Glucophage XR: Yes or not?

[Doitnow]

I am newly diagnosed (two weeks) but already managing my bg with low carb. My doctor gave me a script for glucophage XR. Should I take it even if I can manage bg w/o it? I know it is best in long term to do no glucophage but I've heard it speeds up weight loss.

Should I try it just to see if it speeds up weight loss? Or stick with the diet?

[wsgts]

Unless you are staying below 100 in the morning with no meds, I would take it at least for a while. The point behind doing low-carb for diabetics is to have "normalsugars" (ala Bernstein), meaning not normal for most diabetics, but normal for non-diabetics.

Ultimately, you are in charge of your healthcare, and nothing your doctor can do to make you take the Glucaphage. However, for me, it does help with weight lose, so I would (and currently do) take it.

Good luck, and check those sugars,

wsgts

[Lisa N]

I also took the Glucophage XR for a time. Although it didn't seem to do much for me in terms of weight loss, it was a very helpful tool in helping me gain quick control of my blood sugars until my dietary changes allowed me to do it without the medication. Only you and your doctor can determine when it's time to decrease or discontinue your medication. For me, that time came when I happened to be on vacation and my blood sugars between meals started dropping into the low 70's. I cut the dosage in half for the remainder of the vacation, continued to monitor my blood sugars and called my doctor when I got home to get his blessing to continue on the lowered dosage. A few months later, I started getting hypos again while on the medication and called my doctor for permission to stop the medication altogether and got it.
Work together with your doctor on this and call your doctor if your blood sugars start getting uncomfortably low (for me that's anything below 75, it may be a different number for you).
Glucophage XR is one of the best medications out there for type 2 diabetics. It doesn't stimulate your pancreas to produce more insulin and it's unlikely to produce hypoglycemic episodes unless you no longer need it. It's also less likely to produce GI side effects such as nausea or diarrhea that the regular Glucophage can sometimes cause. It's also extremely helpful in reducing insulin resistance.
Unless your blood sugars are already running in the normal range (120 or less 2 hours after meals, less than 100 fasting), I would suggest that you take the medication until you can manage those numbers with diet alone, but as always, it's your decision to make. :)

[Sherrielee]

I was hitting low 80's and feeling well on 500mg metformin per day , but when I hit 68 in my yoga class and almost passed out...no more Metformin for me...Dr approval or not!

If your BG is below 100 most of the time.....you have to question the use of any drug...IMHO.

I honestly believe that this health issue is quite personal and unique to each individual!

ADA is NOT a current alley for us! That I know for sure!!

[Doitnow]

Within two weeks of my type II diagnosis, my blood sugars were fasting 90 just by doing low carb.

I appreciate the sound advice to talk it over with my doc but I sort of feel like one of us is speaking in tongues. She talks old fashioned diabetes advice but agrees with me when I stop and mention low carb/bernstein/atkins. It's like she is stuck in a mindshift: she lives in mainstream medical world so she spouts mainstream advice but agrees with me when I tell her what I am doing. So she isn't sure what to do about glucophage for me.

It's up to me, I guess. I will start glucometer on Monday and then I can monitor myself and exercise effective self care.

I don't find the medical profession all that much help. It always seems like it is up to me to figure out what's wrong, get the information to treatmyself and then get a doctor to parrot my own advice.

Thanks for helpful, thoughtful input.

[Sherrielee]

IMHO...your glucometer IS your doctor...nuff said!!

[c6h6o3]

I refuse to give up on the medical profession. If we show them the way, the ADA/AMA/AHA will have to change eventually.

Just think for a minute of the literally millions of Type IIs who could reverse all their complications. That's millions of cardiovascular tragedies avoided, millions of kidneys saved, millions of cases of macular degeneration cured and blindness avoided. (And, I might add, billions of doses of OHAs and insulin which the drug companies won't get to sell.) All through the elegantly simple, low cost, drug free expedient of a low carbohydrate diet.

Doctors are people, too. Don't you think they will respond in the right way if they see results? There are so few patients who have turned their numbers around dramatically that it hasn't really struck most doctors yet. They think the improvement must be due to something else. We need to put it right in front of their face.

Whenever a physician asks me what I do (as my opthalmologist did) to manage my diabetes, I say it loudly, slowly and clearly: "I maintain a HIGH FAT, LOW CARBOHYDRATE DIET and will continue to do so until I die". Say the "HIGH FAT" part with special emphasis. Shock value. They're much less likely to shrug that off.

Jim

[rumford]

Some biochemistry that may help: you can discuss this with your doctor. Glucophage reduces blood glucose by inhibiting release from the liver (gluconeogenesis). On a low carbohydrate diet the glucose you need comes from amino acids from protein being converted to glucose through gluconeogenesis. So the combination of glucophage (inhibiting gluconeogenesis) and low carb diet (relies on gluconeogenesis) may be working at cross-purposes. Ask your doctor if you can reduce glucophage level and let protein (amino acids) regulate glucose. You must, of course, have enough protein.

[c6h6o3]

What about ketosis?

[Lisa N]

Glucophage reduces blood glucose by inhibiting release from the liver (gluconeogenesis).

Partly...here is the complete description of the method of action of Glucophage:

GLUCOPHAGE (METFORMIN)
Purpose of medication and method of action: Glucophage is an oral hypoglycemic agent which lowers blood glucose. It is primarily indicated for Type II diabetes or non-insulin dependent diabetes (maturity onset diabetes). It acts by decreasing liver production of glucose, reducing glucose absorption from the intestine, and improving the sensitivity of cells to insulin .

While it does decrease the amount of gluconeogenesis in the liver, it doesn't inhibit it completely. When you follow a low carb regimen, the majority of your energy needs are going to be supplied by ketone bodies produced through lipolysis, not glucose via gluconeogenesis. Those few cells of the body that do require glucose to function and cannot use ketone bodies (specifically those cells without mitochondria) can still be supplied through protein via gluconeogenesis as well as the 30 grams of carb that you are allowed per day on Dr. Bernstein's plan (or more if you are following another low carb plan) even when you are taking Metformin so the two are not necessarily contraindicated together. I was taking Glucophage XR for several months, first at 1000 mg. per day and then 500 mg. per day, and experienced no problems with it. In reading Dr. Bernstein's book, that seems to be his experience with his patients as well.