Metformin for type 1

okulyd

I've been type 1 since 1984. I've tried lots of things. Currently on a pump with Novolog and CGM. I have also been taking metformin for 7 years. Metformin was prescribed to me for PCOS. For PCOS it works really well. It also works really well for Type I because it stops your liver from dumping glucose. This makes for less dawn phenome (I still have some but not nearly as dramatic). Also it allows for lower basal insulin. I don't know for sure but I estimate that I was able to reduce my basal rate by 25%. Lower insulin means less weight? Not in my case. When I first went on it I had reduced appetite but this was only a short term thing. Eventually my appetite came right back. Also I am not insulin resistant so the effect of metformin may not have been as dramatic for me. I have read that some are able to reduce their basals by as much as 40%.

I have recently stopped taking metformin as I don't want to be on drugs that I don't actually need. I am not convinced that I have PCOS. I am waiting to see if my hormones are elevated after 3 months without metformin since that was why I was on it. Since I stopped metformin for the past 3 months I have learned that maybe I do need it to control diabetes even if I don't have PCOS. My A1C has increased from 5.4 to 5.9. I have had many more highs and many more bad lows. Basals are again increased across the board by 25%. I have sharp spikes in the early am hours but a pump takes care of this pretty well. So...the question is whether or not to take metformin? Good question.

For me, I think the answer is yes. I do think I can get my A1C back down but it will require significantly more work on my part and taking a pill twice a day is pretty easy. The nice flat lines on my CGM are way easier to manage the sharp spikes followed by the sharp decline several hours later. Yes, I know I can get better at managing this with a closer eye on food choices. Bolusing exactly 30 minutes before a meal will also help. Still nobody is perfect and metformin helps level everything out so that on the days you fall short of perfect the peaks and valleys are rolling hills instead of mountains and canyons. Metformin builds up in your system so if you miss a dose here or there isn't an impact. Same thing as far as timing, if you take it a few hours late it doesn't have an impact. Metformin recently has also been shown to extend lifespan. http://www.ncbi.nlm.nih.gov/m/pubmed/24114491/
Who doesn't want that right? So as of yesterday I am now slowing starting to take metformin again starting with one pill per day and gradually increasing to 4 per day.

T1DCarnivoreRunner

First, I'm going to say your A1C's are very good. I have just been able to get under 7 as I've lost weight... and not always as there are sometimes fluctuations.

Second, I'll say I've been on Metformin since long before it was common for type 1's to take it. I've been taking it for type 2 for more than half my life. I'm a "double diabetic" (I have both type 1 and type 2), so the original intent for Metformin was to treat type 2, in conjunction with very high insulin doses. As I have lost weight, my daily insulin is less than half of what it was on average at the highest point. I asked my endo if I should stop taking Metformin as I've cut insulin and the type 2 issue is showing signs of going away. He thought it would be valuable to keep taking it as it can still help and there aren't really any down sides to it.