Diabetes Medication recommendation
rabbyduby
Posts: 123 Member
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I know there is some thought that the brand name can possibly provide better results.
Here is a link discussing that.
http://community.myfitnesspal.com/en/discussion/10394798/t2d-glucophage-name-brand-metformin-generic#latest
I'm not advising anything specifically here, but if getting off meds and reversing T2D is the ultimate goal, adding meds seems counter productive. Though, it may certainly be necessary and there's nothing wrong with using any resource you need to get better control.
If it were me, I would first really make a super firm commitment with the goal that blood sugar control and reduction is primary over weight loss.
Generally, being overweight isn't the cause of the diabetes. You could lose the weight and still have T2D. You can even do that and have it progress further. It happens all the time. But you can also, reverse the diabetes or at the very least get it under control enough to prevent complications and lower your overall risk of the myriad of associated issues, and still be considerably overweight.
I would eliminate weight loss from the goals if not making the progress in that you are looking for is the cause of throwing off track. I would make reducing blood sugar and possibly eliminating meds the goal. Then you have a smaller goal that you can achieve on a daily basis. And any day that you might have higher blood sugar, you can look for evidence of what may be responsible and make adjustments or note it for reference.
Ultimately, what you want to achieve is absolutely within your reach. Consistency will get you there.
Check out the Diabetes Discussions link at the top of the group page. There is so much valuable info in there from those with personal experience.
You'll get a ton of support in this group if you utilize it.
Best of luck to you!
You can totally do this!3 -
@rabbyduby - Can you repost your Q? It seems to have disappeared.0
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@RalfLott Sorry not sure what happened to my question but here it is
I am trying to see if anyone can recommend a diabetes medication that my doctor can prescribe in addition to the metformin i take. I am currently on Metformin 1000mg 2x a day. That does not seem to be working. My A1C has been steadily rising even though i have changed my diet quite a bit. I try to do lowcarb under 20g but haven't been quite consistent. I usually get discouraged when i don't see the weight loss and that leads to me bingeing. Ultimately i want to get off all meds, loss weight and bring my a1c down.0 -
Well, I don't have much to add to what @sunny_bunny_ offered.
I'm a big (but shrinking) Metformin XR fan. It's cheap, has as a long history with a good safety profile, and doesn't cause hypoglycemic reactions. It won't allow you to binge without consequence, though.
My suggestions would be to stay on Metformin, give yourself a month or two to see how you're doing once you eliminate the bingeing, and then reevaluate. If you have to add rather than subtract meds, you can make a better second med choice once you discover how your BG behaves when you've done all you can through diet.
And set aside time every day to read up on your diet and disease! There are very few doctors and fewer dietitians who will help you with a ketogenic diet.0 -
Without wanting to be *that person*, nobody here can make any suggestions for you that are better than those your doctor can make.
I can tell you, for example, that Metformin doesn't agree with my GI system in any form. I've also tried drugs from the sulfonylurea class and had issues with lows. I currently take basal insulin (NPH), Invokana, and Bydureon. Until recently I was taking Tradjenta, but it wasn't effective enough in balance for its cost and I wasn't seeing the hoped weight loss. I've also used regular (R) insulin and taken Byetta and Victoza in the past, with varying degrees of success and varying degrees of side effects.
Why tell you all that? To show you that there are many different ways to treat diabetes. It would be irresponsible for me to tell you that "Oh, if you just add XYZ drug, it'll all be better!" If you don't feel that your doctor is listening to you or treating you effectively, you have choices. You can call your doctor out on it, you can find a new doctor, or you can ask for a referral to an endocrinologist. My endo is the lynchpin of my care, and is very supportive of my diet choices. If you're tolerating the Metformin well, I echo @RalfLott. It's a good first-step drug, but it can't do it all on its own.3 -
I am a pre-diabetic on the brand name Glucophage, and I have no idea how it is working this time around again yet, as I've not had updated tests (next month).
I wanted to address the binging in response to poor progress and all that. The only thing that has helped me even blunt the edge of this behavior is adding in amino acid supplements. There is a book out there called "The Mood Cure" that has more specific protocols based on multiple screening tests... Aside from that, here are some articles that might help you decide if that could help you...
carbsyndrome.com/is-your-brain-two-quarts-low/
foodrenegade.com/how-beat-sugar-cravings-glutamine/
https://afpafitness.com/research-articles/alcoholism-need-vitamins-become-well-2
flowingfree.org/diet-and-supplements-that-help-you-quit-smoking/
For me, myself, it has help to put my food issues into the category as addictions, as far as my mindset in treating them. I am a binge and compulsive eater. I've always been an emotional eater, as well as a boredom eater. Even when eating a stupid amount of carbs (last several months, trying to fight my way back to a good level of carbs for my thyroid function), the cravings edges is blunted, though not as much as it is when I'm eating a very low carb diet...
I hope you find something to help.
@genmon00 - might have some suggestions, too. She is a T2D who recently reduced all her meds to a miniscule bit, managed her FBG and A1C numbers, and essentially reduced her status significantly...2 -
Metformin 2000mg/daily is a an optimum dose. Since you say that you haven't been eating <20 grams of carbs consistently, that is where I would start. Commit to eating <20/day for the next three months. The consistent eating should reduce your blood sugar and A1C, reduce/elminate cravings, increase your energy and overall well-being. If you haven't consistently been following a LC diet, that is why you are probably seeing a steady rise in your A1C. I would try a dedicated diet before adding an additional medication.5
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I can tell you, for example, that Metformin doesn't agree with my GI system in any form.
If you're tolerating the Metformin well, I echo @RalfLott. It's a good first-step drug, but it can't do it all on its own.
In musical terms, my guts went from 1812 / Wellington's Victory
to Calm Sea & Prosperous Voyage 
simply from switching to brand Glucophage XR (and kicking my sugar and starch habits).
[See the link @Sunny_Bunny_ posted above on generic vs. brand]
My prescription coverage, however, gets less generous every year, and if Glucophage gets any pricier than $50 / month, my new pharmacist has agreed to order the 7 kinds of generic Metformin he has access to (out of 20+) and let me try each for a week.
My troubles started when my *previous* pharmacy switched generics. After hearing Dr. Bernstein emphasize the potential benefits of brand vs. some generic versions, I figured it was something I'd better try. Glad I did - I would not have believed it!
At present, I take 2000mg of Glucophage; in combination with a ketogenic diet, it does the bloody trick.
(I might have tried Actos or Avandia for my specific pattern of T2D. Fortunately, I wasn't a good candidate for the meds most likely to cause hypoglycemia. If my BG ever starts to climb again
, those would be the ones I'd consider.)
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@RalfLott, I appreciate that description greatly. Generic or brand, regular or XR, mine never got beyond Stravinsky's 'Rite of Spring'
They don't work well at the best of times - much like the various other parts of my body that "just don't do what they're supposed too properly, we're not sure why."
My prior endo said that Actos or Avandia would have been good for me, had he not been worried about the potential heart issues. It's been a process finding the right drugs - and I'm still not convinced we're there - but my personal pharmaceutical cost is astronomical. It takes me 1.85 months to meet my annual deductible just on the cost of prescriptions
A more dedicated effort to LC would certainly help.... So I feel the OP's pain too. 1 -
@RalfLott, I appreciate that description greatly. Generic or brand, regular or XR, mine never got beyond Stravinsky's 'Rite of Spring' They don't work well at the best of times - much like the various other parts of my body that "just don't do what they're supposed too properly, we're not sure why."
My prior endo said that Actos or Avandia would have been good for me, had he not been worried about the potential heart issues. It's been a process finding the right drugs - and I'm still not convinced we're there - but my personal pharmaceutical cost is astronomical. It takes me 1.85 months to meet my annual deductible just on the cost of prescriptions A more dedicated effort to LC would certainly help.... So I feel the OP's pain too.
So even the Stradivarius of Biguanides doesn't elicit sufficiently sweet tones...
Mind you, I do still take a couple insurance Imodiums every day, but that's down from 12.1 -
Hello! I am also a Metformin fan like @ralflott, as Knit mentioned I am a T2D too. When i first started I was on metfometformin 1000mg BID, Actos, and Januvia just to control my bs. I had some success with Inkovana but for women that can become a candida nightmare which happened to me and wouldn't wish on my worst enemy lol. After about 2 months of this WOE, I was able to drop all my meds except for Metformin and a hbp med (which I hope to drop next). I am also down 32 lbs and counting!2
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Aww dumb smiley erased the rest of my post lol anyhoo, I suggest adding excerise to help manage your bs and ask about increasing your met if possible. I feel like met if your guy tolerates it has the least side effects. Good luck and you got this!3
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Thank you for all the suggestions and encouragement. I do take generic metformin which may very well be the culprit. @RalfLott love your description of it. I will ask my Dr. to switch me to the brand and see how that works. Even though i mentioned i haven't been as consistent as i should be i have come a long way with diet. Most days i do eat 20g carbs< but the problem is i will do good for about a week or so then have a cheat. I have also been exercising so that is not an issue for me. I'm convinced the generic metformin may be the issue - it just beats my mind why my a1c was rising steadily with last 3 blood work. I use to be on Victoza until my insurance decided they won't cover it so the doctor upped my metformin dose.
@Sunny_Bunny_ I love your perspective of looking at it from reducing glucose levels rather than weight loss. I must say i'm so hang up on both. But will work on eliminating weight as that gets quite frustrating.0 -
Thank you for all the suggestions and encouragement. I do take generic metformin which may very well be the culprit. @RalfLott love your description of it. I will ask my Dr. to switch me to the brand and see how that works. Even though i mentioned i haven't been as consistent as i should be i have come a long way with diet. Most days i do eat 20g carbs< but the problem is i will do good for about a week or so then have a cheat. I have also been exercising so that is not an issue for me. I'm convinced the generic metformin may be the issue - it just beats my mind why my a1c was rising steadily with last 3 blood work. I use to be on Victoza until my insurance decided they won't cover it so the doctor upped my metformin dose.
@Sunny_Bunny_ I love your perspective of looking at it from reducing glucose levels rather than weight loss. I must say i'm so hang up on both. But will work on eliminating weight as that gets quite frustrating.
Well, hang in there! Log all your food, test your BG fiendishly, and time and consistency will be your greatest allies.
If you have time and inclination, Dr. Bernstein's Diabetes Solution is a gold mine of great info.
PS. I found it therapeutic and effective to purge my fridge and cupboards of tempting carb-tainted foods - all grain products and anything else with more than a tiny amount of unnecessary carbs, especially sugar, per reasonable serving got the are. Frozen broccoli and spinach stayed, but frozen fruit, ketchup, crackers, and oatmeal disappeared. It was fun and liberating once I got started.
Less obvious culprits have followed. Soy sauce containing wheat? Gone. Same with dietary supplements with carb fillers. (The survivors were happy and grateful they hadn't been compromised by sugar, evaporated cane juice, corn syrup, etc.)
Oh, and get rid of your scale if it mistreats you. It's not your friend.
http://community.myfitnesspal.com/en/discussion/10415166/scale-why-should-i-dump-thee-let-me-count-the-ways
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Thank you for all the suggestions and encouragement. I do take generic metformin which may very well be the culprit. @RalfLott love your description of it. I will ask my Dr. to switch me to the brand and see how that works. Even though i mentioned i haven't been as consistent as i should be i have come a long way with diet. Most days i do eat 20g carbs< but the problem is i will do good for about a week or so then have a cheat. I have also been exercising so that is not an issue for me. I'm convinced the generic metformin may be the issue - it just beats my mind why my a1c was rising steadily with last 3 blood work. I use to be on Victoza until my insurance decided they won't cover it so the doctor upped my metformin dose.
@Sunny_Bunny_ I love your perspective of looking at it from reducing glucose levels rather than weight loss. I must say i'm so hang up on both. But will work on eliminating weight as that gets quite frustrating.
Have you had a C-Peptide test to see how much insulin your pancreas can make? I wonder if you're possibly beginning to have beta cell burnout. This is just one possibility of why A1c would be climbing, assuming that you have been taking meds the same as always and have reduced carbs, therefore expecting a reduction. Obviously, if meds aren't taken right or carbs aren't being reduced, that's the more likely explanation...
Another possibility is simply stress. If something else has been stressing you or you've been fighting a new chronic illness or one that has been particularly troubling during the last 3 months, that could also be an explanation.
If it were me, I would assume worst case scenario since maybe needing something more motivating to prevent the cheats could help. Assume your beta cells are giving up... then buckle down knowing that you can possibly save them and maybe even heal some of them. That should help light a fire under ya!
As far as dealing with a desire to cheat goes, if it's sweets that call to you, make a hard rule that you will allow yourself to satisfy the sweet tooth but ONLY with a low carb treat. Hard rule. No bending. You still get a sweet treat without it throwing you off track or messing with your focus. Don't allow them to be an ever day thing though. Pick your occasions and plan something awesome. Even if you feel like you have to do it twice a week for now, start there then try to spread it out more to kick the sweet tooth monster. Or maybe you can manage it more often without issue. I personally can't. If I make a keto dessert for an occasion, I will eat every last bite of it within that day. And I will obsess about wanting to eat more and more. So I make one small dessert and make sure to share it and then I have to wait til a holiday or birthday or whatever. Maybe even just a weekend gathering with friends as long as I feel in control of it and I'm not looking for reasons to justify making stuff. I am a terrible sugar addict! lol
Check out Maria Emmerich for really good recipes or the site www.ibreatheimhungry.com I think that's the right address...
The other thing that personally gave me strength to resist satisfying cravings is that my dad went through chemo and radiation for lung cancer and I had to beg him to eat even the most minimal food to try and stay strong. It was impossibly difficult for him. I have a niece that is a recovered drug addict and lost 3 years of her freedom right before her daughter was to start kindergarten. She fought a battle I hope I never know and she won! My daughter was diagnosed with Type 1 Diabetes 6 weeks before she was leaving for college 4 hours away. She had always been absolutely terrified of needles but she had no choice but to prick her finger 8-10 times a day and give herself a minimum of 5 injections a day. She cried and cried every time and it was a never ending struggle that occurred about every hour of every day. Even being woke up at night to endure it again.
Those guys made me feel like I have no business boo-hooing about wanting candy and how hard it is to just NOT eat it. When I looked at my sugar addiction "struggle" compared to their struggles, I was embarrassed for myself. I was stronger than that! I just didn't know it. I just didn't have something pushing me to do the hard things like my family did. So I had to do it myself. And I could, because it really wasn't hard when I thought about them...1 -
I have to say I am T2, and I seem to have responded well to the LCHF diet and a 1000 generic metformin twice a day. Whne I was on the meds and following the the American Diabetes diet, I had glucose readings mostly in the 200's. They went to low to mid 100's almost as soon as I started the LCHF diet. I have slowly lost weight, and the numbers are on a mostly declining trend. Last night before bed, my glucose was 107. This morning it was 102. An hour after lunch today it was 108.
I have a checkup Monday, and I am really hoping for an A1C below 6. Three months ago it was 6.9. Six months ago it was 12.8. I am happy with progress.6 -
Wow!
You could be the ADA's poster child (if only it cared more about a cure than medical management....).2 -
Wow!
You could be the ADA's poster child (if only it cared more about a cure than medical management....).
I doubt I will even tell my doctor what I am doing. I will let him think it is because he is a good doctor, and a patient has finally listened to his recommendations. For me at least LCHF has been nothing short of dramatic in terms of benefit.4 -
My A1C finally made it to the patient portal. It was 6.1. The mySugr app was predicting 5.8, so it is higher than I expected, but still an improvement over 6.9 in January.7
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My A1C finally made it to the patient portal. It was 6.1. The mySugr app was predicting 5.8, so it is higher than I expected, but still an improvement over 6.9 in January.
Could be a difference from MySugr because on keto your red blood cells tend to live longer than when eating high carb therefore they collect more glycation simply because they are alive longer to do so. A1c is a 3 month estimate because that's about how long the cells typically live. Yours should actually be older than that
so I bet MySugr was right on 2 -
If you test regularly with an accurate, reliable meter, that should give you a clearer picture than A1c, according to Dr. Bernstein. (Of course he uses A1c if you don't test often and that's the best info you have.)
In short - victory!0 -
Sunny_Bunny_ wrote: »
Could be a difference from MySugr because on keto your red blood cells tend to live longer than when eating high carb therefore they collect more glycation simply because they are alive longer to do so. A1c is a 3 month estimate because that's about how long the cells typically live. Yours should actually be older than that so I bet MySugr was right on
At the end of the day, I am making progress. The diet is manageable. 6.1 is a good reading. I am checking frequently and the mySugr has a lot of data. I had forgotten about the longer life of the red blood cells, but that might explain it.If you test regularly with an accurate, reliable meter, that should give you a clearer picture than A1c, according to Dr. Bernstein. (Of course he uses A1c if you don't test often and that's the best info you have.)
In short - victory!
I am counting this one in the win column. I will focus on good eating and hope to lose some more weight.
Restaurants are challenging. I went to lunch with a group I belong to, and scoured the menu. I got a cabbage salad with chicken breast. It came with some Oriental something salad dressing. I checked glucose an hour after eating and it was 170! That is the highest I have seen in a long time. That dressing did not taste sweet, but it must have had some sugar in it!
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This is the first time I looked at the community and found your group. This is wonderful and filled with information. Thank you. I was on two insulins, Humalog and Lantus, plus metformin 1000 twice a day, and Glimepiride. The doctor also increased my Thyroid medicine Levothyroxine, and told me now that I was perimenopausal, I may have to take more meds. I gained 5 pounds in 3 days from the medicine switch, as I was doing their diet of 45 carbs a meal, and walking 5 miles a day, with only a 10 pound loss. So it almost wiped out all my hard work for three months of working to lose weight. I was so frustrated. Then I saw LCHF diet online and started eating opposite from what they were telling me to do. In four days, I went off both insulins, and my blood sugar is averaging 110 now, and I have lost more weight this week than all my efforts from the past year. Amazing how my body is responding to this new way of eating. It has really helped my focus on quality of nutrients instead quantity of food and carb. Very happy camper here.6
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krazykat3232 wrote: »This is the first time I looked at the community and found your group. This is wonderful and filled with information. Thank you. I was on two insulins, Humalog and Lantus, plus metformin 1000 twice a day, and Glimepiride. The doctor also increased my Thyroid medicine Levothyroxine, and told me now that I was perimenopausal, I may have to take more meds. I gained 5 pounds in 3 days from the medicine switch, as I was doing their diet of 45 carbs a meal, and walking 5 miles a day, with only a 10 pound loss. So it almost wiped out all my hard work for three months of working to lose weight. I was so frustrated.
Then I saw LCHF diet online and started eating opposite from what they were telling me to do. In four days, I went off both insulins, and my blood sugar is averaging 110 now, and I have lost more weight this week than all my efforts from the past year. Amazing how my body is responding to this new way of eating. It has really helped my focus on quality of nutrients instead quantity of food and carb. Very happy camper here.
Congrats! So happy for you.
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krazykat3232 wrote: »Amazing how my body is responding to this new way of eating. It has really helped my focus on quality of nutrients instead quantity of food and carb. Very happy camper here.
What are your macros? It sounds as if the transition has been smooth for you. This all sounds very good!
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Fat 107g - Protein 120g - Carb 40g a day. I boost the fat with coconut oil in my coffee to up the calories and to feel full all day. I can not get all the calories in each day (1600), I do make sure it is over 1200, but the sodium is bumping the limit. I hear people need the sodium level to stay up when first starting out.2
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When I was diagnosed, my doc said there are three components to get rid of Type 2: lose some weight (I was about 150lbs overweight), eat low carb, and exercise every day. I was on Victoza and HATED giving myself shots every day. I committed to the three components and was able to go off meds in 3 months. My A1C dropped from 8.9 to 4.9. I am still working on losing all the weight (just over 100 to go) but I am no longer diabetic. My doc says the exercising every day (I walk about 30 minutes - nothing hard) and eating healthy foods made all the difference for me.5
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When I was diagnosed, my doc said there are three components to get rid of Type 2: lose some weight (I was about 150lbs overweight), eat low carb, and exercise every day. I was on Victoza and HATED giving myself shots every day. I committed to the three components and was able to go off meds in 3 months. My A1C dropped from 8.9 to 4.9. I am still working on losing all the weight (just over 100 to go) but I am no longer diabetic. My doc says the exercising every day (I walk about 30 minutes - nothing hard) and eating healthy foods made all the difference for me.
Congratulations!
1. You have a good doc:
2. Your.doc has a smart and determined patient!
Kudos. 2 -
@rabbyduby, how goes the voyage?1
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The brand that my Publix Pharmacy, Atlanta area, gives for free (no charge at all!), is from Ascend Laboratories. My gastric tract has no problems with taking it. There are other stores around that do the same or charge practically nothing at all. I use the GoodRx app to get my prescriptions now that my insurance has gone to fecal matter.1
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