|
|
Post by mnkdkarma on Sept 19, 2016 20:43:37 GMT -5
Diagnosed with T2 a year ago - for 3 years prior to that doctors tried to put me on Metformin, which I resisted. After diagnosis my A1c has ranged from 6.6 to 7.2. Endo prescribed Metformin despite my request to be put on Afrezza. Endo has prescribed Afrezza for T1 previously, so is not averse to Afrezza. Would appreciate suggestions on how to convince him to allow me to take Afrezza. Also welcome suggestions for medical literature citing the drawbacks of Metformin.
|
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Sept 19, 2016 21:07:26 GMT -5
|
|
|
|
Post by agedhippie on Sept 19, 2016 21:09:46 GMT -5
Diagnosed with T2 a year ago - for 3 years prior to that doctors tried to put me on Metformin, which I resisted. After diagnosis my A1c has ranged from 6.6 to 7.2. Endo prescribed Metformin despite my request to be put on Afrezza. Endo has prescribed Afrezza for T1 previously, so is not averse to Afrezza. Would appreciate suggestions on how to convince him to allow me to take Afrezza. Also welcome suggestions for medical literature citing the drawbacks of Metformin. It's difficult - unless you have kidney problems metformin is the correct thing at this point so he is unlikely to let you jump straight to Afrezza. There are a lot of things he is probably going to want to put you on before he gets to insulin. Endos in the US do not like putting people on insulin before they absolutely have to. The only thing you could try would be the papers that mnholden posted about putting Type 2 into remission with insulin. |
|
|
|
Post by sportsrancho on Sept 19, 2016 21:19:42 GMT -5
|
|
|
|
Post by curiousdoc on Sept 19, 2016 21:31:34 GMT -5
No one usually likes to hear it... but a low carb (perhaps even ketogenic) diet and weight loss would probably remove the need for any medications at all eventually...
|
|
|
|
Post by avichen on Sept 19, 2016 22:05:23 GMT -5
I advocate for T2D early insulin treatment too! What I suggest is, change the doctor until you found one who willing to prescribe insulin! My experience, with my T2D friend who took insulin live a better life than I did. I was in metformin, then acarbose, then now finally insulin injection. My T2D friend took insulin all his life, because his daughter is a doctor and take charge of his health. The result, I have had my heart problem, done bypass surgery, damaged kidneys, damaged liver, damaged bladder...etc etc... and my friend never had all those complications throughout his life. Some doctors just "follow the rule", telling them to prescribe metformin for T2D. They never really done any further study, never read research papers, never really care to attend medical conferences. The only way to help yourself is to get away from all those amateur "just follow rule" doctors. Get one who really cares, who really passionate about his/her work, who attend medical conferences, and read newly published medical papers.
|
|
|
|
Post by peppy on Sept 19, 2016 22:42:39 GMT -5
Diagnosed with T2 a year ago - for 3 years prior to that doctors tried to put me on Metformin, which I resisted. After diagnosis my A1c has ranged from 6.6 to 7.2. Endo prescribed Metformin despite my request to be put on Afrezza. Endo has prescribed Afrezza for T1 previously, so is not averse to Afrezza. Would appreciate suggestions on how to convince him to allow me to take Afrezza. Also welcome suggestions for medical literature citing the drawbacks of Metformin. The question was why metformin and not afrezza.
reply, MNKDkarma physicians have standards of care. Here are the standards.
To convince: MNholdem and Mannmade are the people that know those studies better. They will post. Good luck
|
|
|
|
Post by slugworth008 on Sept 19, 2016 22:43:45 GMT -5
No one usually likes to hear it... but a low carb (perhaps even ketogenic) diet and weight loss would probably remove the need for any medications at all eventually... That's a tough diet to achieve though. Guess it would be worth it if it worked. |
|
|
|
Post by peppy on Sept 19, 2016 22:51:23 GMT -5
No one usually likes to hear it... but a low carb (perhaps even ketogenic) diet and weight loss would probably remove the need for any medications at all eventually... That's a tough diet to achieve though. Guess it would be worth it if it worked. Meat and salad. Meat and broccoli. Meat and cauliflower.
Meat in the morning, meat in the evening, meat in the afternoon. hmmm
salad, cauliflower, spinach, broccoli for breakfast. hmm, broth.
yes, it works. Do not awaken the pancreas. meat/fish and eggs interchangeable. (Do not die of a heart attack.)
|
|
|
|
Post by mnkdkarma on Sept 19, 2016 23:11:38 GMT -5
Appreciate the guidance...one last question...is Metformin, in and of itself, a dangerous drug or is it simply a drug with bad side effects which eventually leads to other diabetic drugs that are even worse?
|
|
|
|
Post by peppy on Sept 19, 2016 23:33:44 GMT -5
|
|
|
|
Post by agedhippie on Sept 20, 2016 10:38:55 GMT -5
Appreciate the guidance...one last question...is Metformin, in and of itself, a dangerous drug or is it simply a drug with bad side effects which eventually leads to other diabetic drugs that are even worse? If your kidneys are not damaged (eGFR of under 45) then Metformin is fine. The FDA Drug Safety Communication covers Metformin specifically for it's use in people with reduced kidney function but also includes the general review of Metformin. Make sure that you get the extended release version of Metformin, and start at 1000mg or less to avoid a lot of problems. It takes about a month to become effective (slow accumulation). Maximum dosage is 2250mg per day but you shouldn't be at that level. The side effects largely go away after the first month. Be aware that Metformin does not always work. Some people have genetics that prevents them from metabolizing it although that is fairly rare. Metformin is the most effective of the oral meds and has the least side effects. Type 2 is progressive, live long enough and everyone ends up on insulin.  |
|
|
|
Post by derek2 on Sept 20, 2016 16:10:44 GMT -5
Appreciate the guidance...one last question...is Metformin, in and of itself, a dangerous drug or is it simply a drug with bad side effects which eventually leads to other diabetic drugs that are even worse? If your kidneys are not damaged (eGFR of under 45) then Metformin is fine. The FDA Drug Safety Communication covers Metformin specifically for it's use in people with reduced kidney function but also includes the general review of Metformin. Make sure that you get the extended release version of Metformin, and start at 1000mg or less to avoid a lot of problems. It takes about a month to become effective (slow accumulation). Maximum dosage is 2250mg per day but you shouldn't be at that level. The side effects largely go away after the first month. Be aware that Metformin does not always work. Some people have genetics that prevents them from metabolizing it although that is fairly rare. Metformin is the most effective of the oral meds and has the least side effects. Type 2 is progressive, live long enough and everyone ends up on insulin. That. Right there. Switched back to Metformin + basal + prandial from Janumet + basal + prandial and added Trulicity 3 weeks ago. BGs had been rising over the last year despite best efforts. I'm already 80% back to target range. Sometimes you just need to mix it up, or in my case talk to a smart endo and listen to her... |
|
Deleted
Deleted Member
Posts: 0
|
Post by Deleted on Sept 20, 2016 16:21:26 GMT -5
If your kidneys are not damaged (eGFR of under 45) then Metformin is fine. The FDA Drug Safety Communication covers Metformin specifically for it's use in people with reduced kidney function but also includes the general review of Metformin. Make sure that you get the extended release version of Metformin, and start at 1000mg or less to avoid a lot of problems. It takes about a month to become effective (slow accumulation). Maximum dosage is 2250mg per day but you shouldn't be at that level. The side effects largely go away after the first month. Be aware that Metformin does not always work. Some people have genetics that prevents them from metabolizing it although that is fairly rare. Metformin is the most effective of the oral meds and has the least side effects. Type 2 is progressive, live long enough and everyone ends up on insulin. That. Right there. Switched back to Metformin + basal + prandial from Janumet + basal + prandial and added Trulicity 3 weeks ago. BGs had been rising over the last year despite best efforts. I'm already 80% back to target range. Sometimes you just need to mix it up, or in my case talk to a smart endo and listen to her... Garbage. Did you try Afrezza as meal time? |
|
|
|
Post by derek2 on Sept 20, 2016 17:21:57 GMT -5
That. Right there. Switched back to Metformin + basal + prandial from Janumet + basal + prandial and added Trulicity 3 weeks ago. BGs had been rising over the last year despite best efforts. I'm already 80% back to target range. Sometimes you just need to mix it up, or in my case talk to a smart endo and listen to her... Garbage. Did you try Afrezza as meal time? I'm in Canada. Afrezza is not available to me. And please lay off the ad hominem. |
|
