Had the Avandia Talk With My Doc
 

It took her a long time to get around to it, but she finally asked me if I wanted to switch from Avandia. She suggested Metformin, which I've heard is good for controlling B/G, but can cause some stomach problems. I didn't want to make any decisions regarding changing my medication at that time because I had started LC and felt my numbers would improve, so stuck with the Avandia. My thinking was that at some point in the near future I might be able to reduce or eliminate my oral medication all together. I am Type 2. Also, I had not too long ago heard the latest findings on tight B/G control and it was found that tighter control did not decrease the death rate in diabetics (hope I'm remembering this correctly).

Well it's now three months later, and despite sucessfully LCing for that time, I am surprised to find that my fasting B/G has actually gone up from 7.0 in July, 2007 to 7.3. I'm also surprised to find that my total cholesterol and tryglecerides have gone down. I say surprised because although I have heard that these would improve, I had been warned that they might not be so good the first time - so I'm surprised that they improved - surpirsed and pleased since my doc has been after me to start taking Lipitor for over a year.

So-o-o-o my question is, since it's apparent I do need to switch from Avandia for one because it's just not a good medication to keep taking, and secondly because it's no longer getting the job done, is Metformin a good choice?

I welcome all responses - need help figuring this one out. Keep in mind these were the only 2 choices she gave me. I think I'm still at the point where diet and medication can keep my B/g in check.

Getting away from Avandia may be a good step as it causes fluid
retention on the heart and sometimes,according to study
results,cardiovascular problems.Actos is supposed to be safer.
Metformin is probably the safest diabetes drug.If you have
concerns about GI problems,you should probably take the extended release version of Metformin.You can check out
detailed information on prescription drugs at www.rxlist.com.
Good luck
Eddie

Tighter control does decrease death rates in diabetics. The ACORD study was a seriously flawed study. The closer you get to a normal A1c, the better your odds of living complication free. Have you had your A1c done prior to and after starting low carb?

Have you read Dr. Bernstein's "Diabetes Solution"? It outlines all the benefits of tighter control as well as giving you step by step instructions on how to achieve it.

I don't know if I knew they found that the study was flawed. I remember thinking that the results of the study didn't make sense, since tighter control HAS to be better.

Also, you make a great point about whether I had my A1c done before and after. I did have it done before, but can't find the results and so was going by my 2007 A1c and comparing it to this last one. So my number may have even higher than 7 and this current number may have indeed come down.

Thanks for making me think!!!!!!!!!!!!!!!!! :thup:

Just had to get a refill on my diabetes med and have actually called the Dr. back to get the Metformin (extended release). To be honest the only reason I didn't want to try it is because I work in an office and didn't want to have any unexpected accidents, since I'm a long way from the restroom. My son actually takes Metformin and has told me he has to cut his dose to prevent this from happening to him at work.

Thanks so much for the info.

PamLynn
Does your son take immediate or extended release Metformin?
Extended release is much less likely to cause GI problems.
About the ACORD study:
It involved type 2 diabetics who already had cardio problems.
Results seem to be a bit perplexing.Nevertheless I will
continue to strive to keep my A1C in the 5's(last one was 5.5)
Cheers
Eddie

The people in the ACORD study were also on extremely high-carb diets and taking glucose lowering medications including insulin. Many of the people died of coronary incidents which may have been contributed to by hypoglycemia. It is almost impossible to avoid hypos with high carbs and lots of insulin. Bernstein's theory of small numbers explains this much better than I can in the space of a post.

As Eddie said, most of them had already experienced the devastating damage of long-term poor control and the target A1c of 7 isn't anywhere near normal A1c. I would try to get below 6.

Eddie: Not sure which one he's on, I'll have to ask him. He is having a difficult time controlliing his B/G. The Metformin did bring it down quite a bit, but it's still too high.

About the cardio problems, didn't know that either. Guess I shoulld go back and read the report. Congrats on you A1C. Wow 5's, I wish I could see 5's. Is that w/meds.?

PamLynn
I take 10 mg of Glipizide ER and 1500 mg of Metformin ER
each day.I am also a weightlifting fanatic.I eat 50-75 grams
of carbs per day.
Eddie

Really appreciate the info. I will at least go to the Bernstein forum and read through some of the threads. You're telling me 7 is not good - don't I know it. I was pretty torn up when I saw that number. Hopefully with the change in medication my number will be much better next time. And as you made me realize, my actual previous number may have higher than 7, and this latest test may indeed represent a drop in my A1c. I'm hoping that's the case I'm working my program pretty well, but there's always room for improvement.

Wow, I can't believe how many diabetic patients I am hearing about who's doctors have actually read the ACCORD study and are beating them over the heads with it.
Makes you wonder about how selective they are in what they read and believe, doesn't it?
Here's some great reading on what was wrong with those studies.
http://diabetesupdate.blogspot.com/search?q=accord

Metformin has a long proven safe track record, and really is the only oral diabetes drug I feel safe taking. I'm glad you're going to give it a try.
I did have gastrointestinal distress with the regular met and asked my doctor for the extended release. The extended release has never caused me any trouble, even taken on an empty stomach.
Good luck to you. Maybe this time next year, we'll both be off drugs and controlled by LC diet alone.

BTW, I started with an A1c of 11 and was on glipizide, Actos, metformin and Lantus.
Now it's 5.4 on metformin only. Thank you low carb.

I don't understand why they are pushing the ACCORD study onto patients? It's like telling someone who is doing well to do worse. :q:

I mentioned on another thread my doc wants all of his patients to have an A1C above 6. I decided it was not worth getting into an arguement or discussion.

ps - he gave me a copy of the ACCORD report from the NE journal

Maybe you should get a new doctor, Rob.

I can see that it might be a good idea for diabetics to have an
A1C above 5.0 to avoid hypo but a doctor setting a goal of
above 6.0 IMHO is absurd!
Eddie