Metformin

[Daffodil256]

My husband is nearly 86. He is on 12mg of Prednisolone. Now he has been diagnosed with a blood sugar level of 7.9. He has been prescribed Metformin, and is very frightened , because of the possible side effects. Can anyone tell me if it always happens please?

[Koalajane]

Prednisolone can spike blood sugars and cause steroid induced diabetes. Not everyone gets it. I did and instead of metformin which can cause diarrhoea I was put on gliclazide. I came off it 6 months later as I had put my diabetes into remission. I changed my diet to low carb healthy fats and increased my walking.

I found gliclazide worked well for me.

[SnazzyD]

Did he try a low carbohydrate diet at any point? If not, might be worth a try because it can make all the difference to blood sugars when on Pred.

[Daffodil256 in reply to SnazzyD]

I am trying to give him low carbohydrate meals, but it is hard. He was only diagnosed on 22nd March. My biggest problem, is desserts, as he insists on having them. Also, he sits most of the day, as he has a bad back.

[SnazzyD in reply to Daffodil256]

Has the importance been explained? I guess it depends what he’s more scared of. Does he get his own dessert?

[PMRpro Ambassador]

Do you mean the pred side effects or the metformin side effects?

[Amanda_iona in reply to PMRpro]

I'm on a low dose of pred, and also metformin. I found it upset my digestion quite a lot at first - diarrhoea or dreadful wind, so I just take one tablet. But now, a few months on, the side effects have stopped completely. So worth persevering.

[Daffodil256 in reply to PMRpro]

Metformin side effects. He is quite frightened.

[PMRpro Ambassador in reply to Daffodil256]

Like pred, no-one gets them all and some get none! If he develops any and they are intolerable, then he can just stop it and go back to the doctor.

[Bcol in reply to Daffodil256]

My OH takes Metformin and has no discernable side effects.

[PMRpro Ambassador]

I know how difficult it is to persuade UK gentlemen to try different things and US sugar-free won't cut the mustard! So here are some links to UK sites with ideas

diabetes.co.uk/food/low-car...

diabetes.org.uk/guide-to-di...

bbcgoodfood.com/howto/guide...

I know this one says gestational diabetes but diabetes is diabetes and low carb/sugar is the same for all. It has a really clear and easy explanation of what to use and not use although in order to access her recipes you have to subscribe - think of it as a cookery book that is added to all the time. Join for a couple of months, find recipes for things he likes and write them down the old-fashioned way!

gestationaldiabetes.co.uk/g...

and the Beeb collected these:

bbc.co.uk/food/collections/...

[Anna135]

I'm on 1500 mg metformin a day (3 tablets), and the only side effect I have is that I get full a lot more easily. This has helped me to gradually lose 15kg over two years, so I consider that a mostly good side effect!

I take the extended release, and I increased my dose quite slowly, starting with just 1 tablet. This is recommended in order to reduce the risk of side effects.

[paulus65]

Steroid induced diabetes happened to me and for a time I was taking Metformin and Gliclizide with no particular unpleasant side effects. As I tapered pred I also tapered (and have now stopped) these meds.

[Pixix]

I had steroid induced diabetes, & went onto the Keto diet for one month, & lost a stone & beat the diabetes into submission! There were lots of recipes for me to look at online & I didn’t feel hungry on the diet! My aunt has been on metformin for about 15 years, no side effects (she’s 90 now), & a friend on them for one year hasn’t complained of any.

[Telian]

I think everyone’s individual with the symptoms. My husband and son did suffer briefly. Your husband will only know if he tries.

Personally with readings of 7.9 I’d concentrate on my diet before taking diabetic medication. Desserts must be limited though - you should be able to get something less sugary that will help your husband’s desire for his ‘afters’.

I’m in the same boat and my ‘diabetic’ nurse wants prevention so has advised re diet and given me a blood sugar testing kit as she says I am not yet diabetic.!Apparently guidelines advise that anyone on long term steroids and not diabetic should test their levels each day. Doesn’t seem to be common knowledge. I’m in my 10th year of pred and haven’t heard this before. Only if my levels go consistently over 12 have I to get back to her. That seems high but it’s what she said. My levels are all over the place each day - can be as high as 10 and plummet to 3 the next (when I start to go into hypo). I carry glucose tablets when I go out as hypo symptoms come on rather quickly. GP blames the steroids. I’ve been told if my levels go consistently high they would prescribe Gliclazide. Currently I’m on 6.5 pred having just reduced slowly to that. My body is taking some adjusting so maybe that’s why my sugar levels are dancing around. Good luck.

[PMRpro Ambassador in reply to Telian]

I suppose the real point is that steroid induced diabetes is not due to lack of insulin or insulin sensitivity at the start and dietary adjustments will improve the situation, I don't see the point of daily testing though - if you coincide with a pred-induced spike you may miss all the time it is fine.

[Telian in reply to PMRpro]

I get what you’re saying and the variations in readings I didn’t understand. You’re right I do have to eat to overcome the hypo’s. The majority of readings are within normal range but it’s not occasionally the spikes happen it’s every few days. I have just finished a difficult taper so letting body adjust and hoping the hypo’s then stop. I dti funfair it strange that a regular 12 reading is the point to start worrying. Isn’t that too high ! Today was 4.5 and I was having the shakes. Normally it would be in the 3s for me to feel like that. I ate a sandwich which I didn’t feel I needed but it made no difference so after a desperate bag of crisps and a Kit Kat, which I don’t eat normally, I still felt wobbly. What helped was Lucozade, again not my drink as I shouldn’t have fizzy. I didn’t go to the shops as planned as didn’t feel safe. Things aren’t getting better and at the moment I am taking the readings daily. I feel I should take them only when I feel unwell. The nurse said currently daily before or after lunch. I see Dr SM on the 17th. More ammunition for her to put me on Mtx? In the meantime GP just says to make sure I have glucose handy when I go out.

[Broseley]

I too like my desserts, but I switched to stewed rhubarb with goats milk yogurt. You can sweeten it by adding some dried fruit or try ginger or cinnamon. I love it!