Insulin Resistance Question

TheVirgoddess

I know this would be better suited for my physician, and the internet isn't the right place to get health/medication advice.

I'm still going to ask anyway.

Last April I was diagnosed with insulin resistance and told to lose weight in an effort to reverse it. I was also put on Metformin (500mg) twice a day.

So far I've lost 66 pounds. My weight is now 166 on a 5'4" frame. I was last at the doctor in November, but couldn't see my actual physician, as he was in a really bad car accident and won't be back for a few more months. I saw the only other Doctor in the practice and asked about getting my fasting glucose redone - and said that when I get symptoms of low blood sugar to call (I know?!?).

The past few days, I've started to feel poorly after I eat/take the Metformin (so only breakfast and dinner). Shaky, nauseous, and generally unwell. I'm guessing these are signs of low blood sugar. My question is, should I stop taking the Metformin - or continue until I can be seen?

I know I need to call my doctor, and that is my intent, on Monday - though I'll be stuck with the questionable doctor again, so I'm not sure how much good it will do.

Thanks in advance.

Psychgrrl

Time for Urgent Care! Low blood sugar can be very dangerous and can lead to coma. It can also be dangerous for you to take yourself off your meds without a doctor's approval. Do not try to correct your body on your own without really knowing what's going on with it.

You should see a doctor ASAP. If you can't get in to see your regular doc or someone at the practice, head to an Urgent Care facility near you.

Liftng4Lis

Doesn't your doctor's office have an emergency on call doctor?? Call them, this sounds scary.

shaynepoole

Do you test your blood sugar, that's one way to check for sure - but if you are feeling badly after you eat, I am not sure - I would expect what you would be feeling that way after periods of not eating - but your doctor would be the best resource

They should generally have an answering service/on call doctor if needed

PrizePopple

If Miss_1999 is available she might be a good person to ask as she's dealt with PCOS/IR and Metformin for awhile now.

Though looking, it seems that Metformin can in fact cause hypoglycemia. Too much insulin in your system can also cause it as well. I can't say I would recommend not taking medication, but you know your body better than anyone else and are the only person who can make that call.

TheVirgoddess

Liftng4Lis wrote: »

Doesn't your doctor's office have an emergency on call doctor?? Call them, this sounds scary.

They are a really small practice, I don't think they do.

I feel okay now, it's usually bad up to an hour after I eat.

I think I might take half the pill, and see how that feels.

Thanks all!!

missiontofitness

TheVirgoddess wrote: »

Liftng4Lis wrote: »

Doesn't your doctor's office have an emergency on call doctor?? Call them, this sounds scary.

They are a really small practice, I don't think they do.

I feel okay now, it's usually bad up to an hour after I eat.

I think I might take half the pill, and see how that feels.

Thanks all!!

Don't mess with the dose; go to the ER or urgent care tonight.
If the pill is causing these symptoms, you should not continue to take this medicine before seeing a doctor. And right now, you should be seen immediately.

TheVirgoddess

I'm okay right now. We ran out and got a blood sugar monitor, and my sugar is perfect. I'm going to be keeping a close eye on it until I can be seen.

elphie754

TheVirgoddess wrote: »

I know this would be better suited for my physician, and the internet isn't the right place to get health/medication advice.

I'm still going to ask anyway.

Last April I was diagnosed with insulin resistance and told to lose weight in an effort to reverse it. I was also put on Metformin (500mg) twice a day.

So far I've lost 66 pounds. My weight is now 166 on a 5'4" frame. I was last at the doctor in November, but couldn't see my actual physician, as he was in a really bad car accident and won't be back for a few more months. I saw the only other Doctor in the practice and asked about getting my fasting glucose redone - and said that when I get symptoms of low blood sugar to call (I know?!?).

The past few days, I've started to feel poorly after I eat/take the Metformin (so only breakfast and dinner). Shaky, nauseous, and generally unwell. I'm guessing these are signs of low blood sugar. My question is, should I stop taking the Metformin - or continue until I can be seen?

I know I need to call my doctor, and that is my intent, on Monday - though I'll be stuck with the questionable doctor again, so I'm not sure how much good it will do.

Thanks in advance.

I would not stop taking a medication before seeing your doctor. You can, however, go to any pharmacy and get a glucometer. Some of the cheap ones are like 20$ and come with about 10 test strips. You do not need a prescription to buy one. That way you can test your sugar when you start to feel that way to give you a better idea if it is high or low. Low blood sugar can be really dangerous (can cause you to to become altered and if low enough, stop breathing) so if your glucose is that low when you test it, call your MD immediately (or 911 if extremely low).

abatonfan

Hi! I'm a type 1 diabetic and constantly experience hypogylcemia.

Walmart has a meter called ReliOn that is about $10 for the meter and $9 for 50 test strips. The meter might be useful for you to determine how high your blood sugar is whenever you wake up (fasting BG) and whenever you feel those symptoms to determine if your blood sugar is low (hypoglycemia -anything below 70mg/dL) or if it not low (false hypoglycemia that occurs after long periods where BG is at a higher level).

If your blood sugar is low, most physicians recommend the rule of 15 when treating it.
1. Eat 15g of sugar if your blood sugar is below 70.
2. Wait 15-20 minutes
3. If your blood sugar is still below 70, repeat the process. If it is above 70, consume a snack with 15g carbs and some fat or protein to keep your BG up.

GaleHawkins

TheVirgoddess wrote: »

I'm okay right now. We ran out and got a blood sugar monitor, and my sugar is perfect. I'm going to be keeping a close eye on it until I can be seen.

Awesome and now you know.

Finally picked up a glucose/ketone meter last month and it is the only way to really know. Being able to spot check anytime is good. I plotted my measurements for a couple weeks until I figured out my range which was OK.

FatFreeFrolicking

I have insulin resistance and take Metformin as well. Due to the insulin resistance, I am hypoglycemic.

It definitely sounds like low blood sugar to me. Do you have a glucose meter? If not, I would go to a local pharmacy and purchase one (OneTouch Ultra mini is the most accurate on the market… it's $19.99). Don't forget to buy test strips and lancets (which your doctor can call in a prescription for when you are able to see him… it'll be cheaper this way). When you experience these symptoms, it's important for you to know what your blood sugar level is. Your doctor will want to know also. If you already test your blood sugar and your levels are normal, my guess is that the medication itself is making you ill.

Metformin can actually make you nauseous and give you diarrhea if you do not follow a fairly low carb diet. This happened to me when I was taking the regular version of Met. Every time after I took the pill (with dinner), I would have to rush to the bathroom. I eventually had to switch to the extended release version. I haven't had any problems with it and have been on it for about a year now. So my next question is… Do you take the regular version or the extended release version?

FatFreeFrolicking

PrizePopple wrote: »

If Miss_1999 is available she might be a good person to ask as she's dealt with PCOS/IR and Metformin for awhile now.

Though looking, it seems that Metformin can in fact cause hypoglycemia. Too much insulin in your system can also cause it as well. I can't say I would recommend not taking medication, but you know your body better than anyone else and are the only person who can make that call.

Metformin doesn't directly cause hypoglycemia. It only causes low blood sugar when combined with other anti-diabetic medications, some birth controls, and some beta-blockers.

PrizePopple

FatFreeFrolicking wrote: »

PrizePopple wrote: »

If Miss_1999 is available she might be a good person to ask as she's dealt with PCOS/IR and Metformin for awhile now.

Though looking, it seems that Metformin can in fact cause hypoglycemia. Too much insulin in your system can also cause it as well. I can't say I would recommend not taking medication, but you know your body better than anyone else and are the only person who can make that call.

Metformin doesn't directly cause hypoglycemia. It only causes low blood sugar when combined with other anti-diabetic medications, some birth controls, and some beta-blockers.

Well since you seem to have your PhD and know the side effects of Metformin better than anyone else I suggest that you speak to the Mayo Clinic and let them know they are wrong...

http://www.mayoclinic.org/drugs-supplements/metformin-oral-route/precautions/drg-20067074

"Metformin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take metformin with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly. "

And drugs.com too while you're at it.

http://www.drugs.com/sfx/metformin-side-effects.html

"Metabolic

Common (1% to 10%): Hypoglycemia
Very rare (less than 0.01%): Lactic acidosis[Ref]"

FatFreeFrolicking

PrizePopple wrote: »

FatFreeFrolicking wrote: »

PrizePopple wrote: »

If Miss_1999 is available she might be a good person to ask as she's dealt with PCOS/IR and Metformin for awhile now.

Though looking, it seems that Metformin can in fact cause hypoglycemia. Too much insulin in your system can also cause it as well. I can't say I would recommend not taking medication, but you know your body better than anyone else and are the only person who can make that call.

Metformin doesn't directly cause hypoglycemia. It only causes low blood sugar when combined with other anti-diabetic medications, some birth controls, and some beta-blockers.

Well since you seem to have your PhD and know the side effects of Metformin better than anyone else I suggest that you speak to the Mayo Clinic and let them know they are wrong...

http://www.mayoclinic.org/drugs-supplements/metformin-oral-route/precautions/drg-20067074

"Metformin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take metformin with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly. "

And drugs.com too while you're at it.

http://www.drugs.com/sfx/metformin-side-effects.html

"Metabolic

Common (1% to 10%): Hypoglycemia
Very rare (less than 0.01%): Lactic acidosis[Ref]"

Considering I have an education in nursing and have taken a variety of pharmacology courses and have dealt with a number of patients on Metformin (diabetic and non-diabetics), I'm going to say, yes I do know more about the drug than you. I've worked closely with endocrinologists who have all said the likelihood of Metformin causing low blood sugar (in a patient who doesn't take other diabetic medications or any of the mediations listed below) is very uncommon. If Metformin caused low blood sugar itself, I certainly wouldn't be prescribed it considering I have chronic hypoglycemia.

"Metformin does not usually cause low blood sugar (hypoglycemia). Low blood sugar may occur if this drug is prescribed with other anti-diabetic medications."

"Hypoglycemia (low blood sugar) may result if you take Fortamet with drugs that lower blood sugar, such as: alcohol, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin or other salicylates, sulfa drugs, monoamine oxidase inhibitors (MAOIs), beta-blockers, or probenecid. It may also interact with furosemide, nifedipine, cimetidine or ranitidine, amiloride or triamterene, digoxin, morphine, procainamide, quinidine, trimethoprim, or vancomycin."

Source: http://www.rxlist.com/fortamet-side-effects-drug-center.htm

"Another advantage of metformin is that it does not cause hypoglycemia (low blood glucose) when it is the only diabetes medicine taken."

Source: http://www.diabetesselfmanagement.com/diabetes-resources/definitions/metformin/

"Therefore, Metformin rarely causes hypoglycemia (low blood sugar) and it doesn't usually cause weight gain."

Source: http://clinidiabet.com/en/infodiabetes/education/treatment/pharmacy/02.htm

FatFreeFrolicking

FatFreeFrolicking wrote: »

PrizePopple wrote: »

FatFreeFrolicking wrote: »

PrizePopple wrote: »

If Miss_1999 is available she might be a good person to ask as she's dealt with PCOS/IR and Metformin for awhile now.

Though looking, it seems that Metformin can in fact cause hypoglycemia. Too much insulin in your system can also cause it as well. I can't say I would recommend not taking medication, but you know your body better than anyone else and are the only person who can make that call.

Metformin doesn't directly cause hypoglycemia. It only causes low blood sugar when combined with other anti-diabetic medications, some birth controls, and some beta-blockers.

Well since you seem to have your PhD and know the side effects of Metformin better than anyone else I suggest that you speak to the Mayo Clinic and let them know they are wrong...

http://www.mayoclinic.org/drugs-supplements/metformin-oral-route/precautions/drg-20067074

"Metformin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take metformin with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly. "

And drugs.com too while you're at it.

http://www.drugs.com/sfx/metformin-side-effects.html

"Metabolic

Common (1% to 10%): Hypoglycemia
Very rare (less than 0.01%): Lactic acidosis[Ref]"

Considering I have an education in nursing and have taken a variety of pharmacology courses and have dealt with a number of patients on Metformin (diabetic and non-diabetics), I'm going to say, yes I do know more about the drug than you. I've worked closely with endocrinologists who have all said the likelihood of Metformin causing low blood sugar (in a patient who doesn't take other diabetic medications or any of the mediations listed below) is very uncommon. If Metformin caused low blood sugar itself, I certainly wouldn't be prescribed it considering I have chronic hypoglycemia.

"Metformin does not usually cause low blood sugar (hypoglycemia). Low blood sugar may occur if this drug is prescribed with other anti-diabetic medications."

"Hypoglycemia (low blood sugar) may result if you take Fortamet with drugs that lower blood sugar, such as: alcohol, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin or other salicylates, sulfa drugs, monoamine oxidase inhibitors (MAOIs), beta-blockers, or probenecid. It may also interact with furosemide, nifedipine, cimetidine or ranitidine, amiloride or triamterene, digoxin, morphine, procainamide, quinidine, trimethoprim, or vancomycin."

Source: http://www.rxlist.com/fortamet-side-effects-drug-center.htm

"Another advantage of metformin is that it does not cause hypoglycemia (low blood glucose) when it is the only diabetes medicine taken."

Source: http://www.diabetesselfmanagement.com/diabetes-resources/definitions/metformin/

"Therefore, Metformin rarely causes hypoglycemia (low blood sugar) and it doesn't usually cause weight gain."

Source: http://clinidiabet.com/en/infodiabetes/education/treatment/pharmacy/02.htm

And by the way, I have a friend who has insulin resistance and went to the Mayo clinic a few weeks ago to have various testing done. The doctors there even told her Metformin does not directly cause low blood sugar.

missiontofitness

Well, this thread escalated quickly.

ForecasterJason

missiontofitness wrote: »

Well, this thread escalated quickly.

Yeah, though given the first two sentences from the original post, I'm not all that surprised.

mommarnurse

TheVirgoddess wrote: »

I know this would be better suited for my physician, and the internet isn't the right place to get health/medication advice.

I'm still going to ask anyway.

Last April I was diagnosed with insulin resistance and told to lose weight in an effort to reverse it. I was also put on Metformin (500mg) twice a day.

So far I've lost 66 pounds. My weight is now 166 on a 5'4" frame. I was last at the doctor in November, but couldn't see my actual physician, as he was in a really bad car accident and won't be back for a few more months. I saw the only other Doctor in the practice and asked about getting my fasting glucose redone - and said that when I get symptoms of low blood sugar to call (I know?!?).

The past few days, I've started to feel poorly after I eat/take the Metformin (so only breakfast and dinner). Shaky, nauseous, and generally unwell. I'm guessing these are signs of low blood sugar. My question is, should I stop taking the Metformin - or continue until I can be seen?

I know I need to call my doctor, and that is my intent, on Monday - though I'll be stuck with the questionable doctor again, so I'm not sure how much good it will do.

Thanks in advance.

It's not actually the weight loss as a direct link to making the cells more sensitive to insulin, it's the exercise itself. Specifically, cardio.

Get yourself a glucometer and take your own blood sugar. People have successfully been able to come off of Metformin from healthy eating and regular cardiovascular exercise.

Miss_1999

FatFreeFrolicking wrote: »

PrizePopple wrote: »

FatFreeFrolicking wrote: »

PrizePopple wrote: »

If Miss_1999 is available she might be a good person to ask as she's dealt with PCOS/IR and Metformin for awhile now.

Though looking, it seems that Metformin can in fact cause hypoglycemia. Too much insulin in your system can also cause it as well. I can't say I would recommend not taking medication, but you know your body better than anyone else and are the only person who can make that call.

Metformin doesn't directly cause hypoglycemia. It only causes low blood sugar when combined with other anti-diabetic medications, some birth controls, and some beta-blockers.

Well since you seem to have your PhD and know the side effects of Metformin better than anyone else I suggest that you speak to the Mayo Clinic and let them know they are wrong...

http://www.mayoclinic.org/drugs-supplements/metformin-oral-route/precautions/drg-20067074

"Metformin can cause low blood sugar (hypoglycemia). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take metformin with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly. "

And drugs.com too while you're at it.

http://www.drugs.com/sfx/metformin-side-effects.html

"Metabolic

Common (1% to 10%): Hypoglycemia
Very rare (less than 0.01%): Lactic acidosis[Ref]"

Considering I have an education in nursing and have taken a variety of pharmacology courses and have dealt with a number of patients on Metformin (diabetic and non-diabetics), I'm going to say, yes I do know more about the drug than you. I've worked closely with endocrinologists who have all said the likelihood of Metformin causing low blood sugar (in a patient who doesn't take other diabetic medications or any of the mediations listed below) is very uncommon. If Metformin caused low blood sugar itself, I certainly wouldn't be prescribed it considering I have chronic hypoglycemia.

"Metformin does not usually cause low blood sugar (hypoglycemia). Low blood sugar may occur if this drug is prescribed with other anti-diabetic medications."

"Hypoglycemia (low blood sugar) may result if you take Fortamet with drugs that lower blood sugar, such as: alcohol, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin or other salicylates, sulfa drugs, monoamine oxidase inhibitors (MAOIs), beta-blockers, or probenecid. It may also interact with furosemide, nifedipine, cimetidine or ranitidine, amiloride or triamterene, digoxin, morphine, procainamide, quinidine, trimethoprim, or vancomycin."

Source: http://www.rxlist.com/fortamet-side-effects-drug-center.htm

"Another advantage of metformin is that it does not cause hypoglycemia (low blood glucose) when it is the only diabetes medicine taken."

Source: http://www.diabetesselfmanagement.com/diabetes-resources/definitions/metformin/

"Therefore, Metformin rarely causes hypoglycemia (low blood sugar) and it doesn't usually cause weight gain."

Source: http://clinidiabet.com/en/infodiabetes/education/treatment/pharmacy/02.htm

In a person who's insulin levels are normal, it absolutely *could* cause hypoglycemia, I think that's why the OP was wanting to have a fasting glucose test repeated. Keeping a watch on her blood sugar levels with the glucometer is the best option right now until she an see a physician.

I have been prescribed both, Metformin XR and Byetta for IR. I've passed out several times due to low blood sugar. This is a common side effect of Byetta if I don't eat enough, or eat within a certain amount of time after taking my injection.

OP, with the weight loss you've had, it's not a bad idea to go on in and have more blood work done. See where your hormone levels are, if there are any imbalances now? If not, you may be able to treat your IR with diet and exercise alone, or they may reduce your Metformin to once daily. It's definitely something to look into, and congrats on your weight loss!

TheVirgoddess

I did get a blood glucose monitor shortly after I posted this thread, and have been watching my blood sugar levels all weekend. I'll be calling my doctor today, though I haven't felt bad at all since I posted this thread, I'd still like to get new blood work.

I appreciate all the input.