Metformin, insulin resistence and half marathon - help please

I had the same problem training for my first half last year. Granted, I was not officially diabetic, only pre-diabetic and given Metformin and a 120g carbs/day diet. I lost a lot of weight on diet and Metformin alone but a few months later worried about hitting a weight loss plateau and started walking, then running.

After the running bug bit me and I was a couple weeks into my 10k to half marathon program I was having trouble at most anything over 6 miles, which I knew I could do. My doctor gave me a glucometer and prescription for test strips so I could test my blood sugars before and after runs. I was running low on my runs. This meant I had depleted my glycogen reserves and my low carb diet could not replenish them before my next run.

So I increased my carb intake, avoiding sugary carbs EXCEPT as a recovery drink. In that first 20 minutes after a long run your body is in overdrive using insulin to transport sugars to your muscles as glycogen. If you give your body quick digesting sugars during that short window you will not see a 2 hour post meal blood sugar high, and you will also replenish your glycogen stores faster by absobing those sugars then (depending on your exact diabetic condition this may or may not apply to you). Outside of that recovery drink my carbs were preferably low GI carbs to prevent spikes. I found I handled these added carbs with zero impact to my daily fasting blood glucose reading, and maintained normal 2 hour post meal readings as well.

I saw immediate results in my running performance.

Warning though, just because it worked for me in my condition as a pre-diabetic who had been running distances for a few months by then is no guarantee it will work the same for anyone else where any of those variables would be different.

If you can not increase carbs, there are people who claim success a keto runners, but my experiences in that state were a bit too miserable for me to considee exploring that any further.

Check with your doctor before taking any advice from here. Your doctor is highly unlikely to discourage you from running to combat diabetes. But your doctor knows your conditions and what changes can be made to help adapt to your desired lifestyle infinitely more than random people or articles on the internet.

As for gels and such, yes, I use GU gels. Based on my body weight I take two gels every hour on any run over 2 hours in length.

badlydrawnperson wrote: »

I'm training for a half marathon at the moment and my runs are up to around ten miles. I take metformin for insulin resistence and try to stick to a low GI diet. On my longer runs I'm finding I'm struggling for energy and can feel myself hitting a sugar low (nausea, light headed ness etc). The people I run with all take gels or jelly beans or similar, but this feels really anti how I normally eat - too much sugar makes me shaky and a bit mental. What do other people do/take? Btw I am by no means a good runner - am finding these long distances hard, and am overweight, but have set myself the challenge to get myself round and am running for charity so I just I want to do it in a way that best helps my body. All thoughts greatly appreciated.

I reversed my type 2 diabetes

Part of the process was exercising fasted and making my body adapt to use a higher mix of fat as fuel

Your mitochondria will adapt.

Google endurance training mitochondria

Hundreds of hits and university papers.

I'm doing cycling as cardio. I'm up to 40+ mile rides at over 17 mph while starting fasted and taking in 200 or so carb calories

When I get shaky on long runs it is because my blood sugar got to low. On one 10 miler, I started feeling that way around mile 8. I finished my run, drank a bottle of TrueMoo chocolate milk, and then grabbed an ice cream cone from McDonald's while running an errand. When I got home, it had been maybe 1.5 hours since I finished my run (and at least an hour since I had eaten the ice cream cone). My blood sugar was 86. So yes, I was very low after my run.

I don't normally eat on my long runs but I think I'm not helping my performance. I just got some energy beans to try next time. While I am IR and on Metformin, I never had success on a low GI or low carb diet so I don't limit those things normally. Exercise has done the most to help with my weightloss. But all the long runs are definitely depleting me so I'll be trying the beans for my next long run.

A resident MFP'er (his name escapes me at the moment) and Type1/Type2 swears by glucotabs. They precisely give you what you need when your sugar is low, so they don't hinder your weight loss efforts on top of that.

I'd add a handful of nuts to my diet the day before the run.

I understand about the mental shift! It's hard because you are so used to turning away from certain things, and then you find yourself in a situation where you need them!

There is a hilarious movie I just love

Run Fat Boy, Run

Pretty funny.

Out of shape guy tackles marathon to impress girl

badlydrawnperson wrote: »

I'm training for a half marathon at the moment and my runs are up to around ten miles. I take metformin for insulin resistence and try to stick to a low GI diet. On my longer runs I'm finding I'm struggling for energy and can feel myself hitting a sugar low (nausea, light headed ness etc). The people I run with all take gels or jelly beans or similar, but this feels really anti how I normally eat - too much sugar makes me shaky and a bit mental. What do other people do/take? Btw I am by no means a good runner - am finding these long distances hard, and am overweight, but have set myself the challenge to get myself round and am running for charity so I just I want to do it in a way that best helps my body. All thoughts greatly appreciated.

Have you talked to your dr? If you are insulin resistant and recently started exercising or upped your exercise, then the solution might be to simply come off metformin.

badlydrawnperson wrote: »

Only slightly scared by the reference to 'endurance athletes', although I guess 'knackered slightly deluded charity runner' doesn't have quite the same ring...will google

Off course...

I'm a "wannabe athlete", but keto is suitable for common people also.

badlydrawnperson wrote: »

aggelikik wrote: »

badlydrawnperson wrote: »

[quote="aggelikik;33786126"

Have you talked to your dr? If you are insulin resistant and recently started exercising or upped your exercise, then the solution might be to simply come off metformin.

Thank you, I have a pretty stable exercise routine for the last 12 years - around 5x high intensity running/Cardio/weights a week - it's just that I've increased the length of duration due to longer runs in the short term. I came off metformin a few years back for 18 months, maintained my diet/exercise and put on 21 pounds, my doctor has advised me I am likely on for life, so I suspect coming off is not my solution. Thanks for the suggestion though - hearing other people's thoughts helps me to refine my own.

May I ask what dr is treating you? If this is not an endocrinologist, I would suggest you get an appointment with one. And if he is, I would suggest you get a second opinion. Metformin for life for controlling weight instead of lowering calories is really weird medical advice.

The metformin is linked to PCOS, which in turn creates insulin resistance, similar to type 2 diabetes. I was under a consultant at the hospital for a couple of years getting the treatment right through medication and changed diet, during which time I lost around 8 and a half stone. I now routinely see a GP to monitor through hormone balance through blood tests etc (I'm UK based). [/quote]

I have PCOS and am insulin resistant, so I understand that metformin is prescribed sometimes for help with PCOS, when lifestyle changes are not possible, or not happening fast enough. However, it is also my understanding that unless you are a diabetic, metformin is not prescribed as a long term solution. It is used short term to help PCOS patients, and it has the side effect of helping with weight loss, but is not supposed to be used long term as a weight loss aid. This is why what you mention sounds very unusual to me. In the 20+ years since my original diagnosis, we discussed only briefly metformin with a reproductive endocrinologist to help with fertility issues, and he considered it as a temporary solution. My grandfather was a diabetic and even in his case, the endocrinologist wanted to keep metformin to a minimum and aim for diabetes control through diet and exercise. This is why I find it surprising that your dr wants you on metformin for life, just to help with weight control. I was under the impression that risks by far would outweigh the benefits in a non-diabetic patient. I would be very skeptical about trusting a GP in such issues personally, mainly because I have seen first hand how outdated a GP's advice can be compared to an endocrinologist when it comes to hormonal disorders.

aggelikik wrote: »

badlydrawnperson wrote: »

[quote="aggelikik;33786126"

Have you talked to your dr? If you are insulin resistant and recently started exercising or upped your exercise, then the solution might be to simply come off metformin.

Thank you, I have a pretty stable exercise routine for the last 12 years - around 5x high intensity running/Cardio/weights a week - it's just that I've increased the length of duration due to longer runs in the short term. I came off metformin a few years back for 18 months, maintained my diet/exercise and put on 21 pounds, my doctor has advised me I am likely on for life, so I suspect coming off is not my solution. Thanks for the suggestion though - hearing other people's thoughts helps me to refine my own.

May I ask what dr is treating you? If this is not an endocrinologist, I would suggest you get an appointment with one. And if he is, I would suggest you get a second opinion. Metformin for life for controlling weight instead of lowering calories is really weird medical advice.
[/quote]

For women with PCOS it is not weird medical advice.

omma_to_3 wrote: »

aggelikik wrote: »

badlydrawnperson wrote: »

aggelikik wrote: »

badlydrawnperson wrote: »

[quote="aggelikik;33786126"

Have you talked to your dr? If you are insulin resistant and recently started exercising or upped your exercise, then the solution might be to simply come off metformin.

Thank you, I have a pretty stable exercise routine for the last 12 years - around 5x high intensity running/Cardio/weights a week - it's just that I've increased the length of duration due to longer runs in the short term. I came off metformin a few years back for 18 months, maintained my diet/exercise and put on 21 pounds, my doctor has advised me I am likely on for life, so I suspect coming off is not my solution. Thanks for the suggestion though - hearing other people's thoughts helps me to refine my own.

May I ask what dr is treating you? If this is not an endocrinologist, I would suggest you get an appointment with one. And if he is, I would suggest you get a second opinion. Metformin for life for controlling weight instead of lowering calories is really weird medical advice.

The metformin is linked to PCOS, which in turn creates insulin resistance, similar to type 2 diabetes. I was under a consultant at the hospital for a couple of years getting the treatment right through medication and changed diet, during which time I lost around 8 and a half stone. I now routinely see a GP to monitor through hormone balance through blood tests etc (I'm UK based).

I have PCOS and am insulin resistant, so I understand that metformin is prescribed sometimes for help with PCOS, when lifestyle changes are not possible, or not happening fast enough. However, it is also my understanding that unless you are a diabetic, metformin is not prescribed as a long term solution. It is used short term to help PCOS patients, and it has the side effect of helping with weight loss, but is not supposed to be used long term as a weight loss aid. This is why what you mention sounds very unusual to me. In the 20+ years since my original diagnosis, we discussed only briefly metformin with a reproductive endocrinologist to help with fertility issues, and he considered it as a temporary solution. My grandfather was a diabetic and even in his case, the endocrinologist wanted to keep metformin to a minimum and aim for diabetes control through diet and exercise. This is why I find it surprising that your dr wants you on metformin for life, just to help with weight control. I was under the impression that risks by far would outweigh the benefits in a non-diabetic patient. I would be very skeptical about trusting a GP in such issues personally, mainly because I have seen first hand how outdated a GP's advice can be compared to an endocrinologist when it comes to hormonal disorders.

Again, it's your information that is outdated. She isn't on Metformin for weight control - she's on it to make her body function properly with the insulin resistance. When her body isn't functioning properly, she gains weight. No amount of diet nor exercise (and I exercise A LOT and have for years) can fix all PCOS cases. And I do see an endocrinologist...one that is the head of his department at a major university medical system.

She said her dr has her on metformin because it helps her control her weight. Which is what I was replying to. No need to be rude. OP is stating a common side-effect of diabetes meds: when she exercises, she gets hypoglycemic. If she were a diabetic, meds come with instructions on how to deal with this. If she has no such plan for hypoglycemia, she needs one. And always the goal with metabolic disorders is to get lifestyle changes that can help minimise the need for meds. From OP's routine, I suspect she might be much closer to this goal than she thinks. Why you find this upsetting, I have no idea.

Metformin assists in all sorts of metabolic processes. Metformin is supposed to help with glycemic highs but it's not supposed to cause low blood sugar. Nevertheless, when I experienced significant weight loss while on Metformin, I started to experience low blood sugar moments. I had to develop a strategy around that, including carrying glucotabs with me.

My dad, type 2 as well, expected to be on Metformin for life. But when he developed kidney problems along with all his other medical conditions, he had to come off it. Metformin can interfere with kidney function. He says he had no idea Metformin was doing such a good job of taking care of his blood sugars. Now that he must use insulin to control his sugars, he has to monitor much more closely.

The doctor who supervised my weight loss says Metformin has so many benefits for her patients, called it a "miracle drug". Though I did not observe any big weight loss from it, I suspect it was doing a lot to curb my insulin resistance.