what happens if stop Metforamin?

[PamelaSC]

I've read that if the eGFR is <30 the doctor will most likely take you off Metforamin. My husband's been on it for about 3 years. If he has to quit, will his diet become more strict as far as carbs, etc? Or is there a different drug? Since diagnosed with T2, he's lost over 100 pounds and I'm thinking that will make a difference too. His blood glucose has been consistently good as long as he doesn't go crazy with carbs. But I know he doesn't adhere to a low carb diet. At least not like he did in the beginning.

[Hidden]

If your husband has lost 100 lbs. and is still going overboard on carbs the likelihood that he is going to maintain a good A1c is poor. Metformin is one of the best medications for T2D but it is not recommended for those with CKD. I was taken off all meds for T2D just over 2 years ago and was able to control it by diet and exercise. Just last month my PCP asked me to go back on it for a short period of time to get my A1c back below 5.8. My GFR is 57 with a two year average of 49. Once this prescription is completed and I get past a couple of other health issues I will stop the glipizide-metformin combination. As it is I'm only taking a half pill each day.

Why isn't your husband taking these issues more seriously? With T2D and CKD he has serious issues and he can't get away with loading up on carbs and ignoring both issues. You didn't mention hypertension but has that been an issue for him? There are other injectables he can take but they depend on other circumstances and he should speak to either his endocrinologist or PCP or both.

How often is he taking his blood glucose readings? He should be doing it more than once a day and under those conditions, he must see his glucose rise after loading up on carbs and he has to realize that he will pay for that eventually.

Is he seeing a nephrologist? I would imagine that this has come up from time to time with his doctor, especially with his PCP. Has he been to Diabetes Education classes and does he understand what going on too many carbs will do to his health with T2D and CKD?

Do you or someone else go with his to his appointments? Lots of questions, I know but they are critical ones and need to be answered or he will be facing health issues that eventually may be beyond his ability to control as he would like.

[PamelaSC in reply to Hidden]

His A1C is normal. I went with him to his last nephrologist appointment 2 almost 2 weeks ago. I’ve been reading like crazy about all this stuff trying to educate myself - I have a biochemistry science background so can understand fairly well even though I’ve been out of the lab for 17 years. He doesn’t want to hear much about all this. Says I go immediately to the worst possible outcome and it just makes him worry too much. Example of something. The doctor said max 2000 mg/day sodium. He thinks it’s ok to save up the “allowance “ and eat it all in one meal. I told him I don’t think it works that way - trying to be diplomatic.

He didn’t go back to the cardiologist for almost 10 years despite a history of CHF (from a virus) because the doctor said if it dropped below 35-40 they should talk about an implanted defibrillator. At that time it was in the low 40s I think but can’t remember and he didn’t save the results. He wouldn’t have gone last week if the nephrologist hadn’t insisted.

He takes his glucose readings once a day at variable times. And he does moderate crabs if it seems that he ate something that put him “in the red zone”.

Now he’s saying that if this kidney/diabetes thing makes it so he can’t eat he might as well kill himself. I don’t think he was serious.

We did go through all the stuff in the kitchen and get rid of moderate to high sodium items and are replacing what we can.

But, yeah, he’s in serious denial. I keep bringing up dialysis and transplants and planning for the future but he acts like i’m not even talking.

In the last 8-9 months, his eGFR has gone from 44 to 26. Nephrologist is still trying to figure out what’s going on. He didn’t even get referred until his eGFR was 32.

Waiting for echo results and more blood/urine being done Wednesday

[Hidden in reply to PamelaSC]

We have had a few wives in the community with stories similar to yours. A husband unwilling to take the steps needed to help themselves.

If he doesn't wake up soon to his illnesses he will have fewer and fewer options and along with that even less control.

I was diagnosed just over 2 years ago and my GFR was 32. Since then I am careful about what I eat and my GFR has averaged 49. The most recent labs actually had me at 57.

It can be controlled but he has to get serious.

Also, let me say, from my own experience that failure on his part to get serious will expose him to other health issues, serious ones. Has he prepared his will along with his Advance Directive? He should.

[Jayhawker in reply to PamelaSC]

I was pulled off metformin several years ago. I’ve have no difficulty controlling my A1C without diabetic meds. My A1C ranges from 5.3-5.4 like clockwork. I do this by both tight carb control and exercise. I do something (eg, walking, short lite workout on my elliptical machine) about an hour after each meal.

So for me it’s a combination of tight carb control and exercise that works. At this point my cardiovascular health is still in good shape. I’m still not needing BP medication nor diuretics. And, yes, I’m in renal failure but not yet on dialysis. I’ve been in renal failure since January of 2017.

So, if your husband will embrace his treatment plan, he’ll likely experience at least a modest improvement.

While I was initially in shock with the CKD diagnosis, I knew that I couldn’t afford to wallow in denial or stress and anxiety. I absolutely had to learn as much as possible AND begin working in tandem with my treatment team.

Your husband's attitude about all of this will, in great part, dictate the outcomes he’ll achieve. The ball is in his court.

I have not seen such a marked improvement in my renal health as others, including Mr Kidney, have as they’ve made these changes. However, I have still incurred enough benefits from making these lifestyle changes that I would encourage everyone to do the same. It’s about how I feel and function daily. When I do what my medical team tells me to do, I absolutely feel and function better. I’m sure your husband will too.

Jayhawker

[barbara55109 in reply to Jayhawker]

Do you work? How do you walk an hour after each meal with a job?

[Jayhawker in reply to barbara55109]

Yes, I’m a university professor. So I can walk about an hour after lunch around campus for about 15 minutes. I walk after breakfast before going to campus. I teach graduate classes which are in the evening so it’s harder for me to walk after dinner actually . On the three nights I have night class I eat a little later and often hop on my elliptical machine about an hour later. I take my dog for a walk right before bed at night too.

Jayhawker