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Medical Forum / Diseases and Disorders / Diabetes / April 2006Abuse of metformin
Yesterday in one of local papers, the Parisien, there was a two page spread on dieting strategies that could kill you. Among them was the use of antidiabetic products. Here's what the article had to say (I have translated it from the French): ANTIDIABETIC PRODUCTS The Effects They stop the desire to eat sugar. "Using antidiabetic drugs to lose weight is fashionable right now among certain doctors," claims Jean-Michel Cohen, a doctor specializing in nutrition. The specialists who try this method start with the idea that by acting on the body's insulin production - hormone produced by the pancreas, at the origin of the weight gain - this type of drug favors weight loss. The most frequently prescribed drug is metformin. Several laboratories manufacture it. The Dangers "It is not only ineffective but dangerous," claimms the nutritionist. Metformin lowers the blood glucose in the body and causes a hypoglycemic reaction, with fainting and malaise. Not so serious? For those who are not knowledgeable, it can be catastrophic, notably at the wheel," says the nutritionist, who also warns of fatal risks. I can certainly attest to the fact that metformin can make you lose weight. During the brief time I tried it, I lost 5 pounds. In fact this is one of the main reasons I stopped taking it, since at the resulting 112 pounds I was underweight. But what really got to me with this stuff was the galloping diarrhea it gave me. It threw my body chemistry out of kilter for a couple of months. Weight loss, like diabetes itself, sure seems to bring all the nutty doctors out of the woodwork. Donna Evleth Donna Evleth > Yesterday in one of local papers, the Parisien, there was a two page spread > on dieting strategies that could kill you. Among them was the use of [quoted text clipped - 31 lines] > > Donna Evleth an even more dangerous abuse which is rarely mentioned is use of insulin by bodybuilders. It is used to speed up metabolism and move more energy into cells, resulting in faster muscle growth. The dangers there are obvious. Just think how little a T1 needs in comparison to a T2. Bodybuilders regard it as safer than using steroids and less likely to be detected in any drug testing for sports. Ratty >> Yesterday in one of local papers, the Parisien, there was a two page spread >> on dieting strategies that could kill you. Among them was the use of [quoted text clipped - 41 lines] > > Ratty Especially when one considers that the nurse(s?) who got their kicks from killing patients used insulin as their poison of choice. > The Dangers > "It is not only ineffective but dangerous," claimms the nutritionist. [quoted text clipped - 3 lines] > knowledgeable, it can be catastrophic, notably at the wheel," says the > nutritionist, who also warns of fatal risks. Metformin is generally said not to cause hypos unlike the sulfs. So the "nutritionist" seems to be over-egging the pudding with alarmist remarks. > From: "Peter C" <peterc_2003@europe.com> > Organization: ntl Cablemodem News Service [quoted text clipped - 13 lines] > So the "nutritionist" seems to be over-egging the pudding with alarmist > remarks. Still, if you take this stuff when you don't have a legitimate reason to need it, you are in trouble, in my opinion. I feel I lost weight with it because of the diarrhea it induced. This is a bit like taking laxatives to purge after binging on food, and reputable doctors advise against this. The "nutritionist" in this case is not talking to diabetics, he is talking to normal folks who want to lose weight fast and don't know the risks for them (not for diabetics) that follow. Donna Evleth >> From: "Peter C" <peterc_2003@europe.com> >> Organization: ntl Cablemodem News Service [quoted text clipped - 16 lines] > Still, if you take this stuff when you don't have a legitimate reason to > need it, you are in trouble, in my opinion. Why isn't losing weight a legitimate reason in your view ? I feel I lost weight with it > because of the diarrhea it induced. This is a bit like taking laxatives > to > purge after binging on food, and reputable doctors advise against this. The weight loss factor of metformin is generally said to be a result of its fighting insulin resistance. > The "nutritionist" in this case is not talking to diabetics, he is talking > to normal folks who want to lose weight fast and don't know the risks for > them (not for diabetics) that follow. He invented a risk ( Hypos ) that really does not exist with metformin. Scaring folks with bogeymen doesn't seem like a very professional approach. Wittering about hypoes while driving sounds very much as though the nutritionist in question does not known the differnece between Type 1 and Type 2 diabetes. Metformin is prescribed for other conditions apart from Type 2 Diabetes. > From: "Peter C" <peterc_2003@europe.com> > Organization: ntl Cablemodem News Service [quoted text clipped - 24 lines] > > Why isn't losing weight a legitimate reason in your view ? There are other ways to lose weight that are not so drastic. Like eating less. > I feel I lost weight with it >> because of the diarrhea it induced. This is a bit like taking laxatives [quoted text clipped - 3 lines] > The weight loss factor of metformin is generally said to be a result of its > fighting insulin resistance. OK, I'll take your word for it. >> The "nutritionist" in this case is not talking to diabetics, he is talking >> to normal folks who want to lose weight fast and don't know the risks for [quoted text clipped - 6 lines] > Type 2 diabetes. > Metformin is prescribed for other conditions apart from Type 2 Diabetes. I stand by my position that it is not intended to be a diet drug for people who are not diabetic. Although I am quite willing to be informed. What are the other conditions for which metformin is prescribed? Donna Evleth Donna At the risk of being contradicted, metformin is prescribed to young women who have a certain polycystic problem regarding fertility. Patti Penzance, Cornwall On 19u Levemir @ 8pm and 9u Levemir @ 8 am Novorapid as required Perindopril, aspirin, Simvastatin, 300mg Quinine Sulphate & 75msg Thyroxin. A1c 5.3 >Donna > [quoted text clipped - 7 lines] >300mg Quinine Sulphate & 75msg Thyroxin. >A1c 5.3 Yep. A friend of mine takes it for PCOS.  SignaturePeter Bowditch aa #2243 The Millenium Project http://www.ratbags.com/rsoles Australian Council Against Health Fraud http://www.acahf.org.au Australian Skeptics http://www.skeptics.com.au To email me use my first name only at ratbags.com > I stand by my position that it is not intended to be a diet drug for > people > who are not diabetic. there was a systematic review of the evidence which came to the usual conclusion ..more research needed ! http://www.annfammed.org/cgi/content/abstract/3/5/457 The follow-ups to the this review make it clear that it would help any overweight person who had insulin resistance, that many responsible physicians are using it as such, but obese patients would need to be selected carefully for weight-loss treatment with metformin ... http://www.annfammed.org/cgi/eletters/3/5/457 one doc in the follow-up says he has been using metformin with obese patient "for years" ... clearly he does not regard its use in such circumstances as an "abuse". Although I am quite willing to be informed. What are > the other conditions for which metformin is prescribed? Its used in Polycystic Ovaries Syndrome ( Pcos), steatohepatitis, and other things e.g to help with the side effects of HIV drugs... interestingly enough the authors of this report below do suggest its use with obese patients ! http://www.docguide.com/news/content.nsf/news/8525697700573E1885256D8B003073C9 Donna Evleth <devleth@wanadoo.fr> wrote in alt.support.diabetes.uk: > There are other ways to lose weight that are not so drastic. Like > eating less. I disagree, I wouldn't call using meds a "drastic way", more likely a very ineffective way if it's the only intervention to reduce weight. Losing weight is necessary when there's overweight. Overweight is in about 99% of the cases a lifestyle problem. Changing lifestyle is the only and most drastic way to lose overweight - reason why so many fail to achieve it. Please note: "lifestyle problem" is not the same as "it's all your own fault"; that misunderstanding tends to pollute the discussion way too often, leading to flame wars and bitter insults. Our whole society has been rearranged around lifestyle promoting easy weight gain. Just eating less isn't a solution. Overweight people are known to have a more efficient storage mechanism. When we were running around is bear skins that was an asset, now it has become a liability: the body simply starts storing the calories it gets from the diminished food supply even more efficient. The result is the infamous yoyo effect, making people end up even more overweight. The main reason why so many people are overweight nowadays is caused by their inactivity. You might not believe it, but in our countries most people eat on average a lot less calories than say one century ago (up to 40%); compare 14-16 hours of strenouos physical labour in those day with the occasional half an hour walk most people achieve these days. . Most important is to exercise more, eat a little lessand above all regularly to tell your body food isn't scarce, and eat healthy stuff of course. Amd if _those_ lifestyle changes are coupled with medication to support the effort, I don't see anything wrong about it. SignatureCeeBee *** The Cookie Has Spoken *** > The weight loss factor of metformin is generally said to be a result of its > fighting insulin resistance. > >> The "nutritionist" in this case is not talking to diabetics, he is talking >> to normal folks who want to lose weight fast and don't know the risks for >> them (not for diabetics) that follow. A huge percentage of "normal folks" who have weight problems are insulin resistant and Metformin is an appropriate drug for them. Also, Donna, though some do, not everyone gets digestive problems from Metformin and the weight loss is not caused by the changes in the digestive tract but by the drug causing muscle tissue to burn glucose rather than store it as fat and by suppressing the liver's tendency to dump glucose. > He invented a risk ( Hypos ) that really does not exist with metformin. > Scaring folks with bogeymen doesn't seem like a very professional approach. > Wittering about hypoes while driving sounds very much as though the > nutritionist in question does not known the differnece between Type 1 and > Type 2 diabetes. > Metformin is prescribed for other conditions apart from Type 2 Diabetes. As anyone who reads my postings knows, I'm not a big fan of the drug companies and I'm intensely paranoid about most pharmaceuticals. But Metformin is one of the few drugs that, for me, has no negatives and only positives. It not only keeps me from gaining weight, it also lowers my lipids significantly. If a person knows for a fact that their blood sugar is normal (never goes over 5.5 mmol/l after meals, then metformin might not make sense, but for anyone with Metabolic Syndrome, it is a very appropriate drug. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control Jenny <lottadata@hotmail.com> wrote in alt.support.diabetes.uk: > Metformin and the weight loss is not caused by the changes in the > digestive tract but by the drug causing muscle tissue to burn glucose > rather than store it as fat and by suppressing the liver's tendency to > dump glucose. There's quite some uncertainty about that. There is indication that Metformin induces weight loss from relatively small scale trials, but the exact cause is still laregly unknown. Explanations include reducing the intestines sensitivity to process food and decreased hunger feelings, but explanations are incosistent. If the latter is true, it has to do with the creation of certain hunger inducing hormones. Some meds already choose that way to assist in losing weight. I know of Reductil - or whatever it's called around the world. SignatureCeeBee *** The Cookie Has Spoken *** > Jenny <lottadata@hotmail.com> wrote in alt.support.diabetes.uk: > [quoted text clipped - 8 lines] > Explanations include reducing the intestines sensitivity to process food and > decreased hunger feelings, but explanations are incosistent. In my own experience metformin allowed me to eat more and lose weight, and then after I reached goal it allowed me to maintain the weigh while eating at a level that causes weight gain without metformin. I put in a few months logging my food intake with software and measuring portions because I really wanted to understand how much I could eat, so there's no question in my mind of Metformin's effect. It's effect on my blood sugar is quite modest--1500 mg drops it 1.1 mmol/l (20 mg/dl) but has no effect on fbg. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control > From: Jenny <lottadata@hotmail.com> > Newsgroups: alt.support.diabetes.uk [quoted text clipped - 9 lines] > rather than store it as fat and by suppressing the liver's tendency to > dump glucose. Thanks for the information. I never knew all this. I admit that I tend to be very negative about metformin because it gave me such a bad time. I guess I should really blame my ex-GP for prescribing this drug for someone like me. He knew I was thin already. You don't have to be a master medic to know that, all you have to do is look at me. I don't know what he was thinking of. Donna Evleth > Thanks for the information. I never knew all this. I admit that I tend to > be very negative about metformin because it gave me such a bad time. I > guess I should really blame my ex-GP for prescribing this drug for someone > like me. He knew I was thin already. You don't have to be a master medic > to know that, all you have to do is look at me. I don't know what he was > thinking of. I think metformin also has a cardioprotective effect as well. I'm sorry I don't know the mechanism. I know it's not just for diabetics who are overweight. I've found that i can avoid gastric upset by keeping to a lowish GI diet. Seems if I eat a standard carb heavy diet, i'd get a lot of gas. SignatureJohn38 - t1 (LADA) since 2003 : DAFNE (glargine/aspart) > From: John38 <dev-null@reiteration.net> > Reply-To: dev-null@reiteration.net [quoted text clipped - 7 lines] > lowish GI diet. Seems if I eat a standard carb heavy diet, i'd get a lot > of gas. Since I also have coeliac disease I never ate a carb heavy diet. When bread, pasta, and breakfast cereals make you so sick you just don't. Donna Evleth > Since I also have coeliac disease I never ate a carb heavy diet. When > bread, pasta, and breakfast cereals make you so sick you just don't. Hi Donna Didn't relise you were coeliac. Perversely, the habits of carb avoidance may have spared you metabolic syndrome! I avoid wheat, but I'm not coeliac. It is just a PITA to calculate for wheat (apart from durum pasta) because there is something that my body does when exposed to wheat that makes compensation with insulin non-stoichiometric. So I try to avoid it. (trouble is, it seems i've not been trying hard enough but thats another story...) SignatureJohn38 - t1 (LADA) since 2003 : DAFNE (glargine/aspart) > From: John38 <dev-null@reiteration.net> > Reply-To: dev-null@reiteration.net [quoted text clipped - 14 lines] > to avoid it. (trouble is, it seems i've not been trying hard enough but > thats another story...) I have seen in the literature that a connection has been made between coeliac disease and type 1 diabetes. Now there are suspicions that type 2 may be involved also. I wouldn't be surprised. Donna Evleth > From: Jenny <lottadata@hotmail.com> > Newsgroups: alt.support.diabetes.uk [quoted text clipped - 4 lines] > goes over 5.5 mmol/l after meals, then metformin might not make sense, > but for anyone with Metabolic Syndrome, it is a very appropriate drug. I have just been reading up on Metabolic Syndrome. I am not sure whether I have it or not. I have some but not all of the symptoms. For example: Elevated weight circumference - 35 inches or more. My waist measures 30 inches. Elevated triglycerides - 150 mg/dL or more. My triglycerides when tested in January were 58. Reduced HDL - less than 50 mg/dL. My HDL is 81. Elevated blood pressure - equal to or over 130/85. I have the 130 on the top, but my smaller figure is lower, 75 to 80. Elevated FBG - more than 100 mg/dL Mine varies. Sometimes it is between 100 and 110. Lately it has been around 85. The recommendation for managing Metabolic Syndrome is weight loss to achieve a BMI of 25 kg/m2, not an option for me since my BMI is already 18.7, and increased physical activity, at least 30 minutes of moderate exercise most days. I walk at least two miles every day. So do I have it, or don't I? The only thing about myself that I have been able to determine to date is that I am a thin person with a fat person's disease. And that presents a whole set of bizarre problems and misunderstandings. Donna Evleth > The only thing about myself that I have been able to determine to date is > that I am a thin person with a fat person's disease. And that presents a > whole set of bizarre problems and misunderstandings. not all type 2 have met. syndrome. not all type 2 are fat. not all type 1 are thin. not all type 2 are old. not all type 1 are young. some type 1 are insulin resistant. some type 1 take metformin. it might not be for just insulin resistance. insulin resistance increases with age. this happens even in normals. SignatureJohn38 - t1 (LADA) since 2003 : DAFNE (glargine/aspart) > > The only thing about myself that I have been able to determine to date is > > that I am a thin person with a fat person's disease. And that presents a [quoted text clipped - 4 lines] > 1 are insulin resistant. some type 1 take metformin. it might not be for > just insulin resistance. insulin resistance increases with age. I'm beginning to think that the *current* distinctions between type 1 and type 2 are outdated and possibly harmful - given that it mostly seems to be based not on the cause, nor even the effect, but the *treatment* given out: whether insulin injections from the start (type 1) or not (type 2). Although I note that if a type 2 has to move to insulin injections they still retain the "type 2" label. Surely it would be better to separate these broad categories as being "insulin-deficit" (the nearest analogy to current type 1) and "insulin-resistant" (and make this the formal definition of a Type 2), while accepting that sometimes people may have both symptoms and need to be treated for both? In other news, I've been a lot better myself recently. HBA1c has dropped by four and a half points in three months since being on metformin, which apparently is quite a fast improvement, and cholesterol readings have dropped from 5.3 to a much healthier 4.1. Maintaining weight at 13 stone (BMI = about 23.5). Oh, and my mother has made an almost miraculous improvement after her GP decided to try her out on metformin tablets (on the grounds that "things couldn't probably get much worse" after a month or so of being stuck mostly with a BG of over 20, punctuated by occasional violent hypos). Three weeks of metformin tablets later, she's injecting less than half as much insulin and has managed to get her BG level to actually stabilise in the range between 5 and 14, with no hypos... Jonathan. > I'm beginning to think that the *current* distinctions between type 1 > and type 2 are outdated and possibly harmful - given that it mostly > seems to be based not on the cause, nor even the effect, but the > *treatment* given out: You have got this completely arse-over-tip , the distinction between Type 1 and Type 2 IS based on the "cause" : even though the causes of both are not very well understood, it is transparently obvious that the two types have very different causes hemce the distinction between them. The treatments are different because the "causes" are different. > > I'm beginning to think that the *current* distinctions between type 1 > > and type 2 are outdated and possibly harmful - given that it mostly [quoted text clipped - 6 lines] > very different causes hemce the distinction between them. > The treatments are different because the "causes" are different. Well perhaps you'd like to explain how it is that you get doctors who can *be* uncertain, or confused, about whether a particular patient is type 1 or type 2. In my own case, I was told that I had very much type-1 symptoms at the current time, and I was very nearly put on type-1 insulin injection treatment. My mother, with exactly the same symptoms 30 years ago, actually was diagnosed as a type 1, and doctor after doctor has stood by that diagnosis, or at least never questioned it, until three weeks ago when a GP (*not* a consultant!) finally decided to try out a type-2 treatment (metformin tablets) on the grounds that "things can't possibly get any worse than they have been for thirty years". Her consultant has now reclassified her as a "type 2 but one with insulin-deficiency complications", rather than even as being a "type 1 with insulin-resistance complications"... It may be that the "causes" are recognised as different for type 1 and type 2, but it certainly happens that the *treatment* assigned, and the diagnosis made, can often depend on the symptom, which can be misleading, rather than the actual cause which may not have been determined at the time of diagnosis. I mean, when the symptoms are a current blood glucose level of over 25, a HBA1C level closer to 15 than 10, a ketone reading that's off the scale, and the fact of having lost nearly four stone in a comparatively short space of time, and still being comparatively young... everything I've ever read about diabetes points to such symptoms, all in conjunction, indicating a type 1, and a pretty severe one at that. And yet here I am, as a type 2 and now well under control... Jonathan. >> "Jonathan Ellis" <jonathan@franz-liszt.freeserve.co.uk> wrote in > message [quoted text clipped - 19 lines] > can *be* uncertain, or confused, about whether a particular patient is > type 1 or type 2. it is for a very obvious reason. ... some of the symptoms are similar ... but the correct diagnosis will be made in the end. Confusion over the correct diagnosis to make doesn't alter the fact that the distinction between Type 1 and Type 2 is made on "causes" not on the treatment ( which have similarities ) being meted out. Type 1 diabetics are not diagnosed Type 1 because they have to use insulin from day 1 as you were suggesting ... the reverse is true, they have to use insulin from day 1 precisely because they have being diagnosed with Type 1 Diabetes. > > I'm beginning to think that the *current* distinctions between type 1 > > and type 2 are outdated and possibly harmful - given that it mostly [quoted text clipped - 6 lines] > very different causes hemce the distinction between them. > The treatments are different because the "causes" are different. Wrong, wrong, wrong! Treatment depends on presentation rather than cause!!! The problem has already happened! Certainly, that's what my experience is anyway :) SignatureJohn38 - t1 (LADA) since 2003 : DAFNE (glargine/aspart) > I'm beginning to think that the *current* distinctions between type 1 > and type 2 are outdated and possibly harmful - given that it mostly > seems to be based not on the cause, nor even the effect, but the > *treatment* given out: whether insulin injections from the start (type > 1) or not (type 2). Although I note that if a type 2 has to move to > insulin injections they still retain the "type 2" label. As far as I know, the causes differ. Type 1 is an autoimmune disease where active autoimmune responses attack the beta cells. Type 2 is a predisposition that has a strong genetic component, to become insulin resistant after certain environmental and physical criteria have been met. Well, that's my understanding of it. Basically, type1 autoimmune, type 2 not. > Surely it would be better to separate these broad categories as being > "insulin-deficit" (the nearest analogy to current type 1) and > "insulin-resistant" (and make this the formal definition of a Type 2), > while accepting that sometimes people may have both symptoms and need > to be treated for both? My experience of treatment where I am is that they try to treat with d&e, if that doesnt work, with insulin secretagogues, it that doesnt work, with insulin, which always works. In my case, pills stopped working after a year or so. In retrospect, my presentation was of more a type 1 than 2. But it doesn't matter, because treatment is the same. Obviously they would not treat presentation in DKA with d&e !! When anything up to 20% of the population might be diabetic and of that 20%, 90% are type 2, you're not goung to want to run a c-pep test costing 400 UKP for each individual presenting in a social healthcare environment in order to establish what type a person is when that exercise is justified very weakly. So yes, I agree with you in the point you make, and in my experience, things are being done this way. SignatureJohn38 - t1 (LADA) since 2003 : DAFNE (glargine/aspart) >> I'm beginning to think that the *current* distinctions between type 1 >> and type 2 are outdated and possibly harmful - given that it mostly >> seems to be based not on the cause, nor even the effect, but the >> *treatment* given out: whether insulin injections from the start (type >> 1) or not (type 2). Although I note that if a type 2 has to move to >> insulin injections they still retain the "type 2" label. >As far as I know, the causes differ. Type 1 is an autoimmune disease >where active autoimmune responses attack the beta cells. Type 2 is a >predisposition that has a strong genetic component, to become insulin >resistant after certain environmental and physical criteria have been >met. Well, that's my understanding of it. Basically, type1 autoimmune, >type 2 not. Err....not too sure on that cause that do not describe me. I have no genetic or lifestyle disposition and up to 3 years ago I was 100% healthy. I got my autoimune system damaged by physical means and the treatment of that ailment by drugs administered by the NHS. However, I am now T2. >> Surely it would be better to separate these broad categories as being >> "insulin-deficit" (the nearest analogy to current type 1) and [quoted text clipped - 15 lines] >exercise is justified very weakly. So yes, I agree with you in the >point you make, and in my experience, things are being done this way. > From: Pete <aspen3@freeuk.com> > Organization: X-Privat NNTP Server - http://www.x-privat.org [quoted text clipped - 14 lines] > physical means and the treatment of that ailment by drugs > administered by the NHS. However, I am now T2. My own experience is a complete mystery to me. I am T2. But why? Not a clue. I must have a strong genetic component, but where it comes from I have no idea, since I have no known diabetes in my family on either side. I do not have any lifestyle disposition, since I have never in my life been overweight, have never had high blood pressure, high cholesterol or high triglycerides. I have not had any ailments that would damage my autoimmune system. All I can come up with as an explanation is just bad luck. Donna Evleth >> On Fri, 28 Apr 2006 15:44:53 +0200, Donna Evleth ><devleth@wanadoo.fr> >> wrote: >> > The only thing about myself that I have been able to determine to >date is [quoted text clipped - 9 lines] >for >> just insulin resistance. insulin resistance increases with age. >I'm beginning to think that the *current* distinctions between type 1 >and type 2 are outdated and possibly harmful - given that it mostly >seems to be based not on the cause, nor even the effect, but the >*treatment* given out: whether insulin injections from the start (type >1) or not (type 2). Although I note that if a type 2 has to move to >insulin injections they still retain the "type 2" label. >Surely it would be better to separate these broad categories as being >"insulin-deficit" (the nearest analogy to current type 1) and >"insulin-resistant" (and make this the formal definition of a Type 2), >while accepting that sometimes people may have both symptoms and need >to be treated for both? >In other news, I've been a lot better myself recently. HBA1c has >dropped by four and a half points in three months since being on >metformin, which apparently is quite a fast improvement, and >cholesterol readings have dropped from 5.3 to a much healthier 4.1. >Maintaining weight at 13 stone (BMI = about 23.5). >Oh, and my mother has made an almost miraculous improvement after her >GP decided to try her out on metformin tablets (on the grounds that [quoted text clipped - 3 lines] >than half as much insulin and has managed to get her BG level to >actually stabilise in the range between 5 and 14, with no hypos... >Jonathan. I always understood that the distinction between T1 and T2 was very simply the fact that a T1 has NO capability of producing insulin at all. Mainly because either they have no pancreas [accident/operation/surgery/genetic] and a T2 has the capacity but it is faulty/burnt out or otherwise damaged. A T2 may use insulin but that does not make em a T1 etc. Seems simple to me. >I always understood that the distinction between T1 and T2 >was very simply the fact that a T1 has NO capability of >producing insulin at all. Mainly because either they have no >pancreas [accident/operation/surgery/genetic] and a T2 has >the capacity but it is faulty/burnt out or otherwise >damaged. That's not quite right. A T1 is diabetic because they don't produce enough insulin. They may produce some or none. A T2 is a diabetic because their body doesn't properly use the insulin that they produce. There are medicines that can help a T2 use their insulin more effectively, but if that isn't enough then they will also be given additional insulin. >A T2 may use insulin but that does not make em a T1 etc. In theory there's no reason why someone can't have both T1 and T2 diabetes at the same time. SignatureBernard Peek London, UK. DBA, Manager, Trainer & Author. > >I always understood that the distinction between T1 and T2 > >was very simply the fact that a T1 has NO capability of [quoted text clipped - 5 lines] > That's not quite right. A T1 is diabetic because they don't produce > enough insulin. They may produce some or none. Hm. I believe there are some forms of diabetes where someone isn't producing enough insulin but is classed as a T2. Does this happen in cases that are NOT associated with insulin resistance? > A T2 is a diabetic because their body doesn't properly use the insulin > that they produce. There are medicines that can help a T2 use their > insulin more effectively, but if that isn't enough then they will also > be given additional insulin. I know that quite often a T2 diabetic will actually have *more* than normal circulating insulin and it still doesn't work. > >A T2 may use insulin but that does not make em a T1 etc. > In theory there's no reason why someone can't have both T1 and T2 > diabetes at the same time. What happens if a T2 becomes exceptionally severe if left untreated (often undiagnosed) for too long? Does it happen that the pancreas can get kind of "exhausted" and drop, either gradually or suddenly, from producing too much insulin (which isn't working properly anyway) to too little, possibly zero? Because if that can happen... then I could well imagine such a person developing the type of zero-insulin complications which could conceivably resemble T1, even though the basic underlying original problem was T2. Which, if this is the case, is what I suspect actually happened to two generations of my family... Jonathan. > What happens if a T2 becomes exceptionally severe if left untreated > (often undiagnosed) for too long? Does it happen that the pancreas can > get kind of "exhausted" and drop, either gradually or suddenly, from > producing too much insulin (which isn't working properly anyway) to > too little, possibly zero?> Jonathan, That most certainly can happen. And it can happen not only from years of undiagnosed type 2 diabetes, but also much more swiftly from taking certain drugs which cause extremely high blood sugars, which poison the remaining beta cells. Also, there are forms of inherited diabetes, often diagnosed as type 2, where the person makes insulin, sometimes a lot of it, but the insulin doesn't work properly though NOT because of insulin resistance, but because of something else. That's what I have. I have written up a page about those kinds of diabetes (MODY) at: http://www.phlaunt.com/diabetes/14047009.php --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control >>I always understood that the distinction between T1 and T2 >>was very simply the fact that a T1 has NO capability of >>producing insulin at all. Mainly because either they have no >>pancreas [accident/operation/surgery/genetic] and a T2 has >>the capacity but it is faulty/burnt out or otherwise >>damaged. >That's not quite right. A T1 is diabetic because they don't produce >enough insulin. They may produce some or none. >A T2 is a diabetic because their body doesn't properly use the insulin >that they produce. There are medicines that can help a T2 use their >insulin more effectively, but if that isn't enough then they will also >be given additional insulin. >>A T2 may use insulin but that does not make em a T1 etc. >In theory there's no reason why someone can't have both T1 and T2 >diabetes at the same time. I knew it was something like that. >> The Dangers >> "It is not only ineffective but dangerous," claimms the nutritionist. [quoted text clipped - 7 lines] >So the "nutritionist" seems to be over-egging the pudding with alarmist >remarks. If metformin caused hypos it would be on the list of drugs that have to be notified to driving licence authorities. It doesn't so I can assume it isn't. Also, when I had a car accident recently the insurance company asked me if I take any medication. As insurers are always looking for excuses not to pay, I can only assume that the fact that my car will be back on the road next week (with really lovely new paint work) is evidence that the insurance company isn't worried about a bit of metformin. The only real hypo I've had since starting metformin was the first time I went walking with my new iPod on. I lost track of time and just kept on power walking until I almost fell down. Turns out that I had exceeded my usual exercise time by about twenty minutes. Bloody Rick Wakeman and his over-long compositions. SignaturePeter Bowditch aa #2243 The Millenium Project http://www.ratbags.com/rsoles Australian Council Against Health Fraud http://www.acahf.org.au Australian Skeptics http://www.skeptics.com.au To email me use my first name only at ratbags.com >>> The Dangers >>> "It is not only ineffective but dangerous," claimms the nutritionist. [quoted text clipped - 3 lines] >>> knowledgeable, it can be catastrophic, notably at the wheel," says the >>> nutritionist, who also warns of fatal risks. >>Metformin is generally said not to cause hypos unlike the sulfs. >>So the "nutritionist" seems to be over-egging the pudding with alarmist >>remarks. >If metformin caused hypos it would be on the list of drugs that have >to be notified to driving licence authorities. It doesn't so I can [quoted text clipped - 4 lines] >paint work) is evidence that the insurance company isn't worried about >a bit of metformin. >The only real hypo I've had since starting metformin was the first >time I went walking with my new iPod on. I lost track of time and just >kept on power walking until I almost fell down. Turns out that I had >exceeded my usual exercise time by about twenty minutes. Bloody Rick >Wakeman and his over-long compositions. Metformin does not cause hypo's. 1] It inhibits the livers ability to produce glucogen. Therefore, normal physiacal activiy will use up that which is already available in the blood stream. Because the levels of glucose in the blood stream will not be replenished to the same level as prior to taking metformin, then the overal level will reduce. This reduction will 'reset' the body's 'trigger' mechanism which up to this point [prior to taking Metfartin] will have assumed the pre metformin level to be normal. this will be interpreted by the body as 'hunger' when in fact it is not. This 'trigger' resetting is precisely why those who go on diets find the first three weeks or so the hardest. Because it takes up to 3 weeks for the trigger to reset and about 1 hour to undo....... Because the liver is being inhibited and overal levels of G in theblood are then subsequently lower, a source of fuel to meet the deficit is needed and the body's first line of resource is the digestive tract. After that the fat stores about the muscles and finaly the Brown fat cells. After that you die. So because of this mechanism, there is no chance of a normal person becoming hypo at all. For that to happen [a real hypo] they would have to eat less than a diabetic for a considerable time, and be devoid of all fat stores about the muscles. In theory it could happen but it is highly unlikely since they would colapse of some other ailment first. 2] ehances glucose take up by the muscle tissues by adding an extra 'hand hold'. This makes it easier for the muscles to 'grab' the nutrient. The more muscle you have [larger engin capacity] then the greater the fuel requirement. This is why we are advised to exercise regularly and try to keep muscles toned and indeed build some if you are able. [Incidentally my wife has a serious broken leg and has been restricted in walking for over 6 weeks now. Her muscle tone has deteriorated so much she has to have intense physio. So it shows just how easy it is to lose that tone] Increased uptake of nutrient will deplete the energy store more quickly and cause a greater deficit in the blood stream. With a reduced liver production as well then the required fuel must come first from the digestive tract. If that is low, depleted or contains poor quality and slow processing types, then the fats about the muscles are used as well. 3] and restricts the digestive systems ability to process carbohydrates. These are processed quickly so by restricting the processing in the gut the drug prevents a quick or volumous release into the blood when required by the body to do so [see above - 2] Incidentally, this is why metformin causes the sh.ts. It is an indicator that there is too much of the wrong food in the gut or too much volume and it gets rid of it with a restricted processing. This causes dehydration since moisture is needed to process the un digested components. Examination of your bowel movements and careful consideration of your feeding habits can indicate your dietry needs. So if a normal person takes Metformin and if they are fit and have good musculature and little fat and on top of that severely restrict their diet................you figure it out. A normal person would have to be suffering from malnutrition before going hypo in the correct sense of the word. However, they will definately have what is commonly refered to as a Phantom Hypo which is simply the reaction of the body when it detects the lowering of the 'normal' levels of BG which may not necessarily be normal and may be in fact more elevated then would be considered normal for that person. [such as in a fat git] Just my Rant for the day. VBG |
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