Guest guest Posted October 11, 2003 Report Share Posted October 11, 2003 > No, I've never heard that. I'm > pretty sure you can restart it > if you wish. Oh, now you question it, I would have to look it up again. Thinking about it, I seem to remember that it was in the metformin safety report and that one of the contraindications for a treatment with metformin was that a previous treatment with it had already failed once. But that is one of the reasons why we are sorry that my wife has to go off it because of her kidneys. It has been so successful these few years and it would be a pity not to be able to resume if the kidney problem proves to be reversible. I was hoping that there might be somebody here who has been in the same situation and would be able to give us hope! I know that there is always hope but I mean hope that an elevated creatinine level can be reversed. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2003 Report Share Posted October 11, 2003 Thornton wrote: > But that is one of the reasons why > we are sorry that my wife has to go > off it because of her kidneys. Yup. That would be a reason to stop metformin. > I was hoping that there might be > somebody here who has been in the > same situation and would be able to > give us hope! I know that there is > always hope but I mean hope that > an elevated creatinine level can > be reversed. It may depend on how advanced her kidney disease is. Dr. Bernstein writes that early kidney disease can be reversed with tight control. In fact, I recall reading a recent study confirming that. There have been a number of people on this list who have reversed protein in their urine. I'm not sure about creatinine. Edd Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2003 Report Share Posted October 11, 2003 > There have been a number of people > on this list who have reversed > protein in their urine. I understand that microproteinurea is reversible up to 300mg/liter but my wife is right at the bottom of the range at 30mg/liter so she has no problem in that area. It is her creatinine clearance that contra- indicates metformin and I am told that doesn't show until half the kidney function has already been lost! I find Bernstein's comments on the subject in his book to be rather scanty and somewhat dated. 24-hour urine collection went out of style some years back except maybe for hospital patients! We are going to see the physician on Monday and I am collecting information so that we can discuss the situation with him half-way intelligently! Regards Thornton Pforzheim, Germany Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2003 Report Share Posted October 11, 2003 Thornton wrote: > I find Bernstein's comments on the > subject in his book to be rather > scanty and somewhat dated. 24-hour > urine collection went out of style > some years back except maybe for > hospital patients! His book was written several years ago. A new edition was finally published just this last August, but I haven't read it yet, so I don't know if he's changed his position. > > > We are going to see the physician > on Monday and I am collecting > information so that we can discuss > the situation with him half-way > intelligently! i hope the doctor appointment goes well. Good luck to the both of you. Edd Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2003 Report Share Posted October 11, 2003 Thornton wrote: > > >Does anybody have any tips? > > Thornton >Pforzheim, Germany > > > My first (and last) thought would be switching to insulin. Lantus for a basal, and Humulog for meals, but then I'm no doc. I will say it worked for me, and very easily. -- Dave - 8:48:09 PM T2 - 5/98 Glucophage, Lantus & H A 4th generation Diabetic - Davors Daily Aphorism: Early bird gets the worm, but the second mouse gets the cheese -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2003 Report Share Posted October 12, 2003 > My first (and last) thought > would be switching to insulin. > Lantus for a basal, and > Humulog for meals, but then > I'm no doc. > I will say it worked for me, > and very easily. Yes, but I am dreading the day when her physician decides she should use insulin for meals. She doesn't eat recognizable meals at all! Just little bits and pieces at totally unpredictable times of the day and night. On top of that is the gastroparesis that occasionally holds back all the food for many hours after she eats. Suppose she injects enough Humalog for a certain amount of food and then her stomach holds it back for 5 hours or more (often happens)? We would be looking at a deep hypo and no way to get it back up except with one of those glycogen kits - and that stuff hurts! The standard advice here is that you have the glycogen mixed and ready to hand, then you watch the patient until the hypo has reached the stage at which she is feeling no pain and then you inject the glycogen but I really don't want to get onto that if I can avoid it. The doc has decided provisonally to go for straight Amaryl but we have never tried that before and I am expecting a really big hypo problem. If she goes onto insulin I will let you know what happens! Regards Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2003 Report Share Posted October 12, 2003 my protein in my urine is high and my Dr has said nothing about taking me off Glucophage, I am doing well on it, I have read nothing about kidney function problems but liver problems I would seek another opinion. Thornton wrote:When my wife phoned in yesterday for the results of her quarterly blood test, the physician told her that her serum creatinine value had increased, which indicated the onset of kidney disease and to stop taking Gluco- phage because of the increased risk of lactoacidosis. It is a pity because she had been doing so well on Glucophage and Amaryl. If I remember correctly, Glucophage is a drug you can only take once - If you go off it for any length of time then you can't go back on it again. On Monday he is going to decide what she should change to but it is probably going to be Amaryl which he knows she tolerates well. The problem is with gastroparesis she is going to have unpredictable hypos on Amaryl alone. Diabetes is like that, isn't it? Just when you think you have it under control, it takes the next step! The biggest change is going to come from a reduced protein diet - she was told to cut out meat altogether last quarter but didn't take any notice! Now she has to! Does anybody have any tips? Thornton Pforzheim, Germany Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2003 Report Share Posted October 12, 2003 > my protein in my urine is > high and my Dr has said nothing > about taking me off Glucophage, > I am doing well on it, I have > read nothing about kidney > function ... High protein in urine is not the same thing, that is a sign of a " leaky kidney " , I believe. High creatinine clearance* is when the kidneys are holding something back and could result in metformin accumulating in the blood which increases the risk of lactoacidosis. (* Number 1 on the list of contra- indications for metformin, see: http://www.rxlist.com/cgi/generic/metformi_od.htm ) I feel sure that your physician will have been checking it reguarly and would have mentioned it if you were out of limits. > ... problems but liver problems > ... No, I don't think that the liver has anything to do with it. > I would seek another opinion. We sure will! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 12, 2003 Report Share Posted October 12, 2003 Pike wrote: > my protein in my urine is high and my Dr has said nothing about taking > me off Glucophage, I am doing well on it, I have read nothing about > kidney function problems but liver problems I would seek another opinion. There may be reason to stop the Glucophage in the early stages of kidney disease. Protein in the urine is an indication of kidney disease. You really ought to discuss just how high your readings are and what to do about it. Generally, the advice you receive on these kinds of diabetes lists is to strive for better glucose control. Often that can reverse early kidney disease. As for taking Glucophage with kidney disease, this is the problem. Your kidneys filter out lactic acid from your blood. Apparently, Glucophage creates a greater load on the kidneys in terms of dealing with lactic acid. If the kidneys are unable to keep up with the demand, then blood levels of lactic acid can reach high enough to cause lactic acidosis which is a life threatening condition. The official literature on this drug warns that 1 out of 33,000 people who take Glucophage develop lactic acidosis. In addition to that, there are a number of circumstances which contraindicate taking the drug. Kidney disease is one of them. It's also advised to stop taking the drug when you have X-rays/CT-scans which use contrast media or general anesthesia because these things stress out the kidneys and may allow lactic acidosis to develop. They also recommend stopping it during serious illness when you may get dehydrated. You can read up on the drug at http:\\www.rxlist.com . Edd Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2003 Report Share Posted October 13, 2003 > -----Original Message----- > From: Thornton > ... 24-hour > urine collection went out of style > some years back except maybe for > hospital patients! Why is 24 hour collection out of style? Is it just too inconvenient? My doctor still uses it, and, if it was not included in a physical, I (as a diabetic) would ask for it. I'm willing to carry around the container as long as useful information can be obtained. Tom the Actuary Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 14, 2003 Report Share Posted October 14, 2003 > Why is 24 hour collection out > of style? My physician (and my wife's) laughed when I suggested it. They both said that modern lab methods don't require it! > Is it just too inconvenient? My > doctor still uses it, and, if > it was not included in a physical, > I (as a diabetic) would ask for it. The explanation I read when I looked was that except in a clinic, they can never be sure that there has been a 100% collection. > I'm willing to carry around the > container as long as useful > information can be obtained. Yes, you know that but they don't! And it's not much fun if you have collected 23 hours of it and you drop the full bottle in the car! I guess that it is still done in clinics when they have the patient wired up to a bag with a catheter but otherwise not, not over here at any rate. Regards Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.