Metformin Update #1: Slow Start Comes to a Screeching Halt

A month ago, I wrote about how I was going to start taking an oral diabetes medication called Metformin. You can read all about what is is and why I started taking it by clicking here. (If you didn’t read that post when it was initially published, I recommend skimming it quickly before you continue reading this one…otherwise, what I have to say next might not make much sense.)

All caught up? Good. Now I can tell you that my first Metformin update isn’t much of one…because I’ve already stopped taking it (for now, anyways).

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For now, this vial of pills will remain mostly full.

After two weeks of taking one pill after dinner daily, I decided that I needed a break from my new diabetes therapy. There’s a lot going on in my life right now – I’m moving to a new state in a matter of days, so all my spare time is spent either packing or seeing my family and friends. Adding a new medication into the mix, one that can cause unpredictable blood sugars, just doesn’t make sense. And while it could be argued that I could make adjustments to my insulin dosages to help mitigate the number of lows I experience, I simply don’t have the patience to fiddle around with my insulin-to-carb ratios or basal rates at this time. It’s all too much change at once, and even though I’ve become much more comfortable with new things in my adulthood, I still need time to acclimate to them.

I explained all that, albeit much more succinctly, to my endocrinologist via my patient portal messaging system a few days ago. And she’s totally on board with my decision, thank goodness. I’m free to resume Metformin again when I’m ready.

The affirmation from my endo that I was doing the right thing feels great. It helps me feel more confident in making choices that benefit my body’s health as well as my mental health. Even though now doesn’t feel like a good time to be taking daily doses of Metformin, I know that won’t always be the case. Maybe, in time, it’ll become a crucial component of my diabetes care and management routine – maybe I’ll end up valuing it as much as my OmniPod or CGM. But for now, I’m okay with putting it off just a bit longer.

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Molly, Meet Metformin

You may have read the title to this post and said to yourself, “Met-WHAT?”

Metformin is the new medication I’ve started taking (along with my typical insulin) to help regulate my blood sugars.

Maybe you didn’t make it all the way to that second sentence; instead, maybe you just Googled Metformin to learn more about it. And you probably immediately got confused, because the Google search results explained that Metformin is a medication normally prescribed to people with type 2 diabetes. You know that I have type 1, though, so what gives? Why am I taking this new pill?

You see, for about a year or so, my endocrinologist has been gently encouraging me to try Metformin. She expressed concerns over the fact that I’ve had diabetes for more than 20 years, and in that span of time, I’ve had to take a lot of insulin. Like, an incalculable amount. And while that insulin helps to keep me alive, there’s also risks associated with it. Namely, she explained to me that there’s research that indicates that people with type 1 who rely on large amounts of insulin have a higher risk of developing cancer later in life.

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Whoa. The “c” word. Something I never thought I’d hear during a doctor’s appointment. If you know me personally at all, then I’m sure it’s not hard to imagine that I pretty much shutdown at the mention of “cancer”. Almost immediately, I panicked and asked why she thought this research was worth mentioning. She said that it was part of her reasoning for wanting me to start Metformin. The idea is that it would make my insulin more effective, and ultimately decrease the amount of insulin I need each day. She went into a little more detail, mentioning that the only side effects tend to be nausea/upset stomach – and that’s when I stopped listening. I politely told her that I didn’t think Metformin was a wise option for me at that time, and later that day, when I took to Twitter to ask other T1Ds what they thought, I gained swift validation that I’d made the right decision: Other T1Ds with Metformin experience told me that the stomach issues they had when taking it were miserable and that they wouldn’t recommend giving it a try. Plus, I consulted with my T1D pharmacist aunt, and her opinions matched those of the other T1Ds on Twitter. So that was all I needed to hear to feel at peace with my choice to not take Metformin.

In fact, it was enough for me to turn my endocrinologist’s offer down during our next two or three appointments. I was relieved that she never pushed me to try it, but there was a small part of me that wondered whether I should give it more serious consideration. Maybe I should let her talk me into a little, rather than brushing it away and using fear as my excuse.

So we did talk about, during my most recent visit with her earlier this month. She gave me some more compelling reasons to consider taking it. Not only could I reduce my insulin intake, but it might also help me with some preexisting digestive issues I’ve had since childhood. When I asked her about the negative side effects on the stomach that I’d read about online, she told me that she would only prescribe me the “extended release” version of Metformin, which had a much lower (if any) chance of inducing nausea or any less…desirable gastrointestinal disorders.

This news definitely perked me up. We discussed a plan for introducing Metformin to my body: Start by taking one pill daily after dinner. Increase by one pill each week until I’m at four pills per day, the limit. At any point in time, I could message her with questions if I started to notice low blood sugars in the evening.

I felt reassured by this logical plan, as well as her explanations of the benefits of Metformin. So I bit the bullet and I’m in my first week of incorporating it into my post-dinner routine. I can’t say that I’ve noticed even the slightest difference, which isn’t a bad thing. I imagine that will change as my dosage increases.

I intend to blog about this new journey with Metformin; not just for the sake of keeping track of how it affects me, but to also help inform other T1Ds who may have been or may be in the same situation that I was. We’ll just have to see how it goes, but for now, rest assured that I’ll be honest in my writings about my Metformin experience. At this moment in time, I can’t help but feel hopeful that down the road, I’ll be glad I made this decision when I felt ready for it, as opposed to when I was fearful of it.