Not long ago, I reported here on the possible benefits of Metformin for people with type 1 diabetes. It is of course an oral medication traditionally aimed at type 2 diabetics who are not on insulin. Today, we revisit that issue with a real live test case — my friend and colleague Allison Blass, who's recently added Metformin to her own regime:
A Guest Post by Allison Blass
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Over the past few years, since graduating from college, I noticed something peculiar happening. My insulin requirements had slowly but surely gone up dramatically, to the point that I was taking nearly double the total daily dose of insulin that I was taking just 3 years earlier. Not only that but my blood sugars were actually get worse, and my weight had also slowly gone up.
During a discussion with my endocrinologist in November, she mentioned the possibility of going on Metformin or Symlin. I was familiar with Symlin, having tried it unsuccessfully in college. I had never heard of anyone with type 1 diabetes going on Metformin, but I was intrigued. My endocrinologist and I decided that I was going to try amping up my work-outs at the gym first, and if I didn't find that successful, I would go on Metformin.
In the meantime, I had read more about people going on Metformin and heard from people with type 1 on the TuDiabetes community who were starting to explore the possibility of taking Metformin to help increase their sensitivity. Last month, I had my next appointment. While my A1C had dropped (about .5%), it was still higher than I wanted and I was still have unexplained and stubborn high blood sugars. I requested Metformin.
My endocrinologist explained how it would work: unlike people with type 2 diabetes, I would still have to take insulin using my pump, but the Metformin would help my body use this insulin more effectively. I would be more sensitive to the insulin. We were going to start titrating the dose of the extended version of Metformin, starting with 500 mg, then moving up to 1,000 mg after a week since Metformin can cause gastrointestinal problems like nausea.
Boy did I have gastrointestinal problems! I won't get into the TMI details, but I became good friends with the bathroom for the first couple of weeks. Now in my third week on Metformin and using 1,000 mg, the side effects have started to subside and it's much more infrequent. I didn't have any nausea and unlike Symlin, which burned and worked unpredictably, this was the only frustrating part of Metformin but it was something I knew would go away. The burning and unpredictability of Symlin never ended, even after three months of using it.
My blood sugars immediately started to drop. By the time I was up to 1,000 mg, I was going low at least once a day. I have already started to lower my basal rates and dropped my sensitivity factor. Now that I'm taking insulin, I am also seeing more high blood sugars when I miscalculate the carbohydrates I eat.
Metformin is certainly not a cure, but my body seems to respond to insulin much more effectively than it did before. Combined with visits to the gym, my goal is that by this summer I will be taking less insulin and my A1C will have dropped. My endocrinologist said that Metformin is most effective at 1,000 mg to 1,500 mg, so I am thinking about increasing my dose once again just to make sure I'm getting the "biggest bang for my buck."
After reading Hannah's post about being respectful of the amount of insulin that people take, I wanted to share my story; I think it's important for people to understand that it isn't about what other people do, but to do whatever works — and is best for your own health. So after giving careful consideration to my own health history, I have decided to do something unconventional and different to take control of my health in the best way I can see. Hopefully people will be encouraged to try new things, and not give up when something isn't working out.
Thank you Allison, as always, for your level-headed contribution to our D-world.