Replies to This Discussion

Permalink Reply by Zoe on December 28, 2012 at 12:59pm

IR is not a typical symptom of LADA. But anyone with Type 1 is subject to develop it especially if they follow the typical recommended amounts of carbs!

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Permalink Reply by Dianne on December 28, 2012 at 1:07pm

I agree with you on the carbs..

Here's where I'm coming from with the IR being LADA..

http://forecast.diabetes.org/magazine/features/other-diabetes-lada-...

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Permalink Reply by Zoe on December 28, 2012 at 1:49pm

According to John Walsh, whose opinion I trust, people with LADA, like other Type 1's have little or no resistance to insulin. ("Using Insulin" page 40). And just from the anecdotal info on here, most of us take insulin doses similar to other Type 1's (while people with IR typically take significantly higher doses.)Type 1 is primarily a condition of insulin deficiency, where Type 2 is characterized by resistance. But there are certainly exceptions to all rules with D! I just saw your TDD in your other post, you take less than 20 units a day. That is not a dose of someone with insulin resistance.That's a dose of someone who is insulin sensitive. What makes you think you have IR?

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Permalink Reply by Holger Schmeken on December 29, 2012 at 4:20am

Hello Zoe, Metformin will influence the insulin receptor that it true. Thus the affinity to insulin will improve. For T1 this does not help much but it also influences the production rate of the liver for glucose. This will have an interesting effect for T1 too. They will need less basal insulin for this lower rate of the liver. But the reactivity of the liver will be moderated down too. This has the potential to help T1 diabetics that have a very sensitive or reactive liver. Those with very high release rates after waking up and putting the first foot to the floor. Those who react with huge spikes to physical activity. Metformin has a good safety record but the side effects can be unpleasant (bloating etc). Still I would explore it to see how it can help me if my endo would suggest it to me. It just takes one or two weeks to see the benefits and downsides.

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Permalink Reply by HPNpilot on December 29, 2012 at 6:22am

I developed some insulin resistance and was using really high basal rates at night...approaching 3 u/hour at for part of the night, in order to keep my BG down. My endo said this was fine, but if we wanted to attack the root of the problem - gluconeogenesis by the liver - I could try metformin. I am now taking 500 mg Metformin ER
in the morning and the evening. It has cut my TDD by about 25% and has reduced spiking at meals (it slows digestion too). You have to ramp up slowly to get used to it to avoid the stomach side effects.

My endo has also said she is willing to let me try symlin or Victoza (typically a type 2 drug, now being tested in type 1s) if I wsanted to... but right now , the metformin is working fine and the warnings on symlin and victoza are a little scary regarding potential side effects.

If you do take metformin, you will have to make adjustments in your basal rates, I:C ratios, and ISF factor. Once I retuned everything, things have been relatively stable.

It *is* possible to have insulin resistance with type 1.

By the way, my weight dropped about 5 pounds since taking the metformin. I have a normal BMI for my height (6'0, 170 lbs).

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Permalink Reply by Zoe on December 29, 2012 at 8:56am

Thanks, Holger, I wasn't aware of those uses for Metformin in Type 1's.

What I was questioning, though, is why diabeetusista believed she had Insulin Resistance.

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Permalink Reply by roodgirl on December 29, 2012 at 8:06am

I've been taking Metformin since the day I was diagnosed about 3 years ago (as my primary thought I was Type 2 due to my age). Even when the endo determined it was LADA, he kept me on metformin. Endo felt that even if I didn't have insulin resistance, it would help with sensitivity and allow less insulin to be used. Currently, I only need 2-3 units of basal, plus boluses ranging 1:10 to 1:30, depending on the time of day. Probably still honeymooning a bit, though. I wouldn't choose it specifically for weight loss, but if you think it will help with your BG, it might be worth asking about. Actually, it looks like you've already been to the appt - what did you end up deciding to do?

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Permalink Reply by garidan on December 29, 2012 at 10:03am

If some pill is not needed, why take it?
Metformin is not proved (by scientific papers) to be usefull for type 1 (read: lower A1C), but someone's experiece is good and some other's bad about it.
BUT if you don't have IR, I think you shouldn't take it.
For sure if you don't take metformin some days your BG are highers, but that's because without it all parameters change: basal sensitivity and I/C ratio.
Try not to take it for a month, re-check your insulin parameters and see. If you need only some more insulin but your BG control is good, spare a med and go without metformin.

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Permalink Reply by Wren on December 29, 2012 at 10:40am

I'm T1 with insulin resistance and I started taking metformin about a month ago. Prior to that, my TDD was steadily going up and so was my weight. It was so frustrating to have to take more and more insulin to cover a pretty meager, low-carb diet, while exercising and doing everything I could think of to manage D.

Metformin has allowed me to reduce my TDD a bit and I've lost a few pounds. The weight loss is negligible, but it's a relief to see a stronger relationship between my carb intake, exercise, and insulin needs. Luckily, I haven't experienced any side effects. Good luck with it if you decide to try it!

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Permalink Reply by Siri on January 8, 2013 at 1:52am

I just have to add this and it´s not meant to scare you but Metformin is hard on the kidneys not only your stomach.

I started Metformin after two islet cell transplants. I got off the pump but my blood sugar was a bit too high in the morning and my own insulin production was not enough so the doctors put me on Metformin. Side effects from post transplant medications was heavy for me and when my kidneys started too fail the first thing they took me off to relieve my kidneys was Metformin. Today my kidneys are fine after quitting all meds and going back to being a type 1-diabetic. Kidneys was starting to fail only because of the meds I had to use after the transplant including Metformin.

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Permalink Reply by jims on January 9, 2013 at 7:17am

This argumeant is off the wall.

Metformin helps arrest excess Liver Glucose release and phantom liver dumps.
Type 1 and type 2 arguments are off the wall and simply dogmatic arguments.

If Liver is working fine and handling buffering dumps correctly and insulin resistance is low; there may be no need to take.

On the other hand;it is a tool with certain capabilities.

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