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Medical Forum / Diseases and Disorders / Diabetes / April 2007Metformin and wine?
Met my new endo for the first time today. I am off Glucovance (and its precipitous unpleasant sugar lows) and on Metformin, 2X 1000 mgs. Non-fasting bg, 4 hours after breakfast, was 96. Beginning tomorrow my new meter (Freestyle) will be encharged with telling me the fbg as well. The Metformin says "take with food" and "do not drink alcoholic beverages". I can see not sitting in a bar downing one Scotch after another... but a small half-glass of wine with dinner once in a while? Obviously I will not do anything without asking my doctor (or his VERY capable assistant who explained everything to me with endless patience) bit I'm curious as to how others here interpret "no alcohol". Thanks, Jay >Met my new endo for the first time today. > [quoted text clipped - 15 lines] > >Jay Hi Jay It's one of my favourite subjects, so being lazy I'll give the link to where I've written on it recently: http://loraldiabetes.blogspot.com/2007/03/red-red-wine.html Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Athens and The Adriatic Jay I am on metformin ER, 1500 mgs. My endo told me that I should have a half a glass of red wine every night with dinner for my heart. I couldnt stand the taste so I dont drink it, but he found no problem with it. Loretta > Met my new endo for the first time today. > [quoted text clipped - 15 lines] > > Jay I've been on metformin - currently 4x500 - for a year and a half. I've not had any negative reaction from my docs when I mention that I have a glass of dry red wine most evenings; and an occasional martini. Good luck with your regimen. I added avandia to my metformin last fall when I started seeing some elevation of BG levels. That has helped. FWIW - I've also found that by adjusting my schedule, it has helped eliminate an elevated morning BG that I was seeing: I now take: metformin before breadkast, with the avandia before dinner, before bed, and the final one about 3:30 am - when I often awake. That schedule seems to even things out a little more for me. || Met my new endo for the first time today. || [quoted text clipped - 18 lines] || || Jay The only warnings that I have seen regarding metformin and alcohol are do not drink excessively and do not binge drink. Excessively is open to interpretation but I take it to mean more than one or two ounces per day. Binge drinking, remembering my college days, pretty much speaks for itself. I have asked and my PCP see nothing wrong with my interpretation. By those standards, a glass of wine or two with dinner should not be a problem, but as always YMMV. BJ  Signature-- "Why are so many not smart enough to know they're not smart enough?" - http://www.phule.net/mirrors/unskilled-and-unaware.html "Since early 2005, more than 150 million personal records have been exposed in dozens of incidents, according to information compiled by the Privacy Rights Clearinghouse. " - Companies that collect this data must be held accountable for its security. > || Met my new endo for the first time today. > || [quoted text clipped - 39 lines] > compiled by the Privacy Rights Clearinghouse. " - Companies that > collect this data must be held accountable for its security. BJ: I did a google search awhile back on interaction of alcohol and metformin. Unfortunately I didn't find what I was looking for. My experience is that too much wine in combo with an antihistamine before bed needed for treating a cold (or even maybe for sleep) plus metformin and possibly amaryl, is not a good combo for sound sleep. I believe it causes subclinical lactate buildup (not lactate acidosis but similar) , insomnia and some sort of central depression apnea. Obviously something to stay away from. The package insert for amaryl spells out alcohol being contraindicated due to additive effects in lowering bg levels (hypoglycemia) too much. Larry | On Apr 19, 5:13?am, "BJ in Texas" <nospam189-use...@yahoo.com> | wrote: [quoted text clipped - 60 lines] | | Larry Likely lowering BGs is a similar reason to avoid excessive alcohol with Metformin. Since both effect liver function there amy be some interaction there too. There are also indications that excessive alcohol with Metformin may also contribute to or increase the chances of lactic acidosis. Moderate consumption does not appear to be a problem for most people. I take moderate consumption to I mean a maximum of one or two drinks per day depending on the individual. As always YMMV. BJ Signature-- "Advertisements contain the only truths to be relied on in a newspaper." -- Thomas Jefferson "Since early 2005, more than 150 million personal records have been exposed in dozens of incidents, according to information compiled by the Privacy Rights Clearinghouse. " - Companies that collect this data must be held accountable for its security. > Likely lowering BGs is a similar reason to avoid excessive > alcohol with Metformin. All the other reasons make sense, but this one sounds like a typical "patient is stupid" oversimplification. Vodka, beer, and peppermint schnappes are likely to have very different effects on blood glucose. SignatureWes Groleau "Would the prodigal have gone home if the elder brother was running the farm?" -- James Jordan : Met my new endo for the first time today. : I am off Glucovance (and its precipitous unpleasant sugar lows) and on : Metformin, 2X 1000 mgs. : Non-fasting bg, 4 hours after breakfast, was 96. Beginning tomorrow my new : meter (Freestyle) will be encharged with telling me the fbg as well. : The Metformin says "take with food" and "do not drink alcoholic beverages". : I can see not sitting in a bar downing one Scotch after another... but a : small half-glass of wine with dinner once in a while? : Obviously I will not do anything without asking my doctor (or his VERY : capable assistant who explained everything to me with endless patience) bit : I'm curious as to how others here interpret "no alcohol". : Thanks, : Jay jay, Both my endocrinologist and my pharmacist told me that a glass of wine is just fine. what is to be avoided is heavy drinking (like keeping company with that bottle of scotch). In fact, dry red wine is regarded as positively HEALTHY for the improvemnt in HDLs and for the heart in general:-) Wendy >I'm curious as to how others here interpret "no alcohol". Generally with a glass of red : ) So long as you're not overdoing it, and your labs are fine, I doubt your doc will object. Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.5% BMI 25 > Met my new endo for the first time today. > [quoted text clipped - 16 lines] > Jay > The problem is the idiots who program pharmacy computers. If you check the official FDA labeling for metforman, you will not find ANYTHING about not drinking, it says no EXCESSIVE drinking. The recommended two drinks pf alcohol a night (1 and 1/2 for women) is FINE., 4 nights gives close to maximum benefit, although more nights doesn't hurt. It is the alcohol which counts, not what form it is in. beer and sweet wines carry a lot of extra calories, but are still OK if you account for the extra carbs. I use high proof rum in Crystal light before bed if I haven't had a few glasses of wine with my dinner. If you don't have a liver problem, a substance abuse problem, or an inability to stop at 2 drinks, it is GOOD for you, helps with control, and drops your risk of stroke and heart attack by an astounding 70% >> Met my new endo for the first time today. >> [quoted text clipped - 34 lines] >inability to stop at 2 drinks, it is GOOD for you, helps with control, >and drops your risk of stroke and heart attack by an astounding 70% I agree with all except "It is the alcohol which counts, not what form it is in." Not against other forms, but the literature certainly shows additional benefits for dry red wine. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Athens and The Adriatic > On Thu, 19 Apr 2007 19:57:02 -0400, ted rosenberg > [quoted text clipped - 49 lines] > > - Show quoted text - Ted: You say "few drinks" and then contradict at "stop at 2 drinks". I bet I am a better wine lover than you. Maybe not. I forget what drugs you are taking but I am sure you know potential additive effects with even 3 healthy size glasses plus heavy duty antidiabetic drugs "on board". Liver problems are potentially a concern as well which we need to watch carefully. Larry : Ted: You say "few drinks" and then contradict at "stop at 2 drinks". I : bet I am a better wine lover than you. Maybe not. I forget what drugs : you are taking but I am sure you know potential additive effects with : even 3 healthy size glasses plus heavy duty antidiabetic drugs "on : board". Liver problems are potentially a concern as well which we need : to watch carefully. : Larry Although I generally limit myself to 1 glass of wine when I have it at dinner, I have no problem at Passover, when we (over quite a considerrable time) have 4 glasses, which actually means aobut 2 1/2 total as I don't finish any but the last. I take my metfrmin in the middle of this lengthy exercise . when we actually have dinner, and have never had any problems with this twice a year (2 nights in a row) event. Wendy > : Ted: You say "few drinks" and then contradict at "stop at 2 drinks". I > : bet I am a better wine lover than you. Maybe not. I forget what drugs [quoted text clipped - 13 lines] > > Wendy But... (there's always a "but", isn't there) do you drink the sticky Manishewitz kiddush wine on Passover, or a nice dry kosher pinot or cabernet? Jay : > : Ted: You say "few drinks" and then contradict at "stop at 2 drinks". I : > : bet I am a better wine lover than you. Maybe not. I forget what drugs [quoted text clipped - 13 lines] : > : > Wendy : But... (there's always a "but", isn't there) do you drink the sticky : Manishewitz kiddush wine on Passover, or a nice dry kosher pinot or : cabernet? : Jay We have found a good, easy to take for all, wine, Valflore, which is called semi-dry. It is wnat I woudl call a gentle wine that goes down very easily. I wouldn't touch the old time , traditional sweet wines of my childhood. Does anyone actually still drink those anymore:-) At the worst I woudl think one might have both on teh table so peole could choose, as the do at our synagogue meals. there is usually some sweet stuff for the die-hards to make thier blessing over and nice dry ones for the meal. Wendy > >> On Thu, 19 Apr 2007 19:57:02 -0400, ted rosenberg [quoted text clipped - 45 lines] >> wine. >> No Alan, that is an old discredited study. It turns out that the selection in that study wasn't correct. Later studies disproved it. It seems that the wine drinkers also had other factors which affected the study. Eliminating them and it turned out to be alcohol plain and simple >> Cheers, Alan, T2, Australia. >> d&e, metformin 1500mg, ezetrol 10mg [quoted text clipped - 15 lines] > > Two shots of whiskey is someone more than two small glasses of wine. In any case, I have NO trouble stopping at two. >> >>> [quoted text clipped - 49 lines] >seems that the wine drinkers also had other factors which affected the >study. Eliminating them and it turned out to be alcohol plain and simple Hi Ted I didn't actually quote a study - so which of these are you referring to? http://tinyurl.com/2q5jyn or http://highwire.stanford.edu/cgi/searchresults?fulltext=%22red+wine%22+diabetes+ %22type+2%22&andorexactfulltext=and&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp; author1=&pubdate_year=&volume=&firstpage=&src=ml&searchsubmit=redo&resourcetype= 1&search=Search&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;fmonth=Jan&fyear=184 4&tmonth=Mar&tyear=2007&fdatedef=1+January+1844&tdatedef=15+Mar+2007 ( a highwire search on the terms ["red wine" diabetes "type 2"]) or was it one of these: Am J Physiol Heart Circ Physiol 288: H2023-H2030, 2005. First published January 14, 2005; doi:10.1152/ajpheart.00868.2004 Antiatherogenic potential of red wine: clinician update http://tinyurl.com/zpt5m "Complications of atherosclerosis remain the leading cause of morbidity and mortality in industrialized countries. Epidemiological studies have repeatedly demonstrated that moderate alcohol intake has a beneficial effect on cardiovascular disease. The purpose of this review is to examine the epidemiological and biological evidence supporting the intake of red wine as a means of reducing atherosclerosis. On the basis of epidemiological studies, moderate intake of alcoholic beverages, including red wine, reduces the risk of cardiovascular, cerebrovascular, and peripheral vascular disease in populations. In addition to the favorable biological effects of alcohol on the lipid profile, on hemostatic factors, and in reducing insulin resistance, the phenolic compounds in red wine appear to interfere with the molecular processes underlying the initiation, progression, and rupture of atherosclerotic plaques. Whether red wine is more beneficial than other types of alcohol remains unclear. Definitive data from a large-scale, randomized clinical end-point trial of red wine intake would be required before physicians can advise patients to use wine as part of preventative or medical therapies." ********* Diabetes Care, Vol 15, Issue 4 546-548, Copyright (c) 1992 by American Diabetes Association Short-term effect of red wine (consumed during meals) on insulin requirement and glucose tolerance in diabetic patients http://tinyurl.com/f6bfk "CONCLUSIONS--Moderate prandial wine consumption has no adverse effect on the glycemic control of diabetic patients. Thus, it appears unnecessary to proscribe the consumption of red wine in moderation with meals to diabetic patients. Wine contains tannins and phytates that can explain its action." ******** DIABETES CARE, VOLUME 22, NUMBER 12, DECEMBER 1999 p2084 Meal-Generated Oxidative Stress in Diabetes The protective effect of red wine http://care.diabetesjournals.org/cgi/reprint/22/12/2084 "Our data show that red wine is able to preserve plasma from meal-induced oxidative stress in diabetes, suggesting that moderate consumption of red wine during meals may have a beneficial effect in decreasing the risk of cardiovascular disease in diabetic patients." ******** Finally, an interesting one specifically on resveratrol, a red wine component, and the insulin system. Am J Physiol Endocrinol Metab 290: E1339-E1346, 2006. First published January 24, 2006; doi:10.1152/ajpendo.00487.2005 Resveratrol, a red wine antioxidant, possesses an insulin-like effect in streptozotocin-induced diabetic rats http://tinyurl.com/evxtp "Aberrant energy metabolism is one characteristic of diabetes mellitus (DM). Two types of DM have been identified, type 1 and type 2. Most of type 2 DM patients eventually become insulin dependent because insulin secretion by the islets of Langerhans becomes exhausted. In the present study, we show that resveratrol (3,5,4'-trihydroxylstilbene) possesses hypoglycemic and hypolipidemic effects in streptozotocin-induced DM (STZ-DM) rats." Note that I prefer to wait for the human trials confirmation - but it is the first time I've seen this effect of resveratrol noted anywhere. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Athens and The Adriatic Alan, excellent research. I haven't had the time or energy to go looking for the cites that Dr Biggs posted to MHD a few years ago. You have three choices 1) look for it yourself 2) Assume I am wrong 3) Assume I am right None of these will make much difference - You will still recommend red wine (which I love), and, in any case, people who take your advice will still get good advice, simply POSSIBLY less choices. I'll save my efforts for things which will really make a difference.. Ted > >> [quoted text clipped - 59 lines] >> >> <snip> >Alan, >excellent research. I haven't had the time or energy to go looking for [quoted text clipped - 11 lines] > >Ted No problems Ted. And it really wasn't much of an effort. Being lazy I tend to check past efforts; no need to re-invent the wheel. I rarely assume anyone is right or wrong - I check if it's important. I bend that rule for some, like Quentin, who I haven't found to be wrong yet:-) For me, my changes in menu made a tremendous difference; wine was a part of that change. Cheers, Alan, T2, Australia. d&e, metformin 1500mg, ezetrol 10mg Everything in Moderation - Except Laughter. -- http://loraldiabetes.blogspot.com/ http://loraltravel.blogspot.com/ latest: Athens and The Adriatic >No Alan, that is an old discredited study. Nope, current research - check out this guy: http://scholar.google.com/scholar?q=roger+corder&hl=en&lr=&btnG=Search Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.5% BMI 25 > On Fri, 20 Apr 2007 19:49:57 -0400, ted rosenberg > > <tedrosenb...@iname.com> wrote: > >No Alan, that is an old discredited study. > > Nope, current research - check out this guy:http://scholar.google.com/scholar?q=roger+corder&hl=en&lr=&btnG=Search Roger Corder is the author of "The Wine Diet"...surpise! Kurt >> On Fri, 20 Apr 2007 19:49:57 -0400, ted rosenberg >> [quoted text clipped - 4 lines] > >Roger Corder is the author of "The Wine Diet"...surpise! So? He also has tenure, what's your point? Nicky. T2 dx 05/04 + underactive thyroid D&E, 100ug thyroxine Last A1c 5.5% BMI 25 The thing with metformin and alcohol is the high risk of "lactic acidosis" which become more common but not very common if you drink heavily on metformin but it is still a small risk! http://www.medsafe.govt.nz/profs/PUarticles/5.htm#Metformin Its more common if you have renal disease but when I asked my endo about this he said in those without impared kidney function or unbalanced blood tests then a glas or two should be ok and that just to be aware of the symtoms of lactic acidosis! Dont know if thats any help but hey its imformative at lest (the article)! > The thing with metformin and alcohol is the high risk of "lactic acidosis" > which become more common but not very common if you drink heavily on [quoted text clipped - 8 lines] > > Dont know if thats any help but hey its imformative at lest (the article)! Cloudebrains: You state "metformin and alcohol...high risk of lactic acidosis". I read the article from NZ. My impression is perhaps "increased" risk of lactic acidosis and then it is much more related to old age, kidney and liver disease as a primary culprit as you seem to suggest as well. Yes binge drinking to the extreme can be a big problem under these circumstances otherwise the article suggests low risk not high risk. |
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