T2D - Glucophage (name brand) > Metformin (generic) ?
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RalfLott
Posts: 5,036 Member
An FYI for T2Ds on Metformin -
Here's the most recent of many explanations by Dr. Bernstein why he tells his patients to take name-brand Glucophage rather than (cheap) generic Metformin:
https://youtu.be/w9C2ENG-ubg Discussion begins at 21'50"; see also 29'10" (where he mentions "dramatic" differences in BG control).
While some pharmacists will react as if name-brand Glucophage went the way of the dodo, in fact it's readily available.
The variability in content (poor quality control) among some of the generic versions of metformin might explain their unpredictable glycemic and incendiary effects....
I'm about to try Glucophage XR for a month. If anyone's curious, I'll be glad to share my impression.
Here's the most recent of many explanations by Dr. Bernstein why he tells his patients to take name-brand Glucophage rather than (cheap) generic Metformin:
https://youtu.be/w9C2ENG-ubg Discussion begins at 21'50"; see also 29'10" (where he mentions "dramatic" differences in BG control).While some pharmacists will react as if name-brand Glucophage went the way of the dodo, in fact it's readily available.
The variability in content (poor quality control) among some of the generic versions of metformin might explain their unpredictable glycemic and incendiary effects....
I'm about to try Glucophage XR for a month. If anyone's curious, I'll be glad to share my impression.
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I noticed this myself. Generic metformin is not as reliable re BG, plus it gives me tummy problems and, for some reason, panic attacks. Glucophage never gave me any secondary effect. I didn't notice any difference with the XR.
::flowerforyou::3 -
Bummer... I get 180 generic pills for $10.
or 180 name brand for $100. Insurance plays into it for me.
or 
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KetoGirl83 wrote: »I noticed this myself. Generic metformin is not as reliable re BG, plus it gives me tummy problems and, for some reason, panic attacks. Glucophage never gave me any secondary effect. I didn't notice any difference with the XR.
::flowerforyou::
That is, no difference between generic and name-brand XR, or between XR and immediate release?
I've also noticed differences when I've gotten scripts between 2 different generics... I suppose when you've got generics that some big chains will (or will almost) give away, they can't be very costly animals.1 -
KetoGirl83 wrote: »I noticed this myself. Generic metformin is not as reliable re BG, plus it gives me tummy problems and, for some reason, panic attacks. Glucophage never gave me any secondary effect. I didn't notice any difference with the XR.
::flowerforyou::
That is, no difference between generic and name-brand XR, or between XR and immediate release?
I've also noticed differences when I've gotten scripts between 2 different generics... I suppose when you've got generics that some big chains will (or will almost) give away, they can't be very costly animals.
No difference (to me) between Glucophage and Glucophage XR.
I tried 2 different generics before going to Glucophage for good.
::flowerforyou::2 -
I take 1000 mg metformin 2x a day, and have been LCHF for 50 days today... and for the last few days have experienced "dumping syndrome". I was wondering if anyone else has had that problem after doing the WOE?1
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I take 1000 mg metformin 2x a day, and have been LCHF for 50 days today... and for the last few days have experienced "dumping syndrome". I was wondering if anyone else has had that problem after doing the WOE?
That is a high dosage, is it generic or Glucophage? And are you taking other medication/supplements? Magnesium and or coconut oil can provoke that.
I have not experienced that problem (very much the opposite) but it may be an adaptation reaction. It's a bit weird that it took so long to appear, though. Sorry, I have no idea what would give you that reaction, maybe someone else can be more helpful.
::flowerforyou::0 -
@KetoGirl83 Yes, it's generic and it's very high dose... I used to take insulin shots with it but I stopped those because a) they weren't bringing my sugar down, b) I decided to see if what Dr. Fung said about insulin was true for me on LCHF and c) I loathed taking the needle.
One thing I was thinking that maybe with the LC eating, weight loss and being in ketosis, that my dose may be too high. But sugar has tested around 180 still. (While taking insulin shots and eating carb levels recommended by Diabetes Educator, my sugar read over 220 and I gained 20 lbs in a year!)0 -
@KetoGirl83 Yes, it's generic and it's very high dose... I used to take insulin shots with it but I stopped those because a) they weren't bringing my sugar down, b) I decided to see if what Dr. Fung said about insulin was true for me on LCHF and c) I loathed taking the needle.
One thing I was thinking that maybe with the LC eating, weight loss and being in ketosis, that my dose may be too high. But sugar has tested around 180 still. (While taking insulin shots and eating carb levels recommended by Diabetes Educator, my sugar read over 220 and I gained 20 lbs in a year!)
@kmn118 It certainly wouldn't hurt to try Glucophage instead of the generic, you may find it has less secondary effects and is better at controlling your BG.
I wouldn't stop insulin on my own, without a doc support. Even if for nothing else than for the periodic lab tests so that you know what's happening. Since you're the one taking decisions it is even more important to have those numbers. Do you know your fasting insulin?
180 BG is still very high, especially on low carb (btw, I'm not surprised it was even worse with the "Diabetes Educator" diet). Your BG is going down, which is good but it doesn't look like you can lower your met dosage, not until those numbers improve. But you can try IF and/or going lower carb. Keep careful records of your BG and everything you eat.
Have you read Dr. Bernstein's book? If you don't have the support of a doctor you NEED this book.
::flowerforyou::
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I'm an unusual situation because I have "double diabetes" - that is, I have both type 1 and type 2 (I don't make any insulin of my own - type 1; and I'm inefficient with use of insulin - type 2). I've taken metformin for years (more than a decade) and have taken insulin for more than 2 decades.
Personally, I don't notice much difference when I don't take metformin. For example, I haven't had any for a few days now (I ran out, didn't order a refill from my mail order pharmacy in time). It has made little difference, and maybe that is because it isn't Glucophage and it isn't doing anything for me anyway. I've asked my endocrinologist, as I lose weight and take less insulin (evidence that type 2 is going away), whether I can stop taking metformin. His response is that it is helpful even without insulin resistance and a lot of type 1's are taking it now anyway. Since it is about $1 per month co-pay, I don't see an issue with it (except when I don't get an order in time).2 -
I take 1000 mg metformin 2x a day, and have been LCHF for 50 days today... and for the last few days have experienced "dumping syndrome". I was wondering if anyone else has had that problem after doing the WOE?
Metformin is great stuff. It has been in use a long time, doesn't carry the risk of hypoglycemic episodes like some of its kin, and for some of us, it works amazingly well.
But there are many posts here (some mine, ulp!) with combinations of terms such as metformin, imodium, internal combustion, propellant, catastrophic, "toilet camping", etc. But I've never heard "Dumping Syndrome"* before. Bwaahahaaa! That pretty well nails it!
I have spent months and months trying to retard the rabid accelerant in generic metformin, and I have finally bit the bullet and decided to lay out extra $$ for a 30-day experiment on name-brand Glucophage XR. I figure if I have to put $.25 in the slot every time I take one and it lets me wear white pants again, it will have been worth it.
If you're interested - through trial and "error," I have arrived at a formula that works for me most of the time, though it requires more imodium than the "do not exceed" amount of 4 tablets printed on the bottle.*- I take 4 x 500 mg XR daily. I take my first imodium as soon as I wake up, then another imodium before my first meal and the 1st metformin during or after the meal. Similarly, I take another imodium before each additional meal, along with 1 more metformin during or afterwards. Then I take the final metformin with a snack (or, if I'm done eating for the day, after another imodium) before bed, which seems to keep my morning numbers in check.
Ok, so that only makes 4-5 imodiums, and the directions say no more than 4 in 24 hours. Well, .....
Of course, it's not up to me to suggest that anyone else exceed that amount the way I do without asking their doctor, but at the first warning sign that reinforcements are needed to fend off Dumping Syndrome, I take more. On a rocky day, I may take 4-6 more daily than the directions advise (with the approval of my docs).
It has worked out pretty well. Great BG control, but there are still unpredictable appearances of DS, and I'd prefer to take less imodium - if possible!
* None of my physicians, having established that I don't have troubles with constipation, has ever recommended that I adhere to this limit. In a quick web search for imodium toxicity, the few overdose reports I found involved huge doses - in one case, 3 bottles - of imodium. There are many imodium users on MFP as well and many informative posts.1 -
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@RalfLott I wish I could afford the Glucophage, instead of the generic. If you prove that the real deal works much better than the generic, your doctor may write a letter to your insurance company arguing that it is medically necessary that you take Glucopage instead. Would that help with costs? I don't know.
As for the immodium, that does work for me, too well... as i end up needing help the other way after a few "non-productive" days
As of this moment, I am afraid to eat anything, if i have to be somewhere. I will try the immodium to see how that works. Thank you for the suggestion.
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midwesterner85 wrote: »
Ah....
In light of my experience (though not yours!), that possibility didn't enter my mind. >ulp<
But doesn't metformin, as an insulin sensitizer, function by making available insulin more efficient and thus by reducing rather than stimulating glycogen dumping?
Congrats BTW on your ability to handle 2 types of diabetes at the same time!. You bring a different and interesting perspective.1 -
@RalfLott I wish I could afford the Glucophage, instead of the generic. If you prove that the real deal works much better than the generic, your doctor may write a letter to your insurance company arguing that it is medically necessary that you take Glucopage instead. Would that help with costs? I don't know.
As for the immodium, that does work for me, too well... as i end up needing help the other way after a few "non-productive" days As of this moment, I am afraid to eat anything, if i have to be somewhere. I will try the immodium to see how that works. Thank you for the suggestion.
Yes, that's it exactly.
It took several weeks to get my insurance company on board, but eventually it accepted the doctor's statement and granted "prior authorization" (magic words that seemed to help), so I'll get 120 Glucophage XRs for $30, instead of $122 out of pocket.
A tip if you want to look down this avenue - be complimentary and appreciative at all times, get names of everyone you talk to, ask questions ("can I get a copy of the form?"; "what codes/words did you enter to do that test run?", "any special instructions I should give my pharmacist on how to code the claim?" etc.), and take good notes!5 -
midwesterner85 wrote: »
But doesn't metformin, as an insulin sensitizer, function by making available insulin more efficient and thus by reducing rather than stimulating glycogen dumping?
Not exactly. That was the original belief of how Metformin works. More recently (a study was published in 2009 out of John Hopkin's, I believe), it was discovered that Metformin is actually simpler than that. It mimics CBP and manages glucose release from the liver. In fact, for us type 1's that don't make any insulin, it should be especially helpful. Our liver doesn't know the pancreas is releasing insulin (because it isn't), so even when we eat, we are getting a rise in BG from both the food and from our liver releasing glycogen.
Before insulin was discovered, type 1's would be kept alive for longer (months, maybe years... through most of the honeymoon stage) by persistently consuming alcohol. The liver does not dump glucose while processing alcohol. How metformin seems to actually work is similar to alcohol (without the bad pickup lines, lol).5 -
@midwesterner85 - Whew..... So instead of chilling the insulin out so you need less of it, and can get away with storing less glycogen, the metformin actually traps the glycogen that's been stored and holds it hostage inside your liver?
(And to top it off, you're T1 but also insulin resistant, but you're still able to load your liver up with glycogen....)
I feel like my dad just told me the earth really ain't flat.
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KetoGirl83 wrote: »I wouldn't stop insulin on my own, without a doc support. Even if for nothing else than for the periodic lab tests so that you know what's happening. Since you're the one taking decisions it is even more important to have those numbers. Do you know your fasting insulin?
180 BG is still very high, especially on low carb (btw, I'm not surprised it was even worse with the "Diabetes Educator" diet). Your BG is going down, which is good but it doesn't look like you can lower your met dosage, not until those numbers improve. But you can try IF and/or going lower carb. Keep careful records of your BG and everything you eat.
Have you read Dr. Bernstein's book? If you don't have the support of a doctor you NEED this book.
::flowerforyou::
@KetoGirl83 - Good advice! Dr. Bernstein is a great resource.
What do you do with fasting insulin - compare it to your BG to get a fix on your insulin resistance?
@kmn118 - Kudos on ditching the diabetes "educator"!1 -
KetoGirl83 wrote: »I wouldn't stop insulin on my own, without a doc support. Even if for nothing else than for the periodic lab tests so that you know what's happening. Since you're the one taking decisions it is even more important to have those numbers. Do you know your fasting insulin?
180 BG is still very high, especially on low carb (btw, I'm not surprised it was even worse with the "Diabetes Educator" diet). Your BG is going down, which is good but it doesn't look like you can lower your met dosage, not until those numbers improve. But you can try IF and/or going lower carb. Keep careful records of your BG and everything you eat.
Have you read Dr. Bernstein's book? If you don't have the support of a doctor you NEED this book.
::flowerforyou::
@KetoGirl83 - (...)
What do you do with fasting insulin - compare it to your BG to get a fix on your insulin resistance?
(...)
Fasting insulin has to be a lab test so it is a lot more difficult to get than BG. I've been paying full to have the test done because doctors don't think the result relevant (!!).
What I found during these 18 months (and 3 fasting insulin results) is that my insulin numbers were very high and have been getting lower in a similar line as my A1c.
For a T2D, BG is a proxy way to know insulin, if your BG is high it's almost impossible for your insulin to be normal. Dr Fung calls T2D a disease of insulin resistance, of which high blood sugar is a symptom. So I'm very interested in my fasting insulin because only when I have normal numbers there will I consider my diabetes fully reversed.
My last A1c was 5% (yay!) and still my fasting insulin was 10%, about twice what it should be.
::flowerforyou::3 -
Let's see.... If your insulin is 10 and your A1c is 5 (congrats!), that means your body is requiring you to pump out more insulin than you'd like to keep your BG where you want it?1
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@midwesterner85 I have looked for liver dumping and glycogen dumping as a cause for "toilet camping" and haven't found anyone talking about it online. Metformin IS a huge topic on that subject. Still, I have been on metformin for several years without this effect, except at the very first, briefly.
Possibly having a reaction to so much more fat in my diet, but 7 weeks in, I'd have thought I was fat adapted by now. The search continues...0
