with mixed results. A1C went from 8.4 to 9.0!
I have since mixed it up to metformin 1/2 tab four times per day and 1 to 2 hours BEFORE meals. Latest A1C is down to 8.2! Lowest ever since "the ordeal" began.
What I am noticing is that my morning sugars are not too bad: Usually below 8, Often below 7, and sometimes as low a 6! However I do note that when I eat my sugars tend to go up fairly quickly and tend to take their sweet time coming down again. IIRC a typical example would see sugars still be 12ish two hours after eating lunch and be back in line (6 ish) before dinner.
So....
I am considering adding another drug to try and deal with this aspect of my sugar fluctuations.
The $64 question is....
Which drug????
My Diabetic Clinic has always been hot to trot to throw weapons of mass destruction at my body. I a NOT a "pill popper". I believe that one should intake as few and as little additional meds - not only for cost reasons, but all these puppies have side effects and interactions! I firmly believe in the KISS principle - Keep It Simple Stupid!
So all that said - what are your recommendations, and why???
Hmm... I do the half-tab metformin thing too. I'm t2...9 years in. I took another drug and it almost killed me. I now take 2 Chromium Chelate tabs (200)...twice a day. I take them between the met. It seems to work for me but I had to do lots of testing to figure out which pill to take when. You can buy Chromium over the counter and therefore you have control. My sugars were good for awhile so I was able to cut it out but, as soon as I noticed the numbers creeping back up due to a major stress, I started taking it again. Not sure what anyone else thinks about this? Joanne
If you have not reached a max on the metformin, you could sill increas it. The maximum is 2500mg/day. After that, it depends. You say that you are having trouble with meals. Many have had success with the class of drugs that are called GLP-1 analogs. These include Byetta and Victoza. For many these have greatly reduced after meal blood sugars and they have the advantage of reducing appetite and helping weight loss. The downside is that they are injected and some people experience some mild nausea.
Actually, I have been taking Chromium Picolonate and Vanadyl Sulfate since close to day 1. However, I did significantly reduce the amount I was taking when I went on the metformin! Perhaps I shall crank it up again.
At the moment I have been taking 0.5 mg (500 mcg) once per day (Morning) and 10 mg Vanadium once per day (also monring).
When I think back pre-metformin, I found that the combination of Chromium and Vanadium did tend to limit the dynamic range, but not the base. Then I was taking 500 mcg Chromium 4 times a day, and 10 mg Vanadium 4 times per day.
And now that you mention it, I have been under considerable stress over the last couple of months. My company is going through financial troubles, and some were fired, some were laid off, and most of us were cut back to 4 days a week! And a month before Christmas too. I will definitely increase the supplements! I forgot how stress can wreak havoc with all this.
IIRC, the clinic mentioned Victoza. Seems to me that this is a newer drug, so that likely means $$$. I will do my homework on it. I don't like to be on the "bleeding edge" in using any drug. Too often years later problems are discovered.
Interested to hear more from others who use it though!
Well, that is a good general rule. Often drugs are rushed to market these days and there is some uncertainty about their actual safety and efficacy. I used both Byetta and Victoza and looked at them closely. Byetta was approved in 2005 and for my insurance was a preferred drug costing me a single reasonable co-pay for a 3 month prescription. Victoza was another matter. It was only approved 2 years ago and when I took it my insurance would not cover it as a preferred drug. My insurance company has changed and now offers it as a preferred drug. You can of course check your insurance formulary to be sure of your coverage and costs before discussing this with your doctor.
What about Januvia. I took it for a short while after Byetta and Victroza both became ineffective but it was to little to late. I am a 20 year T2 and and have run the course with oral meds so I don't blame the Januvia for not working. I had no problems when taking it but was only on it for a short. Maybe others can shed more light and who knows it might work for you. Then again there is insulin which I think is the best treatment.
Please use caution with vanadyl sulfate. It can be risky for long-term use & in high doses. Vanadyl sulfate can cause beta cell death, DNA damage & interfers with protein synthesis. It's a micronutrient, so not something the body is intended to have in large doses. Vandium requirements are in micrograms, so mg doses are quite a lot.
I agree that you likely could go to max metformin and try that. In addition a complete re-look at your diet to help with any insulin resistance. If you are a thin type 2, and there are, then you may need insulin.
Right now you have a weapon of mass destruction in you and thats high blood sugars as you are running twice over what you should be. If my sugars were as high as yours I would be demanding insulin to at least get me down into normal range and then work on the other stuff.
Well one step at a time. I appreciate that 8.2 seems "high" for a1c. However when my body "tanked", I was getting blood gloucose levels of 25 mmol/L which approximately equates to an a1c of about 14.8.
I am not skinny, so there is more work that can be done in that regard - although I have lost 20 pounds, so not too bad there either.
I am starting to see readings as low as 5.5 mmol/L; however, without a word of a lie, when it gets this low I feel nauseous and like I am going to throw up. 6.0 - 7.0 mmol/L and I feel fine.
I suspect, as does the diabetic clinic, that my system was saturated (quite literally) for so long that it is going to take time before my system gets used to having "normal" sugar levels again.
I have been tested for everything, and at last count 100% of everything in my body was working fine - just the sugars not working. I believe I have been blessed to have had the condition diagnosed within a couple of months of its appearance. So now I have time to get it under control without having to go into a "nose dive" to do it.
It wasn't until I rasised my metformin from 1700 mg per day to 2550 mg per day and cut my carbs to about 30-40 per day that I saw low morning bgs. I also experimented with the timing of my met. I take 850 mg , 3 times a day. Two of them are in the early and mid morning and the last right before bed. As far as other drugs I would not add them until you max out metformin. If your insurance doesn't cover Victoza it can cost $400-$500 per month. Also it has severe side effects for many especially if you overeat. Also many find it only works for 6 months- a year and then loses its effectiveness. Januvia also has side effects like pancreatitis and inflammation. So do your research.
Last fall my a1c went from 8.4 to 9.0. At that time I was doing metformin 1/2 tab morning and night. I switched from that to 1/2 tab 4 times per day, and also modified the timing. It takes at least 2 hours for metfomin to start being effective in your system, so I try to time it about 2 to 3 hours before meals. That covers 3 times, and then 1/2 just before bed.
Just by doing that alone dropped my a1c down to 8.2 - and over the Christmas Holidays no less (yes, I slipped a bit...).
Thank you so much for the info on Victoza and Januvia! Yikes! Just the kind of drugs I want to avoid by the sound of it.
