From Rhode Island, USA:
I was diagnosed with type 1 diabetes almost 20 years ago (I am 29 years old now). Due to my health insurance company's coverage, I am not able to see my diabetes doctor whom I've been seeing for ten years. My new doctor has seen me twice and has recommended that I try Glucophage [metformin, a pill for Type 2 diabetes] in addition to my insulin doses (sliding scale three times a day). I am honestly scared to start taking it. I live alone with my seven year old daughter and am afraid of hypoglycemia. I realize that the Glucophage alone would not cause hypoglycemia, but I am nervous about slipping into insulin shock in the middle of the night due to the combination of insulin and Glucophage. I have searched the internet and have not yet found any information about the effects Glucophage has on people with type 1 diabetes. There is only information about type 2. Is there any information you could give me that would help me to make a better decision as to whether I should take Glucophage? I know that only my doctor can make a recommendation, not you, but any information you could give me would help.
The use of any of the pills that are available for the treatment of type 2 diabetes in a patient who has type 1 diabetes is what is called an "off-label" use. That is, the companies that make these pills have not studied their effects in people with type 1 diabetes, and hence cannot make any official claim that the pill would be of any benefit to someone with type 1 diabetes. As such, there is no recommendation for using these pills in type 1 diabetes as part of their FDA-approved label.
I should point out that many doctors advise using many medications for "off-label" uses. Some of these off-label uses are well-established, and some are only speculative about whether they might help. Of course, if something should go wrong as a result of an off-label use, the doctor would be at risk of a malpractice lawsuit.
In your case, since you are uncomfortable with the proposed off-label use, I'd advise you not to start the pill. You definitely need a high level of comfort and trust in your new physician, and I sense that you have not yet developed that trust. Please go back to your new doctor, indicate your concern, and ask about alternative options you might try. (Also, you might want to talk to your previous diabetes doctor to see if he has an opinion about using this or other pills in your case.)
Original posting 19 Sep 2000
Posted to Medications: Pills for Diabetes
Last Updated: Tuesday April 06, 2010 15:09:12
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