From Sacramento, California, USA:
I realize that this question has been asked already but I'm still not clear on the answer. I'm a 20 year old female, and have had type 1 for 5 years and 3 months (approximately). My doctor just prescribed Glucophage (500mg) twice daily. I know it's been advised for type 2 diabetics only. I take 85 units of R and NPH (Novolin) daily. My blood glucoses swing high and low all the time. She says I have a resistance to the insulin.
I'm concerned with the side effects of this drug. I know the basic ones like nausea, etc., but she only told me about abdominal swelling. I would like to know if the risks outweigh the benefits, and if this drug is appropriate for me. I think it might be worth noting that she is not an endocrinologist, but an internal medicine doctor.
There are many people with Type 1 who are also resistant to insulin and Type 2's who are quite insulin deficient. It is possible that you are somewhat insulin resistant as well as insulin deficient, and it is possible, but not probable, that you have type 2 diabetes. There are young people who get type 2 diabetes and can successfully be treated with oral agents, although it is rare. If you are a type 1 it means that you make little or no insulin and the metformin will probably have very little effect on your control. Metformin (Glucophage) works by telling your liver to turn down the amount of glucose it is making and releasing into your system.
Regarding your question about the safety of Glucophage, it probably won't hurt you: it has rare side effects. One of the things you should know about this drug is the effect on a pregnancy. It is very important at your age to be careful about any unplanned pregnancies. This drug and other oral diabetes medications may cause birth defects if the mother is on them when the baby is conceived. If you are planning a pregnancy in the future it is important to work with your diabetes care team on getting your blood glucose into the goal range before getting pregnant. There are some other oral agents that actually improve insulin action at the cell level that might be better, if you are truly insulin resistant as well as deficient.
The other possibility is that you need some help with changing your insulin regimen to cover your life better. If you haven't had a chance to work with a diabetes educator, you may want to ask your physician to refer you. Maybe she could send you to a center with endocrinologists and diabetes educators for a consultation to help you get a regimen that works for you and teach you how to manage your own insulin coverage based on your lifestyle and then go back to using your doctor as your primary care physician.
Original posting 11 Dec 1998
Posted to Medications: Pills for Diabetes
Last Updated: Tuesday April 06, 2010 15:09:02
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