TYPE i DIABETICS AND GLUCOPHAGE

I JUST WENT TO A NEW ENDOCRINOLOGIST- HE WANTS ME TO GO ON GLUCOPHAGE SO I DON'T NEED MORE INSULIN AND TO PREVENT ME FROM GAINING WEIGHT. I THOUGHT THAT GLUCOPHAGE WORKS ON YOUR LIVER AND PREVENTS IT FROM RELEASING GLYCOGEN-WOULDN'T THAT BE DANGEROUS FOR ME IF I NEEDED THE GLYCOGEN DURING A POTENTIALLY BAD EPSIODE OF HYPOGLYCEMIA? I HAVE ALSO BEEN TAKING AN ACE INHIBITOR FOR ABOUT 7 YEARS (WITHOUT PROBLEMS) TO PREVENT RENAL HYPERTENSION (I HAVE HAD TYPE 1 FOR 23 YEARS) AND THE DR. TOLD ME I DIDN'T NEED IT AND TO DISCONTINUE ANY ACE INHIBITORS. HE'S MAKING ME NERVOUS- AM I WRONG FOR QUESTIONING HIM AND LOOKING AGAIN FOR A NEW ENDOCRINOLOGIST?

[Larry68]

Hi,

I am a long term T1, and I  would like to give you my personal (not medical) view on this.
1. Since you take insulin and are type 1, I find the suggestion that you take a drug to decrease available glucose (liver and intestinal) and decrease your insulin requirement highly questionable. You currently take what insulin you need for the available glucose, based on your knowlege of food and exercise. This is sufficient and relatively easy to manage. Varying what is extracted from your food or released by your liver will change everything you know about your diet today, and increasing sensitivity to insulin just makes thing worse.  If weight gain is an issue, you should attack that independently from your diabetes management through conventional means (reduce intake, exercise, etc.)
2. Conventional wisdom today is that ACE inhibitors reduce internal blood pressure within the kidney, even when overall blood pressure is normal .I have normal BP, but my cardiologist has me take 2.5 mg of enalipril daily, as it is believed to lower the risk of kidney damage evening this case.
3. It sounds like you have educated yourself on your disease (as we all must) enough to question your doctor. That is what you must do, and if you do not feel comfortable with any recommendation, seek another opinion and if necessary, find another endo.

Regards,
Larry

[JDRF-VOL-RL]

Hello, again!  Glucophage is just another name for metformin, which is what you described having problems with in your previous question, isn't it?

[JDRF-VOL-SG]

I cannot comment on the glucophage -- but I do agree with the previous posting about ace inhibitors. Most doctors nowadays do recommend that all diabetic patients take ace inhibitors in order to protect the kidneys from long-term damage. Research has proven this to be helpful for kidney health. And even diabetics with normal blood pressure are often encouraged to take small dosages such as what Larry68 is taking. Not enough to drop blood pressure dangerously, but enough to possibly help protect kidney health. So I agree with you that your endocrinologist seems to be going against the modern norm in this area. I would suggest that you ask him why he feels that you should discontinue this preventive regimen. If he cannot make a good case for his recommendations, you may want to seek another opinion.