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Re: Metformin - Sandy

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At 07:14 AM 1/2/06 -0500, Sandy wrote:

>I would like to know why some of you feel that Metformin is the least

>harmful of all the diabetic meds long term... [snip] He doesn't feel I

>would use insulin either.

There are too many needle-phobic health practitioners out there and they

seem to want to use insulin as a *threat* instead of as the most natural

resource for DM. I finally dropped my PCP (for DM management) in favor of

an endo who was willing to prescribe insulin. The PCP was offering all

kinds of orals instead and kept saying that insulin would give me hypos,

make me gain weight and, generally, not do the job. Wrong on all counts!

The case for metformin: If your digestive system can be made to accept it,

it does NOT give you hypos, moderates the hunger pangs as you ease yourself

into the LC WOE, and does not cause edema (water retention) or weight gain,

at least for *me,* and I have been on it for over 3 years. Others have had

different experiences. A definite YMMV.

Nora

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I might add to Nora's comments about her former doctor's reluctance to

prescribe insulin. The way most doctors prescribe insulin (the way most

of them are taught in medical school) is to prescribe a " set dose "

without regard to how many carbs are being eaten. This rarely works

optimally, since we don't eat the same thing every day and in fact can -

and most often does- cause hypos, weight gain, and generally does not

work.

However, dosing insulin based on carb intake - like pumpers do -- works

very nicely and there are many on this list who do take insulin but are

not on a pump and are in excellent control.

It amazes me that the vast majority of doctors continue to prescribe a

set dose of insulin. The result can be seen in the huge numbers of

patients hospitalized for diabetic-related complications. You'd think

they'd figure out it didn't work well and look for the more obviously

efficient model of MDI (multiple daily insulin) dosing.

Vicki

Re: Metformin - Sandy

> At 07:14 AM 1/2/06 -0500, Sandy wrote:

>>I would like to know why some of you feel that Metformin is the least

>>harmful of all the diabetic meds long term... [snip] He doesn't feel I

>>would use insulin either.

>

> There are too many needle-phobic health practitioners out there and

> they

> seem to want to use insulin as a *threat* instead of as the most

> natural

> resource for DM. I finally dropped my PCP (for DM management) in favor

> of

> an endo who was willing to prescribe insulin. The PCP was offering all

> kinds of orals instead and kept saying that insulin would give me

> hypos,

> make me gain weight and, generally, not do the job. Wrong on all

> counts!

>

> The case for metformin: If your digestive system can be made to accept

> it,

> it does NOT give you hypos, moderates the hunger pangs as you ease

> yourself

> into the LC WOE, and does not cause edema (water retention) or weight

> gain,

> at least for *me,* and I have been on it for over 3 years. Others have

> had

> different experiences. A definite YMMV.

>

> Nora

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And I wish to add that my endo *seems* to be of the more progressive frame

of mind. He asked *me* if I wanted a mixed insulin, to which I shook my

head, NO! Then he just sat there and fleshed out a scheme for setting my

dose of Lantus depending upon my FBG average of the 3 preceding days.

ly, I am going for a lower FBG than what he indicated was the optimum

range but making sure I do not go low pre-prandially. I expect he will

prescribe a fast-acting insulin for meals on my next visit in February

(after my 3-mo. A1c, which I expect to have dropped like a rock). Will let

you know.

BTW, I recently read an excellent book on insulin use (mainly for pumpers

but very edifying for me) that Paice forwarded to me... " think like a

pancreas " by Scheiner, MS, CDE, where he discusses the action of the

different insulins and outlines formulas for determining dosing. Thanks

again, ! *smile*

Nora

At 06:30 AM 1/2/06 -0800, Vicki wrote:

>I might add to Nora's comments about her former doctor's reluctance to

>prescribe insulin. The way most doctors prescribe insulin (the way most

>of them are taught in medical school) is to prescribe a " set dose "

>without regard to how many carbs are being eaten. This rarely works

>optimally, since we don't eat the same thing every day and in fact can -

>and most often does- cause hypos, weight gain, and generally does not

>work.

>

>However, dosing insulin based on carb intake - like pumpers do -- works

>very nicely and there are many on this list who do take insulin but are

>not on a pump and are in excellent control.

>

>It amazes me that the vast majority of doctors continue to prescribe a

>set dose of insulin. The result can be seen in the huge numbers of

>patients hospitalized for diabetic-related complications. You'd think

>they'd figure out it didn't work well and look for the more obviously

>efficient model of MDI (multiple daily insulin) dosing.

>Vicki

>

>

> Re: Metformin - Sandy

>

>

> > At 07:14 AM 1/2/06 -0500, Sandy wrote:

> >>I would like to know why some of you feel that Metformin is the least

> >>harmful of all the diabetic meds long term... [snip] He doesn't feel I

> >>would use insulin either.

> >

> > There are too many needle-phobic health practitioners out there and

> > they

> > seem to want to use insulin as a *threat* instead of as the most

> > natural

> > resource for DM. I finally dropped my PCP (for DM management) in favor

> > of

> > an endo who was willing to prescribe insulin. The PCP was offering all

> > kinds of orals instead and kept saying that insulin would give me

> > hypos,

> > make me gain weight and, generally, not do the job. Wrong on all

> > counts!

> >

> > The case for metformin: If your digestive system can be made to accept

> > it,

> > it does NOT give you hypos, moderates the hunger pangs as you ease

> > yourself

> > into the LC WOE, and does not cause edema (water retention) or weight

> > gain,

> > at least for *me,* and I have been on it for over 3 years. Others have

> > had

> > different experiences. A definite YMMV.

> >

> > Nora

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