Metformin

[Shellc]

I have just been prescribed metformin, I’ve been battling with 7.9 fir a while now , trying to get it down diet wise but am on prednisone so that’s probably why . My question is , it sats to take with or after food . I very rarely eat breakfast so am taking the tablet after lunch , Will this be ok . Been told to take one a day till my body gets used to it

[TheAwfulToad]

Prednisone will affect your appetite and bodyfat distribution, but you should still be able to follow a standard diabetic diet (ie., low-carb high-fat) and get your blood sugar under control that way.

If you're eating a low-carb diet then diet-related glucose spikes should not be an issue; therefore the best time to take the metformin would probably be after your evening meal, because (a) metformin has a fairly short half-life and (b) for many diabetics nighttime is when your liver tends to get things drastically wrong and ramps up glucose synthesis.

Why do you feel you're "struggling" with the diet? Most people find the dietary changes to be psychologically reassuring as well as medically appropriate. It could simply be you've got a few details not quite right?

[TRULYSPEAKING]

Cut down on carbohydrates- rather eliminate carbohydrates from your diet. Take gluten free bread or chapatis. Take fresh fruits, green vegetables, high proteins and fibrous foods. Take nuts- almonds (8 to ten kernels), walnuts (one to two kernels) and peanuts. Roasted grams are good fillers. This all would help lowering your HbA1c levels.

[TheAwfulToad in reply to TRULYSPEAKING]

fruits and peanuts are high in carbs/sugars, but otherwise, I'd agree: medication doesn't fix anything, and diet should come first.

[TRULYSPEAKING in reply to TheAwfulToad]

Sorry Sir,

Almonds, Walnuts and peanuts respectively have 13%, 14% and 16% carbohydrates. Apples have 14%, Oranges have 12%, watermelons 7.5%, strawberries 8%, kiwis 15%, Avocados 9%. Berries generally have low carbs. Wheat 76%, rice 28%.

[TheAwfulToad in reply to TRULYSPEAKING]

16% carbs is a lot if you're aiming for VLCHF ... especially since it's hard to stop at a handful of peanuts

40g of peanuts would be a quarter of a typical keto carb allowance. Is it worth it? Why not "spend" those carbs on having a proper meal?

Yes, berries are generally OK, but again, what's the point in eating fruit? Better to stick with some low-GI veg and/or something fatty, I'd say. It's more filling, and it won't cause an insulin response.

I'm splitting hairs here, but when you're diabetic, I'd say it's best to avoid even moderate-carb foods until you've achieved some measure of glycemic control, which might mean 2-3 months at or near "keto" levels.

[TRULYSPEAKING in reply to TheAwfulToad]

Sir,

I have tried it on my wife. Her Hb1Ac has come down from 7.5 to 6.4 in a period of three months. This is despite her reduced dosage of insulin. She was on Insulin Glargin 42 units to 38 units, Insulin Apidra 16 units three times to 12 units twice daily.

Your remark that “especially when it is hard to stop at handful of pea nuts”. One has to keep restraint in eating anything.

A diabetic has to maintain strict discipline in diet.

Though, you are right that one may have low glycemic foods.

Re your comment “what is the point in eating fruits”. Fruits are essential in building your resistance, in giving you essential minerals and vitamins, in the general upkeep of health.

Roasted grams are good fillers.

I would rest the discussion here as we are having differing views.

[TheAwfulToad in reply to TRULYSPEAKING]

Nothing wrong with having differing views. I'm not arguing with your results, just suggesting that life can be easier. For example, if you don't start on the peanuts, you can't finish them; and if you have a proper meal, you won't be tempted to start on the peanuts "Strict discipline" is no fun at all.

Most people find that completely discarding carbs to begin with - that is, any and all sources of sugars - makes you stop wanting them. This is true for diabetics and for non-diabetics. Once your body has recalibrated to running on fat instead of carbs, you can (sometimes) start reintroducing things like fruit and peanuts.

All legumes contain 10-15% carbs (I assume from the word 'gram' that you're in India) so it's not a great idea to use them as "fillers" - you can easily end up adding 50g of net carbs to your daily intake. Yes, some bodies may cope with that, but again: why take the risk? There's nothing in beans (or fruit for that matter) that you can't get from other things. Given adequate fat and non-starchy vegetables, you will feel full and energized, and you won't need such things.

Again, I'm not disputing your results. Just pointing out that the underlying biochemistry suggests a more sustainable approach.

[cathie]

You can get slow release metformin which is kinder to your body. Steroids do raise blood sugars - one reason they’re not the complete answer

[learn-2016]

Please do not skip any meals the more you skip the more you compensate for it in the next meal.

the met medication says that it must be taken after meals. Yes after lunch should be ok

It all depends on the food we eat. Less oil intake

nuts only 10 a day. roasted grams are very good.

Soak all grains overnite or long hours including rice - i meant brown rice.

Yes less carb for sure.

[Shellc]

I followed the Keto diet for a year and my results still crept up, I don’t eat gluten and have had to stop gluten free as became intolerant to it , dairy is now a problem that it triggers my eczema and berries are causing facial rashes, this is the reason for me struggling as I have intolerances