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Long Lost Member
katiey
Total Posts: 6
Registered on: ‎11-05-2009

A1c 5.2 - Dr. says Metformin?

Hi Everyone,

A year ago I was diagnosed with type 2 after having Gestational Diabetes. I'm 32 yrs old. I have worked hard to get down to my pre baby weight which was about 108 and to my surprise I've gotten down to 102 lbs (I'm short). I had some hope that losing weight would make this all go away, but it hasn't.

My A1c is 5.2. My question is... My Diabetes doctor says that even though my A1c is 5.2 she'd like to put me on Metformin to protect my heart. I was under the impression that if your A1c is below 6 you don't need medication? I am hesitant to start taking medication at this point because I realize soon enough I may NEED to take it to help me control my sugars and the longer I can go without the better in my mind (am I wrong?).

Has anyone heard this about Metformin protecting the heart? Anyone have any thoughts or opinions on this that you could share? I do plan to get my primary care physician's opinion too. But I know that you all have a lot of knowledge as well.

Thank you!
Katie
Contributor
jbronste
Total Posts: 428
Registered on: ‎01-13-2010

A1c 5.2 - Dr. says Metformin?


Haven't heard it, and don't think it's true. I think your A1C is really great and I would totally hold off on the met until you need it. I started out with an A1C of 6, then it came to 5.9, and I'm still not on met (although I will demand it if my A1C starts creeping up).
Contributor
karenl_g
Total Posts: 135
Registered on: ‎08-15-2010

A1c 5.2 - Dr. says Metformin?

I have read and spoken with different people- including my own do who says it may have some benefits for the heart. Of course, that is in my opinion.

Thanks to Alan...who helped me find actual info.

Check out the web site blood sugar 101. The author cites actual studies.

http://www.phlaunt.com/diabetes/14045911.php

Stimulation of AMPK May Be Why Metformin Appears Cardioprotective

AMPK has also been shown to have a protective effect on the heart. This review describes how AMPK may protect the body during heart attacks.

AMP-Activated Protein Kinase Conducts the Ischemic Stress Response Orchestra Lawrence H. Young. Circulation. 2008;117:832-840
doi: 10.1161/CIRCULATIONAHA.107.713115

Metformin May Be Protective Against Heart Disease
This idea has been floating around for years, though there wasn't definitive proof of it. A relatively small study published in March 2009 supports the idea.

Long-term Effects of Metformin on Metabolism and Microvascular and Macrovascular Disease in Patients With Type 2 Diabetes Mellitus. Kooy et all. Archives of Internal Medicine, 169 (6), 616-625 DOI: 19307526

A presentation at the 2009 European Association for the Study of Diabetes (EASD) described research which may point to why metformin is so effective.
Trusted Contributor
morrisolder
Total Posts: 10,548
Registered on: ‎11-28-2009

A1c 5.2 - Dr. says Metformin?

The following is copied from part of this post by oldal4865, a very respected contributor to the alt.support.diabetes newsgroup:

--------------------------------

Metformin is an odd drug. Doctors prescribe it to help control blood sugars but when you look at all the effects, it seems to be more of an anti-death pill for diabetics. For sure, it's an anti-heart attack pill (the #1 problem for T2 diabetics is premature heart attack)

Some reading on metformin:

I am a "metformin pusher" in the diabetic newsgroups, i.e. �in my opinion�, start taking it as soon as possible. Talk to many diabetic educators and you will get the recommendation to put all Type 2 diabetics on metformin as soon as diagnosed.

Some say put them on metformin before they are diagnosed! !

Some reasons for that enthusiasm:

a. Metformin reduces blood sugars
http://www.diabetesnet.com/diabetes_treatments/metformin.php

b. Metformin improves cholesterol and triglycerides
http://www.diabetesselfmanagement.com/article.cfm?sid=5&tid=34&stid=61&aid=1049&sk=5WY7

c. Metformin cuts heart attack risk in T2
http://www.diabetesincontrol.com/issue132/item2.shtml
http://www.diabetesselfmanagement.com/article...

also,

�Common diabetes drug lowers risk by inhibiting proinflammatory factor�
Heart Disease Weekly, July 27, 2003

"This action of metformin may help prevent Atherosclerosis," said Dandona, "and may explain why persons with type 2 diabetes who are treated with metformin are at lower risk of dying from heart disease."

(BTW, so do the TZD, Actos and Avandia)

d. Actually, Metformin just plain reduces overall mortality rates among T2 diabetics
http://care.diabetesjournals.org/cgi/content/abstract...

e. Metformin probably protects dying beta cells which are the proximate cause of T2. Metformin restores insulin secretion altered by chronic exposure to free fatty acids or high glucose: a direct metformin effect on pancreatic beta-cells
�. . . These data raise the possibility that, in diabetic patients, metformin (in addition to its peripheral effects) may have a direct beneficial effect on the beta-cell secretory function. . . .�
http://diabetes.diabetesjournals.org/cgi/content/abstract/49/5/735

Pancreatic Islets from Type 2 Diabetic Patients Have Functional Defects and Increased Apoptosis That Are Ameliorated by Metformin Piero Marchetti, Silvia Del Guerra, Lorella Marselli, Roberto Lupi, Matilde Masini, Maria Pollera, Marco Bugliani, Ugo Boggi, Fabio Vistoli, Franco Mosca and Stefano Del Prato
http://jcem.endojournals.org/cgi/content/abstract/89/11/5535

Diet and Exercise Dramatically Delay Type 2 Diabetes: Diabetes Medication Metformin Also Effective
http://www.niddk.nih.gov/welcome/releases/8_8_01.htm

(Regular, heavy exercise is an extremely potent defense against the host of T2 "bad effects". Metformin is decidedly in second place [see DPT-2} when compared to, say, becoming an aerobics instructor. However, if you are exercise-restricted, metformin becomes a "miracle" drug)

f. Metformin protects against the formation of Advanced Glycosylation End Products (A.G.E.)

Humans �must� die because of two factors involving DNA replication, and a third factor, the formation of Advanced Glycosylation End-Products (A.G.E.) which slowly destroy organs. Since A.G.E. formation is proportional to blood glucose level, diabetics encounter more A.G.E. production and therefore die prematurely.

We can�t do a thing about the DNA (except not smoke). Metformin protects against A.G.E. and, in fact, folks are thinking about using it in non-diabetics to extend life spans.
http://www.ncbi.nlm.nih.gov/entrez/query...

g. Metformin simulates exercise
http://www.dundee.ac.uk/pressreleases/prmar02/ghardie.htmg

h. Metformin helps folks lose weight (though usually only in the first year)
http://www.smart-drugs.net/ias-metformin-weightloss.htm

i. However, metformin can lead to vitamin B12 deficiency and a related high homocysteine levels.
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256DBD002C236D



Morris

Diagnosed Type 2, with an A1c of 11.4 in 2003; averaging a 5.0 A1c since then with diet, exercise and Glipizide XL + meds for blood pressure and cholesterol. 
A bit dated, but scroll down on this page if you want to know more ...


Long Lost Member
katiey
Total Posts: 6
Registered on: ‎11-05-2009

A1c 5.2 - Dr. says Metformin?

Thank you all for the great information. It does seem to have many health benefits. The more I read about it, the more comfortable I am with the idea of going on it.

Contributor
jbronste
Total Posts: 428
Registered on: ‎01-13-2010

A1c 5.2 - Dr. says Metformin?


It cracks me up that metformin and statins are both pushed by doctors for people in the normal range, and yet people are so much more guarded about statin use than about metformin use. It's not without side effects.
Long Lost Member
delaflower
Total Posts: 29
Registered on: ‎11-13-2009

A1c 5.2 - Dr. says Metformin?

I would not go on a drug with numbers like yours. Metformin does have serious side effects.
alan_s
Total Posts: 15,040
Topics: 208
High Fives: 1,594
Solutions: 180
Registered on: ‎10-30-2009

A1c 5.2 - Dr. says Metformin?

I respect the writings of Jenny and Old Al; I had the opportunity to correspond with both of them on this subject a long time ago. Of all the various medications for type 2 diabetes metformin is probably the least dangerous and most prescribed. I take it myself.

But I would prefer not to.

The opinion I wrote on my latest blog applies to metformin too. If medications are needed to achieve my true goal I will take them. I added metformin a few years back for that reason. However, and it is a very important however, I will use them if, and only if, reasonable application of diet and exercise cannot achieve the desired result.

I experimented earlier this year by dropping metformin for three months. Both my FBG and A1c rose. it was only a small rise, but both went above my "6" targets for A1c and FBG mmol/l. So I re-started it a couple of months ago.

But if my A1c had stayed under 6; if, for example, it was 5.2%, I would no longer be taking it. I am not a believer in prophylactic medication, prescribed based on statistical populations rather than on my individual medical assessment.
Cheers, Alan, Type 2, d&e metformin 2000mg, Australia.
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey(latest: Catering For Different Tastes When Cooking)
Born Under a Wandering Star (Latest: Budapest, Hungary)
Established Contributor
arrivedt2
Total Posts: 1,350
Registered on: ‎10-31-2009

A1c 5.2 - Dr. says Metformin?

Under 6 I'd not be on meds. Over 6 and climbing A1c I'd think about them. Right now I'm climbing so I have MetER 2000mg daily but if ever below 6 again I'd lose Met.

Met is rougher than MetER in most bodies!!!

Promise me you'll always remember:
"You're Braver than you believe, Stronger that you seem, and Smarter than you think !"

Christopher Robin to Pooh Bear

Lee, T2 since 07/1988
Live long and prosper.

"Don't waste any tomorrows because of what you didn't do yesterday !"

Contributor
evilnala
Total Posts: 364
Registered on: ‎07-19-2010

A1c 5.2 - Dr. says Metformin?

Katie,

Just to offer a counterpoint, there is a fair amount of research which suggests that very aggressive treatment, including met, gives much better outcomes than standard plans, especially in those who are in their 20's and 30's.

Any decision to use drugs or not should be based on your personal health and risk factors. If I were you, I'd insist on a longer discussion with the doc as to why he wants you on met, what benefits it's supposed to give you, and what aspects of your health and risk factors make it a good idea. I'd also ask for some suggested references to check out for myself.

Personally, met has been a great drug for me, despite it's potential problems. I have to say, even if I get to a point in the future where I find I can maintain very good A1C numbers with met (fingers crossed!) I would also keep an eye on some of my other test numbers and my ability to continue/maintain weight loss. Since met seems to help me with some of these other factors, I would continue to take it if I saw trends I didn't like in these areas, even if my A1C was fine.