For the past few days I’ve been in a good mood. It seems as if I have finally found a way to deal with my biggest diabetes management issue – morning highs. And what makes it even better is that this is a true case of patient power – it wasn’t a doctor who figured out what I needed, it was me. I needed metformin.
The truth is I wasn’t going to write about my experiment with metformin until after I got another A1c, as an official confirmation of success. But yesterday when I woke up, at 4:30 a.m. to go running and tested my blood sugar, I changed my mind. My blood sugar was a perfect 100. And this morning when I woke up early again it was 90. I’m so happy about this that I can’t resist sharing.
I’ve had type 1 diabetes for ten years and for most of those years I’ve struggled with morning highs (dawn phenomenon), waking up with blood glucose levels of anywhere between 120 to 200 usually over 150. Although this has been convenient as far as running is concerned, I know this is far from healthy and have tried to solve the problem with the help of doctors.
Doctors have suggested many things, from changing the kind of basal insulin I use and adjusting the amounts, to injecting into larger muscles. But no one has ever suggested I take metformin to help control my blood sugar levels.
Most doctors it seems, like most people, don’t like to think outside the box or try something different, at least until they have no choice. I don’t mean to criticize doctors in general, but many times it seems as if it’s not me they see, but my disease. That means that rather than tweaking my treatment according to my needs, and making it individual, they prescribe the standard type 1 drug regimen. Metformin belongs to type 2 diabetes treatments, so it seems to not even register in doctors’ minds as a possible treatment for type 1 diabetes.
One of the great things about this age of information is that as patients we have the opportunity to take control of our health care more than ever before. I got the idea to try metformin through my own research, after reading about how metformin reduces insulin resistance and decreases the production of sugar by the liver. It also seems to reduce LDL cholesterol (another problem I suffer from thanks to my liver) and protect against various cancers.
After reading, I decided to ask for metformin at my next doctor’s visit. I didn’t actually think my doctor would go for it (since doctors don’t always like patient power). I rehearsed suggesting it in my mind, trying to figure out a way that would sound polite and respectful, but when the moment came I just said, “Can I try metformin?”. The doctors initial reaction was “Metformin is for type 2 diabetes.” She repeated that a few times which made me think there was no way she would give it to me, but I was wrong. She actually thought it was a good idea and told me it could help with my morning highs.
When giving me the prescription the doctor told me it would take a couple of weeks to start seeing results. She also told me to take a half a pill (425mg) for the first two weeks to make sure I didn’t suffer from any side effects. Luckily, I didn’t and after those two weeks I upped the dose to a full pill, which I take every night before I go to bed.
For the first 2 weeks I didn’t see any results but a few days after I started the full dose (850mg) I noticed an improvement in my morning BG numbers.
I know it’s too early to really make a judgment and most probably after I write this post my morning blood glucose levels will go totally out of control, but it feels as if there has been a change in my body. I go to sleep at the same levels I usually do, after eating the same food I usually do, and wake up lower than usual, but not too low.
I don’t know if the metformin is making a difference in any other way, too – insulin sensitivity or cholesterol, but it seems to have made a huge difference in morning numbers. I hope this continues.
The only problem now is that I need to rethink my mornings and figure out a way to start my runs with higher blood sugar. Maybe I’ll have an energy gel with my coffee.
Hi Brian. The truth is I don’t really know. I’m aware of the increased possibility of hypoglycemia if going to sleep to low or with insulin on board and I am therefore trying to be careful testing at bed time and some nights setting alarms.
I’ve been struggling with morning highs for a while and this seems to solve the problem without increasing insulin which is much more dangerous as far as lows are concerned.
The truth is I can’t understand why more type 1s don’t take metformin but I’m no doctor.
Hi Michael, this is definitely interesting. I notice that you mention that Metformin can decrease the production of glucose by the liver. Have you thought about the possible impact of this on nighttime hypos – does it increase the risks of a having a severe low nighttime since the liver could be less likely to release glucose in response to the hypo?
I am a firm believer in patient power. Noticed you use the Freestyle lite which I was using and now using the Accuchek Aviva which is 20 pts higher than Freestyle. I try to keep my glucose between 80-140 range below 100 fasting 140 two hrs after a meal. Takes alot of discipline…diet and exercise. I am a T1. Interesting article about metformin which is a drug I have been reading alot about. Thanks,
This is fascinating. I think there’s a lot of research to be done about possible ways drugs approved for Type 2 might also help people with Type 1 — particularly when it comes to glucagon production and insulin resistance. I hope that more doctors are as openminded as yours! Definitely keep us posted on your continued results. I’m particularly interested in whether you find that you’re more likely to have lows (especially when you exercise in the AM).