I was type 1 for about 50 years when I changed from animal insulins to modern day insulins. That led to my gaining weight and becoming insulin resistant (IR). I had to use a type 2 med to handle the IR. Avandia was the med my doctor chose, and I used it successfully for 12 years, starting in 1999. Avandia was found to cause many users to have heart problems, so my endo would not renew my prescription, and he prescribed Metformin in early 2011.
I have mixed emotions about Metformin. It has enabled me to lose 22 pounds, and I am now only one pound above my ideal weight (185 pounds). That is great, although I have had to buy new clothes and belts. Lol! My insulin resistance has been decreased, and my insulin sensitivity has increased. That is also good.
Metformin was initially introduced as a med to help with weight loss. Later on, it was found to help with with IR. It has caused me to lose some of my appetite, and I don't want to eat as much now. At one time I was losing an average of two pounds per week. To keep from dropping below my ideal weight, I had to increase my carb intake from 130 to 150 carbs per day. My weight has now stabilized. I don't want to eat that many carbs, and sometimes I have to eat when I am not hungry. That is annoying! If I lower my carb intake, then my weight drops too. I have tried lowering my Met dosages, but then my IR increases, and my BG numbers rise a lot. I am taking 1000 mg of Met in the morning and evening.
While using Avandia my BG's were very good, and I stayed in the interval 70-130 about 90% of the time. I have used Met for 15 months, and have a lot more highs and lows than before. My BG's are now in the 70-130 range only 66% of the time. BG's as low as the high 30s, and as high as the 170s are happening. I rarely had numbers like that while on Avandia. I am now on the roller coaster with my BG's, like I was before pumping.
During the first few years of the new century, I was diagnosed with some spots of neuropathy in both eyes, and neuropathy in my feet. That was caused by the unstable control, and the roller coaster I was experiencing. Complications can occur for that reason, even when the A1c is good. My A1c was below 6.0 for several years when those complications were diagnosed. After using a pump for a few months my BG's stabilized a lot, and my retinopathy disappeared. My neuropathy was still there, but the symptoms rarely appeared. The pain was gone. Pumping is great!
Now, while using Met, my roller coaster control has returned, and I am concerned that my retinopathy, and neuropathy pain may return too. My doctor says he has no other med to offer to help me with my IR. Avandia and Actos have both caused damage to many diabetics, so Met seems to be my only choice. I have tweaked the heck out of my pump, trying to get more stable control. It was easy with Avandia, but seemingly impossible with Metformin. I am apparently stuck with Met, and with the more unstable control. I am expecting those complications to return at any time now. Call me a pessimist, but this happened in the past, and it may happen again.
Interesting point Timmy. I will consider that. Thanks!
Well there is victoza a real game changer. Brand new, long term effects unknown.
Max out the daily metformin dose ?
Cut carbs significantly to whatever it takes to get your S.D. back to where you would like it to be.
Anthony, have you read that Victoza can actually help a T1? I am going to research that.
I an using 2000 mg of Met each day. That is almost the Max dosage allowed.
If I cut carbs I will lose weight, that is why I went from 130 to 150 carbs, to make my weight stable.
Thanks for your suggestions. I have read many suggestions now. All of them have some merit. I have made a list and will take it to my next endo appointment in August.
Victoza can be helpful to T1s. The use for T1s is still off-label, but a number of people (including Bernstein) have been prescribing it to help with weight issues and people that have real cravings. In your case, you don't have any weight issues and you already mentioned a lack of appetite. I wouldn't suggest it.
Not sure if victoza has been studied with insulin that much.
Well the victoza cut my injected insulin by a lot (at least a factor of 2) . The weight loss was dramatic but short lived.
Any future weight loss will be achieve by cutting calories.
The positive effect on blood sugar variance is long lived. It is more potent than metformin in this respect for sure. The down side is super high cost and having no track record.
Weight should be at least somewhat a function of total calorie input so if you cut carbs you should of course replace it with more fat a large handful of cashews should prevent weight loss.
Richard (and others),
How much did adding metformin improve your insulin sensitivity ? Did your TDD go down when you started metformin ? I think I am having some insulin resistance now and am wondering if metformin would help.
With metformin TDD down by 25% maybe with victoza more than 50%.
My sensitivities before Met were 15, 20, and 30, varying throughout the day. Now they are 20, 25, 35. Small increases, not much difference. My TDD was 34 on Avandia, and is now 32-33 on Met. Not much change there either.
I have seen people report that their sensitivities and TDD changed much more than mine when they adjusted to Met. I don't think they had been using Avandia prior to using Met. Avandia was a great med for me. It kept me much more stable than Met does. I do appreciate the way I have lost weight with Met.
I thought they did not ban avandia completely maybe if you scream load enough they will allow you to go back on it.
Just an after thought but Fenofibrate does also help with insulin resistance for Dinosaur on the DD site quite a bit in my case only a little.
Medicare does not cover Avandia, and it is very expensive. I cannot afford it at this time. Met is ok, I just have to watch my fluctuating BGs so closely, and test so frequently. Frustrating, but I can adjust and do it. I am very confident of that!