This medicine is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, panic disorder, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), social anxiety disorder (social phobia), and a severe form of premenstrual syndrome called premenstrual dysphoric disorder (PMDD).
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I have completely befuddled my GP. I am taking Metformin and insulin to control my Type 1 diabetes. I might as well have said Iâm 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. Hereâs the real story.
I have polycystic ovaries. It means they donât work that well. But theyâre 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 werenât 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 Iâm 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 wasnât 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 Iâd get my life back â Iâd be able to eat when I wanted, the timing of the tablets shouldnât impact by blood sugars and I could stray more than 100m from a toilet without fear. He looked at me like Iâd 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 donât make financial decisions based on words like âvery expensiveâ. Call me oldÂ fashioned, butÂ 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 theyâre so unwilling to prescribe it. But for data to be meaningful, you need to understand the numbers â the (for me) better drug was twice the price. But twice the price totals a massive Â£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, Iâd 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 Iâd 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 itâs certainly made a difference to me.