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Metformin Helped My Type 1 Diabetes


Aug 18, 2011

Katherine Marple

My name is Katherine Marple, and I've had type 1 diabetes for 13 years. I'm the first in my family to have the disease, so I've done most of the research and made most of the discoveries on my own. One of those discoveries was the power of metformin (in addition to insulin) to help me control my diabetes.

Before metformin, I tried many different medications and methods of delivery, as well as low-carb diets, to control my glucose levels and lower my A1C.  Humalog, Humulin, R, and Novolog all eventually lost their potency, and I finally came to Apidra (currently the fastest bolus insulin on the market).  But as of 2010, even Apidra couldn't lower my A1C of above 8%.  

I switched to a low-carb diet to lower the amount of insulin I needed, hoping that it would lower my postprandial glucose levels. I ate only between 30 to 80 carbohydrates per day.  A piece of bread is 15 carbs and one banana is 22 carbs, so an entire day on 30 carbohydrates is extremely low.  I also cut out anything white from my diet, including white pasta, white breads, white flour, white rice, potatoes, sugar, and milk.

When my postprandial glucose numbers still hovered at 300 two hours after a meat and vegetable meal, I looked into a possible gastroparesis diagnosis.  Gastroparesis is a delayed stomach-emptying condition from which many long-term type 1s suffer.  It is caused by nerve damage in the stomach muscles.

I went in for testing, and when the results came back negative, I was nearly defeated.  After fighting for years to combat my glucose levels, no method was working.  I felt like I had tried every single option out there, to no avail.

Then I began putting my scientific brain to work.  Over the years with type 1, I had needed to increase even my basal dosages on an almost six-month basis.  Because I was basically the same weight over ten of those years, those increases didn't make sense unless I was also suffering from insulin resistance.  

That's when I came upon a highly informative and well researched article published in January 2010 on diabetesmine.com. The author suggested using metformin in addition to insulin injections to help treat the insulin resistance seen in some type 1s.  

Wikipedia reports that metformin was first used to lower glucose levels in the 1920s, before insulin therapy was discovered.  This information gave me the confidence to give the drug a try.

It took three long conversations with my endocrinologist before he would write the prescription of metformin for me.  It was unheard of to use pill supplements to control glucose levels in people with type 1 diabetes.  After assuring my endocrinologist that I would never stop my insulin injection therapy, but would only lower my insulin dosages as metformin did its job, he agreed to write the script.  

I used metformin for only three months.  In that time, I lowered my twelve-year A1C plateau of 8% to 6.9%.  I had never had a lower A1C in all of my diabetes life.  Also during that time, I slowly introduced carbohydrates back into my diet, starting with very small portions at dinnertime only.  My postprandials were the best I had ever seen them.  It truly appeared that I had been cured of all of my diabetes ailments.  

After lowering my basal dosages to half what they were pre-metformin, I took myself off the pill.  I truly believe that metformin is the reason my A1C dropped significantly and my diabetes control improved.  It seems to have "re-booted" my body in the three months that I used it.

I do think that doctors need to be consulted before we try new therapies to control our diabetes.  However, I do not believe that doctors should always have the final say.  They tend to only prescribe what they know, not always what is best for you.  Try as they might, they will never fully recognize the complexity of our bodies and our disease.  

Every single person with diabetes is different and reacts differently to certain medications.  At the end of each day, it's my body and my life.  This particular method worked for me.

I will continue to try new therapies to better my diabetes life.  I will continue to research and petition until my diabetes life is just a memory and I can stand proud as a former type 1 diabetic.


Categories: A1C, Diabetes, Diabetes, diabetesmine.com blog, Endocrinology, Insulin Injection, Low Carb, Medications, Medications, Metformin, Type 1 Issues, Wikipedia



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Comments

Posted by Anonymous on 18 August 2011

Great article! Really helped me realize what was happening to me. Last time I was at the endo, I was given a doxycline for an infection and restart on Metformin (I was type 2 before my pancreas gave up the ghost). Over the coming two weeks, by blood sugars dropped, as did my insulin, especially at night. On average, with a low carb meal (25-35), I almost don't need a bolus. My bolus, when I was eating higher carbs was also pushing me much lower than expected and found myself running for the glucose tabs. I was blaming the tetracycline class drug, but based on your article, I now have a better guess as to the cause and that I need to call my diabetes educator to fix my pump settings. Thank you!!!!!.

Posted by Anonymous on 18 August 2011

Metformin is also being actively studied for its life-extension and cancer protection capabilities.

Basically the less insulin you need, the better.

Metformin should lower your insulin needs by about 20%, if my personal experience is any guide.

I have been using 2000mg of metformin per day over the last 12 years. I am a Type I for 26 years, and I had similar good results on my A1C after beginning metformin, even though I am thin and don't suffer from insulin resistance.

Metformin causes indigestion in some patients, but if you can tolerate it, it is a wonderful addition to the Type 1's arsenal. Hopefully more endos will wake up to this knowledge.

Google "metformin cancer" and "metformin CR mimetic" for more information.

Posted by mhp1222 on 18 August 2011

how many times a day do you take Met? 500mg? Im type 1 for 7 years, pretty much the same story as you and i take it and it works great.

Posted by Anonymous on 18 August 2011

The combination of insulin deficiency and insulin resistance is not uncommon for long-time type 1 patients. In diabetic circles it is referred to as "double diabetes", and many of these people use metformin in addition to insulin.

Posted by Richard157 on 18 August 2011

I was diagnosed in 1945, when I was 6. I did very well while using animal insulins for many years. In the 1990s I started using the synthetic insulins, and began gaining weight. I reduced my carbs, but still gained. By 1998 I had gained 42 pounds. My doctor finally diagnosed insulin resistance, and prescribed Avandia. I lost 34 pounds while using Avandia because it helped my resistance, and I was using less insulin. I was eating 130 carbs per day while losing weight. Avandia was a great med , but it caused many users to have heart problems. After 12 years of Avandia, and no heart problems, my doctor still insisted I stop that med. I started Metformin early this year and am taking 1000 mg morning and evening. My control is quite good, but it was better with Avandia. I cannot stop taking Metformin, my insulin resistance is very strong and I will never be rid of it. I have had A1c's below 6.0 for almost 10 years, and after 65 years of type 1, I have no diabetes related complications except for mild nerve damage.

It is fantastic that you were able to reboot, and stop the Metformin. I hope you will now have great control and have a long, healthy life like me. Good luck to you!!!

Richard Vaughn

Posted by Anonymous on 18 August 2011

Great info - I actually mentioned suspicions of my being being insulin resistant to my endo about a year ago - I have been type 1 for over 40 years and was unable to get my A1c lower then 7.6 to 7.8 for almost 2 years. She mentioned "double diabetes" and told me I might be a candidate. I started on Symlin and my A1c lowered down to 7.4 - finally after more than a year on it. I am encouraged by your posts and intend to have a meaningful conversation with my endo if Metformin might be right for me too. Thanks!

Posted by Anonymous on 18 August 2011

Great info - you can teach old type 1s new diabetes control tricks!

Posted by Anonymous on 19 August 2011

Please verify your sources before writing professional level articles.

Metformin was not approved for use by the FDA until 1994.

As a technical writer with more than 20 years of experience, we are taught NEVER EVER to quote wikipedia sources. They are frequently inaccurate and not verified. In this case, use medical and scientific sources instead.

http://www.cs.stedwards.edu/chem/Chemistry/CHEM44/diabetes/METAFORM.HTML

In addition, you did not mention the risks of a type 1 who takes insulin using metformin, the side effects or how the medication works.

1) Major risk - inability of the body to treat a dangerous low blood sugar (to rebound) especially in the middle of the night because metformin decreases or eliminates the amount of glucose the body releases from the liver

2) Among the side effects are stomach problems and B12 deficiency.

3)Metformin ( as I mentioned) decreases or eliminates glucose release from the liver and increases insulin sensitivity.

Pleaes do your research if you are going to make a recommendation especially on such a large platform! You need to write the pro's and the con's not just serve as a marketing campaign.

Thank you.

Doris J. Dickson

Posted by Anonymous on 19 August 2011

I am an RD, CDE, and this is very interesting news! How fascinating. I am very happy to be able to relay this as possible information to my patients. On the downside, since metformin is no longer on patent, and there is not a lot of money to be made, and it will lower insulin needs, I have to be a bit cynical about whether or not it will be widely promoted.

Posted by Anonymous on 19 August 2011

I read all these testimonials about how Metformin and Avandia helped control their insulin resistance. What I didn't see were any references to what I consider the key component to dealing with this very serious problem: REGULAR AND VIGOROUS EXERCISE!!!!!
I have been a type 1 for over 50 years. In my youth, I led a very active lifestyle, and took an animal insulin (Lente) once a day. The only times I was really out of control blood sugar-wise was during summers when my rather paranoid grandmother stuffed me with sweets to prevent lows(!) In those days I had to have a blood test at a hospital lab, and wait 4 days for the results to come back. Testing sugars then was a urine dip stick, and ketone strips. Talk about a large margin of error!

Along comes college, and I became quite lazy about doing anything physical. I piled on pounds, gaining nearly 30 lbs. on a 120 lb. frame over 10 years, before I got back into an exercise routine. Without any changes in diet, I lost 25 lbs. over the next 9 months.
Then, with the blessing of my Dr., the inputs of a (C.D.E.), dietitian, and a personal trainer,I started myself on a diet. The number of calories is based on my lean body weight to stay on course. Because I enjoy having good muscle mass, my diet is high in fiber, low in fats simple sugars, includes plenty of protein and lots of vegetables. I don't feel at all deprived, and on occasions when I want to "fall of the wagon", I let 'er rip, and get back on the next day. I've been on this routine for 15 years now. I've made friends with my insulin pump and test my glucose regularly.

I must emphasize, EXERCISE IS THE KEY TO ALL OF THIS!!! The diet alone does not have the effect on insulin resistance for me, and I strongly suspect that's the case for everyone! Our bodies are metabolic machines, and we need to keep them in tune.

At my gym I regularly see and chat with Type 2 and occasionally Type 1 diabetics frustrated with control issues. Typically they show up at the gym after having skipped weeks of regular exercise, have put on a lot of weight, and are having little success in managing their blood glucose levels.

Life with Type 1 today is so much better with the advent of the human insulin analogs, insulin pumps, and CGMs or simple home testing. I test 8-10 times daily because I do have some neuropathy, one being hypo- and hyper- blood glucose unawareness I developed over the years I didn't work out or didn't have the necessary tools. The worst part of that is the cost of the supplies!!

We all are prone to make excuses for why we "can't" do this, that, or the other thing. Reduced vision, orthopedic issues (knee replacement, spinal fusions) are mine. I choose not to make excuses - rather adjust my choice of activities to keep going.

I am sad for so many people who are searching for the "Magic Bullet" to solve all their problems. Don't give up looking for the formula to make your control and your life better. But don't overlook the advantages of regular exercise to help your body and your mind. Find and choose an activity that you can enjoy, and keep it in your medicine cabinet for regular use.

JH

Posted by Anonymous on 19 August 2011

I have to agree with the posting about rigorous exercise. The best biology to remove glucose from the blood is your muscles, hence resistence exercise supplemented with cardio. It doesn't matter if you are a type 1, 2, or a normally functioning person, exercise is a lifestyle committment and most people struggle with such committments.

On the flip side, sub-q insulin delivery is dangerous and physiologically incorrect. We gain weight because we feed the fat cells insulin and the more you eat the more you feed the cells. We must get away from delivering it sub-q!

Let's face it, a cure is decades to generations away but a better treatment has to be around the bend.

Type 2 runs in my family and while I have been a type 1 for close to 30 years, I have been gaining a lot of weight and I joked with my doctor that I'm probably also a type 2, not even knowing it was possible. However, I equate the weight gain to being on an insulin pump and having the freedom to eat at will without the will power.

Type 1 diabetes is a very physically, emotionally and mentally exhaustive disease.

Like I said above, its time we begin having access to better, non-invasive treatments. Enough already with the shots and catheters!

Posted by Anonymous on 20 August 2011

I am surprised about the comments and the article itself saying this is something new or unheard of. It is really rather common. Any pediatric endocrinologist with teenage Type 1 patients knows this therapy well.

Posted by Anonymous on 21 August 2011

I used metformin as a teen 15 years ago in conjunction with insulin therapy. My endos were the ones that started me on it, I didn't have a lot of insulin resistance then, but it did help, I maintained one of the best a1cs out of all of their patients at the time. If I recall correctly, I was in a study at the time concerning the usage of it with insulin. So, it's been on the table for a long time, it just really boils down to what one's endo is comfortable in doing with their patients.

Posted by Anonymous on 25 August 2011

I think this is great news! I've been Type 1 for ten years and have tried everything from modifying my diet to rigorous exercise. I can't get my glucose levels to maintain and my insulin requirements continue to increase on a semi-annual basis. I'm very conscientious of what I eat and exercise on a daily basis, sometimes multiple times per day for more than an hour at a time. Type 2 does run in my family. Despite watching what I eat and exercising (sure to make sure my ouput is bigger than my input), my weight has increased steadily. I know there may be other factors, as anything to do with the human body has many factors... but I'm willing to try this method to see if it works. Great article and thank you for showing me another option.

Posted by Anonymous on 26 August 2011

I was having a rough time with getting my A1C down and my physician did try Metformin offlabel for the insulin resistance.. It did help.. though my body didnt like it in other ways and we decided to stop.. To the technical writer flaming the poster of the article. It was a "This worked for me" sort of testimonial, and an effort was made to get a source, even if it wasn't "good enough" in your mind. Diabetes is still a very much a Your Diabetes May Vary, and at least she brought it up as an option for some. All drugs have side effects and thats to be expected.

Posted by Anonymous on 16 September 2011

Try using a continuous blood glucose monitoring system CBGM...it can lower A1Cs to an astonishing degree! Be very careful of lows with insulin and Metformin!


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