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Permalink Reply by LiL MaMa on November 9, 2010 at 4:49am

wow really!? I think I may go on Metformin asap this diet/exercise is taking over my life! what dose are you on? any side effects?

does anyone know if going on medicine helps save your beta cells??

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Permalink Reply by Paul Curwen on November 9, 2010 at 5:02am

I agree LiL,

After reading some of these comments and doing my own research I'm going to ask the Dr to change my prescription to Metformin instead. I'm only 45 and worry about being on a drug like Januvia for 5, 10 + years. I'm not sure if they even know what complications could arise after that long on it...

Paul

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Permalink Reply by John on November 9, 2010 at 2:10pm

My dose is 500 mg Metformin twice daily, 1.25 mg Glyburide twice daily (down from 2.5 mg twice daily before Metformin). HbA1c stable at 5.6. I am probably insulin deficient, not uncommon at my age (age 72, BMI 23). Minimal side effects from Metformin initially for a few months only.

I am wondering if the tighter post prandial control Metformin is giving me is saving a few of my beta cells as post prandial figures improved slowly over the year that I have been taking it. This author seems to think post prandial glucotoxicity can kill beta cells.

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Permalink Reply by Brian (bsc) on November 9, 2010 at 3:40am

Well, for the life of me, I don't understand why metformin is not "THE" first line medication. Studies have shown that it has the biggest effect on HbA1c. It has been around a long time and is perhaps the best understood and safest of all the diabetes medications. And Jeez. You can get it for $4/month at Walmart.

I'm sure that no doctor would prescribe Januvia just cause it is not as effective, not as safe and more expensive than metformin. But perhaps I am harsh and the doctor is always working in your best interest.

Or are they?

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Permalink Reply by LiL MaMa on November 9, 2010 at 4:47am

OR are they influenced by the drug reps.... hmmm...I HATE DOCTORS lol horrible to say but true

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Permalink Reply by KimKat on November 9, 2010 at 8:28am

I love my $4 Walmart deal with the Metformin. I wonder if Januvia is more expensive.

I think certain drs push certain drugs because they approached by the sales reps for those drugs. They get those free pamphlets and everything. I am not sure exactly how it works but perhaps they get some other freebies too (like medical equipment) if they prescribe one drug over another one.

I just notice how I could go to different doctors for different things and get different drugs that essential are supposed to do the same thing but don't always work as well or, even worse, people are allergic to them! Just sitting in the waiting room you can sort of tell what drug companies the drs prefer with all the pamphlets and such.

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Permalink Reply by Paul Curwen on November 9, 2010 at 8:36am

Hi KimKat,

Do you find Metformin helps with your post meal spikes? My morning fasting numbers are good (88-110 range) but my 1 hour post meal spikes can get high if I have minimal carbs. If Metformin or Januvia dont really help with spikes then theres probably no reason to take?

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Permalink Reply by KimKat on November 9, 2010 at 9:35am

I don't know what my 1 hour numbers are because I don't test at 1 hour only at 2 hour. I can't afford all those strips soo...I have to be frugal with them.

I can normally wake up between 70 -100. Mostly lately it has been in the 80s or 90s though. I have about 15 to 20 carbs for breakfast and I am almost always under 120 at two hours. I was told that the two hours number is the important one - not really the 1 hour number. You want to be at below 140 at 2 hours.

I never tested and just did diet and exercise before so I can't really say what the difference is - only that my dx fasting was 205! I wasn't low carb than though. I had no idea how to do the diet until like a few weeks in so I can't compare. But without Metformin (and not eating much those first horrible weeks), I was in the 100s before breakfast. Plain oatmeal without met made me go up to 258. After a week on the Met, my numbers were in the normal range. It worked quickly for me. But I never ate oatmeal again so don't know about that!

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Permalink Reply by Paul Curwen on November 9, 2010 at 9:52am

Hmmm, If I had 20 carbs for breakfast I would probably spike to 200 at 1 hour and then back to 120-140 at 2 hours. I've read, and been told, that all those 200+ 1 hour spikes over time can lead to complications.

I'll probably call my Dr and have the prescription changed to Metformin but I know she will give me grief for being cautious about Januvia... :(

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Permalink Reply by KimKat on November 9, 2010 at 10:21am

Well, I am a vegan so almost everything I eat has some carbs in it. :) Not too many zero carb vegan foods. I eat pretty much the same breakfast everyday.

I have one piece of low carb sprouted toast (says 7 carbs) with peanut butter (6 carbs for two tablespoons but I don't measure and I think I don't use a whole 2 tbspons as my toast is small) and a serving of soy milk cappucino or chocolate (sweetened with splenda - comes that way) at 4 carbs. I have started drinking coffee again (decaf) so I have some xyitol in that (supposed to be 4 carbs but it is sugar alchohol which doesn't seem to effect my numbers) and a bit of soy or coconut creamer (1 carb).

Without the Met, I might have higher numbers at 2 hours - in fact I am pretty sure I would. I don't want to go back to eating meat and dairy gives me ear aches soo.. I am planning to rehab my diet to cut on the soy though because I am worried about my thryoid.

I think I am gonna write myself a note for tomorrow and I will do a test at one hour and see what it is and let you know. I am sure it varies on different days though.

Taking the Metformin is like taking placebo. It felt weird in the beginning when my numbers were normalizing but now I don't noticing anything other than the numbers. :)

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Permalink Reply by KimKat on November 11, 2010 at 9:44am

Hey Paul,

I remember to test at 1 hour for breakfast today. I woke up at 87 and at one hour I am 120.
So, that is around 30 points. I eat my toast/PB first (13 carbs) than I take my pill than I drink my drink (4 carbs). I waited to have my coffee until after the hour test but mostly lately the coffee seem to be helping with my numbers at the two hour mark. It will probably go down actually and be more like 110 or under.

So, I don't know - I think 30 points is good with the Met. I don't think 30 points is too high of a spike is it?

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Permalink Reply by AngelaC on November 9, 2010 at 4:07pm

Januvia is FAR more expensive. It can run you in excess of $200/month if you do not have insurance.

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