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Post by snowballsmommy on Sept 22, 2016 21:06:31 GMT -5
Yes Scottie, my husband has what you describe on his legs (for years). His doctor sent him to the dermatologist who prescribed a cream!!!
Going to have him mention the metformin connection. My husband has been changing doctors trying to get one to prescribe Afrezza. Get depressed everytime with their responses, including one last week that was on the list of Afrezza prescribers.
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Post by Deleted on Sept 22, 2016 21:09:08 GMT -5
Yes Scottie, my husband has what you describe on his legs (for years). His doctor sent him to the dermatologist who prescribed a cream!!! Going to have him mention the metformin connection. My husband has been changing doctors trying to get one to prescribe Afrezza. Get depressed everytime with their responses, including one last week that was on the list of Afrezza prescribers. This mnkd.proboards.com/post/80116Print the studies Hand it to the doctor Tell that you would start on Afrezza and ask for a sample. |
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Post by scottiemac on Sept 28, 2016 16:11:02 GMT -5
Yes Scottie, my husband has what you describe on his legs (for years). His doctor sent him to the dermatologist who prescribed a cream!!! Going to have him mention the metformin connection. My husband has been changing doctors trying to get one to prescribe Afrezza. Get depressed everytime with their responses, including one last week that was on the list of Afrezza prescribers. What cream? Saw my internist on Friday, had an ABI/PVR Doppler test on Tuesday (ABI = ankle brachial index; PVR = pulse volume recordings) to check the arterial blood flow in my legs, waiting on the results to see if I have PAD (peripheral artery disease.) My tech did ask if I was on antibiotics because she thought it looked like cellulitis to her, which I mentioned to my doctor who replied that bilateral cellulitis is rarer than unicorns but if the ABI came back normal we'd try antibiotics to see if they made any improvement. Will let you know the results when I find out. |
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Post by scottiemac on Oct 7, 2016 19:37:07 GMT -5
What cream? Saw my internist on Friday, had an ABI/PVR Doppler test on Tuesday (ABI = ankle brachial index; PVR = pulse volume recordings) to check the arterial blood flow in my legs, waiting on the results to see if I have PAD (peripheral artery disease.) My tech did ask if I was on antibiotics because she thought it looked like cellulitis to her, which I mentioned to my doctor who replied that bilateral cellulitis is rarer than unicorns but if the ABI came back normal we'd try antibiotics to see if they made any improvement. Will let you know the results when I find out. |
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Post by scottiemac on Oct 7, 2016 19:42:23 GMT -5
FINALLY heard back re ABI/DVR Doppler tests on my legs --- and the results were normal. No blockage, good flow. I'm starting SMZ-TMP antibiotics for 10 days in case it's cellulitis but I gotta say I am still thinking it's the Metformin. On a personal note, we welcomed our 4th grandchild on Monday. Charlotte weighed in at 5 pounds 2 ounces and 19.5". Cute as a button if I do say so myself. |
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Post by xoxoxoxo on Oct 7, 2016 22:54:56 GMT -5
I hate to admit it. But Afrezza won't ever replace metformin as the front line therapy in T2D for a couple reasons. It's generally effective for the recently diagnosed T2D It's practically free. Seriously, check out www.goodrx.com/metformin Worst case is like a nickel a pill. It's easy to use, everyone has taken pills before and it's not very scary It's generally safe. There's really no risk unless you have an underlying kidney problem. In fact, it's being studied because of the side effect of making people live longer. clinicaltrials.gov/ct2/show/NCT02432287I admit I bought into the hype a few years ago, but honestly, there's no way afrezza will ever supplant metformin because of these reasons. Unfortunately the first line of insulin therapy is a basal (long term) insulin which afrezza is not. You aren't going to change doctors minds on either of these points before any of us retire. Maybe 30 years from now but by then technosphere will be off patent anyways. Afrezza should have a market amongst T1/T2, but a T1 on an insulin pump who is relatively stable doesn't see a need to change. Hell my uncle is still using insulin-r because he's comfortable/been happy with it over the last 30 years. It's an uphill battle, but please the projections where afrezza replaces metformin for front line therapy have to stop. It's pure bs. |
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Post by rockstarrick on Oct 7, 2016 23:38:10 GMT -5
I hate to admit it. But Afrezza won't ever replace metformin as the front line therapy in T2D for a couple reasons. It's generally effective for the recently diagnosed T2D It's practically free. Seriously, check out www.goodrx.com/metformin Worst case is like a nickel a pill. It's easy to use, everyone has taken pills before and it's not very scary It's generally safe. There's really no risk unless you have an underlying kidney problem. In fact, it's being studied because of the side effect of making people live longer. clinicaltrials.gov/ct2/show/NCT02432287I admit I bought into the hype a few years ago, but honestly, there's no way afrezza will ever supplant metformin because of these reasons. Unfortunately the first line of insulin therapy is a basal (long term) insulin which afrezza is not. You aren't going to change doctors minds on either of these points before any of us retire. Maybe 30 years from now but by then technosphere will be off patent anyways. Afrezza should have a market amongst T1/T2, but a T1 on an insulin pump who is relatively stable doesn't see a need to change. Hell my uncle is still using insulin-r because he's comfortable/been happy with it over the last 30 years. It's an uphill battle, but please the projections where afrezza replaces metformin for front line therapy have to stop. It's pure bs. No disrespect intended, My Father started taking metformin a few years back, his blood pressure shot through the roof, (HBP is listed as one of the side affects), he has been to the Emergency room several times to get his BP down, it destroyed his stomach, let's just say he had an unpredictable shitter, (for lack of a better word), that seemed to go away after a few months. He has asthma so he hasent tried afrezza, but he hates metformin and wishes he could try afrezza. it may take a while, but I can see afrezza combined with a CGM and a good 24 hour Insulin as a standard, 1 shot a day and afrezza at mealtime is consistantly keeping PWD in zone, not sliding through on the way to another high or another low. Also, T2 diabetics eventually wind up on Insulin therapy, a good portion of those being switched from metformin to Insulin will chose the inhaler over the needle for their mealtime insulin IMO. Just my 2 cents on metformin. Good luck to you |
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Post by peppy on Oct 8, 2016 14:29:58 GMT -5
FINALLY heard back re ABI/DVR Doppler tests on my legs --- and the results were normal. No blockage, good flow. I'm starting SMZ-TMP antibiotics for 10 days in case it's cellulitis but I gotta say I am still thinking it's the Metformin. On a personal note, we welcomed our 4th grandchild on Monday. Charlotte weighed in at 5 pounds 2 ounces and 19.5". Cute as a button if I do say so myself. I scrolled through the metformin fda information. www.accessdata.fda.gov/drugsatfda_docs/label/2008/020357s031,021202s016lbl.pdf This is the only information I could find on the bruising, redness, Metabolism and Elimination "Following oral administration, approximately 90% of the absorbed drug is eliminated via the renal route within the first 24 hours, with a plasma elimination half-life of approximately 6.2 hours. In blood, the elimination half-life is approximately 17.6 hours, suggesting that the erythrocyte mass may be a compartment of distribution." page 3 of 30.
blessings scottie on the news of your newest family member being born healthy. Pep
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Post by scottiemac on Nov 10, 2016 20:22:06 GMT -5
Long overdue update - am off Metformin indefinitely. Probably due to the Bactrim I was on (10 days - never ever again) for possible cellulitis (nope) I developed numbness from chin to neck and around my midsection from waist to hips. Lost my appetite, developed dysphagia (swallowing difficulty) resulting in a 12 pound weight loss in just over 2 weeks. Hospitalized for 5 days with hyponatremia - low sodium in my blood, came in at 125, normal is 136 or higher, so was on saline infusion for 4 days while they slowly increased the sodium. Scoped the throat, nothing mechanically wrong, removed a benign polyp and biopsied the esophagus in 3 places. Found chronic acid reflux for which I am taking generic protonix. In less than 2 years I have gone from 251 to 207 (I was 223 a month ago). While in hospital they checked my glucose 3-4 times a day and with one exception I was in normal range, from 87 in the morning to maybe 107, 109. Hit 144 once and got 2 units of insulin. It clearly was the Metformin causing the original problem on my shins as that has improved about 70%, no redness, shrinking area, mostly slightly purple. Seeing a neurologist shortly to figure why the numbness which has cleared in some places and moved to others. I have hypersensitivity in my hands, can't feel much of my lower legs but the midsection has some normal areas again. None too steady on my feet but otherwise okay. Been one hell of a ride lately.
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Post by rockstarrick on Nov 10, 2016 20:31:43 GMT -5
Long overdue update - am off Metformin indefinitely. Probably due to the Bactrim I was on (10 days - never ever again) for possible cellulitis (nope) I developed numbness from chin to neck and around my midsection from waist to hips. Lost my appetite, developed dysphagia (swallowing difficulty) resulting in a 12 pound weight loss in just over 2 weeks. Hospitalized for 5 days with hyponatremia - low sodium in my blood, came in at 125, normal is 136 or higher, so was on saline infusion for 4 days while they slowly increased the sodium. Scoped the throat, nothing mechanically wrong, removed a benign polyp and biopsied the esophagus in 3 places. Found chronic acid reflux for which I am taking generic protonix. In less than 2 years I have gone from 251 to 207 (I was 223 a month ago). While in hospital they checked my glucose 3-4 times a day and with one exception I was in normal range, from 87 in the morning to maybe 107, 109. Hit 144 once and got 2 units of insulin. It clearly was the Metformin causing the original problem on my shins as that has improved about 70%, no redness, shrinking area, mostly slightly purple. Seeing a neurologist shortly to figure why the numbness which has cleared in some places and moved to others. I have hypersensitivity in my hands, can't feel much of my lower legs but the midsection has some normal areas again. None too steady on my feet but otherwise okay. Been one hell of a ride lately. Wow, glad you are doing better, lucky they could stabilize the sodium levels. Are you going to try to get a prescription of afrezza now that you are off metformin ?? Thanks for the update I hope you feel better soon. |
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Post by esstan2001 on Nov 10, 2016 21:21:04 GMT -5
hope things continue to get better and if you need to be on insulin, that you can find success with Afrezza
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Post by sayhey24 on Nov 10, 2016 21:38:10 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? Diabetes is a progress disease. I watched my father over 20 years start on the pills, then one injection per day, then 2, then 3 and then the massive heart attack. Early use of insulin seems to slow the progression. Afrezza is much different in how it works because it mimics the phase 1 insulin release from the pancreas to shut off the liver glucose production. There are many theories on what causes the pancreas cells to die off and there appears to be some evidence that early use of afrezza can actually stop and maybe reverse the progression. I could go on and on about theories but what is clear is there is no better treatment to lower glucose spikes as a result of eating. Metformin decreases high blood sugar primarily by suppressing glucose production in the liver when you are not eating. This is not how the body naturally works. Why your endo put you on this is because that is their current "standard". As CGMs and real-time cloud monitoring take hold over the next 5 years IMO they will be forced to change. If in the 1800's you had a fever, you would have been bled by a leech. Giving metformin is easy for the endo and the pills are cheap and you will need to keep going back to the endo as the disease progresses. With afrezza you may not need the endo all that much which is not so good for the endo. If it was me I would get a CGM and a doctor to prescribe afrezza. In about 2 months you may not need the CGM all the time as a T2 after you dial afrezza in. It would be nice if there was a CGM rental program from Dexcom or Mannkind for the T2s. |
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Post by scottiemac on Nov 13, 2016 10:03:56 GMT -5
At this point I don't need insulin at all, my levels are in normal range after having been off Metformin for more than a month (morning glucose level was 87-99, postprandial usually in the 108-110 range.) I had been dropping for a year due to weight loss and the recent additional loss seems to have normalized things. Still testing but so far so good. I have a way to go before I hit my target weight but have always planned to take 2-3 years to slowly take it off. Haven't quite caught up with my younger sibling who had gastric bypass and has lost 60 pounds since June but I'm closing in.  |
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Post by snowballsmommy on Nov 13, 2016 18:09:01 GMT -5
Yes Scottie, my husband has what you describe on his legs (for years). His doctor sent him to the dermatologist who prescribed a cream!!! Going to have him mention the metformin connection. My husband has been changing doctors trying to get one to prescribe Afrezza. Get depressed everytime with their responses, including one last week that was on the list of Afrezza prescribers. okay...going to give an update based on my husband's 6 month visit with his endocrinologist on Monday. As a refresher, we are patients at the largest medical practice in New Jersey. Endocrinologist has been unwilling to put husband on Afrezza. He is on metformin and lantus. Says that he doesn't need a mealtime insulin. We even tried an appointment with another practice where the endocrinologist was listed as one who prescribes Afrezza. (when we got there, he said that he doesn't and was unwilling to prescribe, so we went back to the original endocrinologist.) Reason for my post is that at last week's appointment, when my husband was pressing for Afrezza, endocrinologist finally admitted that he is part of a focus group on Afrezza but would not elaborate. He wants to know more before he will prescribe. But he is adamant that he doesn't need mealtime insulin, so he doesn't need Afrezza. So evident to me that they are in bed with BP. |
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Post by sophie on Nov 13, 2016 18:15:57 GMT -5
I'm pretty sure it's unlawful for a physician to get bought out by other pharmaceutical companies. You're probably misunderstanding their words. It's possible that they have interest in Afrezza and want to prescribe, but are waiting on the sidelines to do so until they know it's safe. That's been the sentiment from the few physicians I have spoken to.
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