Using Metformin to treat Type 1

By | 6 November, 2012

I have completely befuddled my GP. I am taking Metformin and insulin to control my Type 1 diabetes. I might as well have said I’m going to start walking on my hands in order to protect my feet from damage. His first thought was that I have suddenly morphed into a Type 2 diabetic, having spent almost 30 years as a Type 1. Interesting, but wrong. Here’s the real story.

I have polycystic ovaries. It means they don’t work that well. But they’re also closely linked to insulin resistance. Normal total daily insulin requirements should be around 0.5-0.8 units per kilogram. I needed around 1.3 units per kilogram, so there was definitely some resistance there. So when we were trying to produce an offspring, and the ovaries weren’t playing ball, we were looking for ways to kick start them. Metformin is recognised as helping to reduce insulin resistance, which can help wake up lazy ovaries. And of course, for us diabetic types, reducing insulin resistance is never a bad thing.

The gynaecologist was, to put it mildly, terrified of giving Metformin to a Type 1 diabetic for fear that the world might end. A quick chat with my diabetes consultant reassured her that I would be able to cope with any changes it caused in my diabetes. The general feeling was that it should reduce insulin requirements by about 20%, and you know what? It did. My total daily dose now works out at around 0.7 units per kilogram, down significantly from the previous 1.3.

My intention was to take the Metformin until I got pregnant. But I’m now considering staying on it permanently. The reduction in insulin requirements is a good thing, and has led to a bit of weight loss too which is nice. I started on standard Metformin, colloquially known as MuchFartin for reasons I now understand. After a month I decided that a life where I had to unpredictably run to the toilet at random times wasn’t really for me. Plus, I was finding that having to take the tablets every 12 hours with food meant that I lost all the flexibility of having the pump, because I had to make sure I ate at certain times so I could take the pills, and if I did it early or late I saw an impact in my blood sugars.

I went back to the Dr and asked to try Metformin Slow Release instead. You take these once a day and they are much less likely to cause stomach problems. That way I’d get my life back – I’d be able to eat when I wanted, the timing of the tablets shouldn’t impact by blood sugars and I could stray more than 100m from a toilet without fear. He looked at me like I’d requested platinum plated pill boxes hand delivered by naked warriors in a gold chariot. Only buy Metformin online from trusted pharmacy. Apparently Metformin SR are very expensive, could I really not cope with the cheap stuff?

I don’t make financial decisions based on words like “very expensive”. Call me old fashioned, but I find numbers to be far more useful. Intrigued, I consulted Dr Google on the massive cost of these amazing pills. Having been told by three different Drs how expensive they were, I have to admit, I was expecting to see a cost in the thousands of pounds per year. Based on averaging a few prices from online chemists, it appeared my preferred treatment was twice the price of the one that was making me ill. No wonder they’re so unwilling to prescribe it. But for data to be meaningful, you need to understand the numbers – the (for me) better drug was twice the price. But twice the price totals a massive £128 per year. A cost which is probably offset anyway by the 20% reduction in the significantly more expensive insulin I would no longer need. Plus, I’d already cost the economy more than that in a week from the amount of working time I wasted sitting on the loo.

So I stuck to my guns and said yes, I really did need it. And it really did resolve all the issues I’d been having. Interestingly, there seems to be a growing trend in using Metformin in combination with insulin to treat Type 1 diabetes, and from my experience it’s certainly made a difference to me.

10 thoughts on “Using Metformin to treat Type 1

  1. Andy

    I’m on Metformin and Insulin – Initially they thought I was a T2 diabetic, so put me on metformin. When they worked out I was T1, they never took me off it….. Not noticed any additional flatulance or toilet trips either…..

    1. Alison Post author

      From what I’ve read, I think the stomach issues are hit and miss – thankfully you seemed to have missed them! If I’d have left it a few months, they might have subsided, but that wouldn’t have sorted my issue of having to take the tablets, and therefore eat, at regimented times – otherwise the impacts on my BG were (for me) unacceptable.

  2. Anna

    Hey Alison, thanks for the post. The more I hear about this the more I wonder if it would be an option for me. Although I don’t have PCOS, I do have a big ‘ol waistline and can go through a lot of insulin resistence and seem to (according to the info above) use around 1.6 units of insulin per kg. Might be worth a chat with the doc!

    AP

  3. Peter Childs

    I’ve actually heard this one before…. as I did have a Doctor suggest the idea to me never went any further however. Due to me having very high insulin doses. (and come on I’m male, not over (partially) over weight and have had type one since I was 8).

    Put simply its perfectly possible to have multiple types of Diabetes at once.

    Also its perfectly possible to build up insulin resistance (hence cause type 2) by taking too much insulin. Lets just say that since I did Dafnee nearly 3 years ago I’ve managed to cut my insulin intake by half but improved my control to the extent I’ve lost about 2% on my HBA1c true its still not perfect, But then I’m not sure Perfection is possible I’m only human.

    Peter.

    1. Alison Post author

      I wouldn’t necessarily agree with all of that. Being insulin resistant is not the same as having Type 2, it’s just a shared symptom. And insulin resistance can be caused by many things – hormones, pregnancy, weight etc. You can reduce insulin requirements as you did by improving overall control (because when you get the doses right, you’re not having to correct highs etc), low carbing, losing weight etc but if you are genuinely resistant to insulin, that’s probably not going to sort the whole problem.

      Interestingly, the first time I came across a Type 1 using Metformin it was in an average weight male, who’d seen his insulin requirements creeping up over the years, making it harder for him to maintain his weight, and decided to try Metformin which made a difference for him.

  4. Melissa

    £128 a year?! For shame. I’m surprised he didn’t complain that you were using more than one test strip a month…

    I’d heard of Metformin being used by someone with PCOS before, but I wasn’t sure exactly why – so you’ve cleared that up!

    I hope the Metformin works nicely for you. And congratulations on the baby news 🙂

  5. Patti Evans

    Tablets, coated, metformin hydrochloride 500 mg, net price 28-tab pack = 91p, 84-tab pack = £1.53; 850 mg, 56-tab pack = £1.31.
    Tablets, m/r, metformin hydrochloride 500 mg, net price 28-tab pack = £2.96, 56-tab pack = £5.92; 750 mg, 28-tab pack = £3.84, 56-tab pack = £7.68; 1 g, 28-tab pack = £5.33, 56-tab pack = £10.66

    I’m not very good at maths, but those are the figures from the British National Formulary as to what the NHS pays for Metformin. The 2nd one is the Glucophage SR. But as I work it out, ordinary Metformin 599g per day works out at £13.03 for a year whereas Glucophage SR works out at £38.58 per annum. Multiply the figures by 2 for 1000mg per day. Stop feeling guilty Ali.
    I take Metformin SR 1000g per day and like you, it has reduced my TDD about the same amount it’s reduced yours.

    1. Alison Post author

      Thanks @pattidevans good to know the NHS aren’t paying internet chemist prices for this stuff. So it’s actually almost 3 times the price, but that total price is probably less than the cost of the GP appointment I used to have the argument about what I need in the first place!

      And I certainly don’t feel guilty – just irritated that I’m expected to be fobbed off with subjective expressions of “oo, it’s very expensive dear” rather than cold, hard, numbers.

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