Cardiac Catheterization on top of Type 2 Diabetes and CKD

I am female, age 77 have Type 2 diabetes, Stage 3B CKD, no thyroid gland, and now a heart condition. Due to have cardiac catheterization in September. I had to cut back on Metformin when my kidney function dropped, but it has now improved, GFR 38. HbA1c 5.6. I have to stop Metformin altogether 3 days before the procedure and for 3 days post. Anybody out there with similar experience and advice?

[Bassetmommer NKF Ambassador]

Hi,

Metformin is a drug that they are very cautious giving to kidney patients. It is something you should really speak to your doctor about. There are other drugs you can take for diabetes that are less taxing on the kidneys.

[orangecity41 NKF Ambassador in reply to Bassetmommer]

Thanks for information on Metformin.

[Hidden in reply to Bassetmommer]

I am currently taking 500mg per day, down from 1000. My endocrinologist is a Clinical Associate Professor at the University of Pennsylvania. The nephrologist also there Is Clinical Assistant Professor. I check with her on all changes in meds, up, down or new. Walking more. I will be off Metformin for 6 days surrounding the procedure.

Doing telemedicine appts. now, due to Covid. Will discuss at next appt. Thanks.

[Darlenia]

Hi Veteran Patient! My husband is 70 years old, has Diabetes Type II, and recently went on dialysis. He's been on pills and insulin over the years. The "gold standard" for diabetes is insulin. It's the most effective treatment and a more natural substance (chemically similar to the insulin produced by your body), and lacks many of the potential side-effects inherent to oral medications. Insulin is administered by a super fine needle "pen" so it's very easy to administer, virtually pain-free, and is administered up to, during, and after surgeries, etc. I say this because it's exceptionally important to stop the damage diabetes does to your kidneys, your vascular system, your cardiac system, etc. in the best possible way. My husband has moved from 100 drops of insulin daily to now 6 drops...with the intent to get off it completely. (If he had done this earlier, we wouldn't be in the situation we are in now.) People assume that when diabetes is "controlled", the threat is removed. But it continues in very subtle ways. Returning your body to it's pre-diabetes condition is your ticket to superior outcomes. Your GFR numbers indicate that you have time to halt the damage. And that is very good news! So it may well be worth it re-examine your diabetes therapy with your diabetes endocrinologist. We wish you the very best in your journey. And I'm cheering you on to a dialysis free, quality life.

[Hidden in reply to Darlenia]

Thank you. I am aware of the pros and cons. My mother was afraid of insulin at a time when there were only 2 oral meds, and she died at 70 from complications of diabetes. My sister is on long and short acting insulin because she could not tolerate metformin. I now have an increased interest in better control over all of my conditions, and am working very hard at it in terms of diet and exercise. As those conditions improved after I began the harder work, I will ask if there are other oral drugs that don't damage kidneys. My BMI is normal.

[Hidden]

They are private doctors who accept Medicare and also use my supplemental insurance of (retired) federal employees' Blue Cross Blue Shield PPO. Opinions of physicans of professorial rank at a leading medical school carry greater weight than other private doctors. In general, Penn is one of the top ten medical schools in the US.

[Hidden]

I did not know that either until recently. I had 3 factors against me regarding renal insufficiency. My father died from that. I am diabetic like my mother was. The third factor and actual trigger was an infection in my ankle after a bimaleaolar fracture and 3 surgeries followed by 6 weeks of two IV antibiotics which left me seriously dehydrated. I lost 15 pound in 6 weeks. Right after that was my first abnormal kidney test.

[Hidden]

Thanks.