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Metformin?
This is really a post for a friend of mine. He has had Type II diabetes for years but is finding very hard to control as his Metformin AS 500mg makes him sick every day.He takes it in the morning just before breakfast and is nauseous the rest for the day. As such he skips taking it most of the time with his glucose in the 300's and even when he does take it his glucose is in the high 200's.
He is wondering if any other diabetics have had this problem with the metformin?
Dennis
He is wondering if any other diabetics have had this problem with the metformin?
Dennis
Good news. My friend saw a different doctor today at the VA. This one was filling in for his normal PC today but she actually listened to what he had to say.
She stopped the Metformin immediately and doubled his other diabetes medicine. She also scheduled him to see another doctor to get him started on insulin. He is suppose to see this other doctor in about 1 week. She tried to get him in to see this other doctor today but he was booked solid hence the doubling of the other medication in the mean time.
Thanks for all of your responses.
Dennis
She stopped the Metformin immediately and doubled his other diabetes medicine. She also scheduled him to see another doctor to get him started on insulin. He is suppose to see this other doctor in about 1 week. She tried to get him in to see this other doctor today but he was booked solid hence the doubling of the other medication in the mean time.
Thanks for all of your responses.
Dennis
COMMUNITY LEADER
Hi Dennis,
your friend's blood sugars are dangerously high. Some people cannot tolerate metformin. Sounds like pursuing the insulin is the best bet. Insulin always works! And yes, it is a long term thing and quite involved, but it sure beats having complications from uncontrolled blood sugar.
your friend's blood sugars are dangerously high. Some people cannot tolerate metformin. Sounds like pursuing the insulin is the best bet. Insulin always works! And yes, it is a long term thing and quite involved, but it sure beats having complications from uncontrolled blood sugar.
My friend has gone through 3 different doctors with this Metformin problem. He has even suggested going to insulin to which his latest doctor replied "that is a life changing thing and I don't want you to have to go through that". He is seeing another new doctor next week and is hoping the new doctor will listen to him this time. He has been in the hospital several times for surgeries and each time they treat his diabetes with insulin while in the hospital. So this time he is planning to have this new doctor look at the records for when he was in the hospital so they will see that he is given insulin.
Dennis
Dennis
I don't know what VA you have dealt with but what you described does not happen at the Nashville VA that both my friend and I go to.
I have gone with my friend to many of his appointments ( going in the exam room with him) and also have had my own experiences with my doctors at this VA that do not care about what is going on with their patients. And even with a doctor that does care a lot of the time that hospital panel doesn't care what your doctor says about medications that you need.
The pharmacy at the VA does not work anything like what you said. when you need to get a medication filled you pick up a number and see which ever pharmacist happens to call your number. At that point they tell you how to take/use a medication and you then wait for your name to be displayed on a board to pick up your medication. they DO NOT go over anything else.
I was just diagnosed with diabetes myself and it was only after reading the insert for my medication that talked about having to be sure and test my glucose that I called in to my primary care doctor did I get a meter ( after 2 months) and see a dietician because my doctor forgot to schedule that part after my diagnoses. I have seen no other doctor for my diabetes nor have any been scheduled.
Then even seeing the dietician was a joke. The appointment only lasted about 5 minutes. He gave me a booklet on diet and told me to keep my glucose between 70 and 120 and keep my meals at 40g of carbohydrates. Everything I have read on-line has said that I should have been given both before meal and after meal glucose levels and that I should start with about a 70g level for diet to start with and adjust it as needed according to how my glucose does.
As for a nurse I see which ever nurse happens to call me prior to seeing my primary care. The last time I saw my primary care a saw a nurse that definitely doesn't know about diabetics. It was at this appointment when I finally got my meter so she knew I was diabetic. It was only after dismissing me to wait to see my primary care that she remembered that she was suppose to check my feet. She was also the nurse that gave me my meter. She asked if I knew how to use it ( which I did ) gave me another booklet about diet, and that was it.
I have gone the patient advocacy a couple of times in the 3 years I have been getting care at this VA because of doctors not giving me the care I need. At other times I have gone through my psychologist ( PTSD) in order to force other doctors to do what they should be doing. But now you can't even use that route because of the in fighting at the hospital.
Dennis
I have gone with my friend to many of his appointments ( going in the exam room with him) and also have had my own experiences with my doctors at this VA that do not care about what is going on with their patients. And even with a doctor that does care a lot of the time that hospital panel doesn't care what your doctor says about medications that you need.
The pharmacy at the VA does not work anything like what you said. when you need to get a medication filled you pick up a number and see which ever pharmacist happens to call your number. At that point they tell you how to take/use a medication and you then wait for your name to be displayed on a board to pick up your medication. they DO NOT go over anything else.
I was just diagnosed with diabetes myself and it was only after reading the insert for my medication that talked about having to be sure and test my glucose that I called in to my primary care doctor did I get a meter ( after 2 months) and see a dietician because my doctor forgot to schedule that part after my diagnoses. I have seen no other doctor for my diabetes nor have any been scheduled.
Then even seeing the dietician was a joke. The appointment only lasted about 5 minutes. He gave me a booklet on diet and told me to keep my glucose between 70 and 120 and keep my meals at 40g of carbohydrates. Everything I have read on-line has said that I should have been given both before meal and after meal glucose levels and that I should start with about a 70g level for diet to start with and adjust it as needed according to how my glucose does.
As for a nurse I see which ever nurse happens to call me prior to seeing my primary care. The last time I saw my primary care a saw a nurse that definitely doesn't know about diabetics. It was at this appointment when I finally got my meter so she knew I was diabetic. It was only after dismissing me to wait to see my primary care that she remembered that she was suppose to check my feet. She was also the nurse that gave me my meter. She asked if I knew how to use it ( which I did ) gave me another booklet about diet, and that was it.
I have gone the patient advocacy a couple of times in the 3 years I have been getting care at this VA because of doctors not giving me the care I need. At other times I have gone through my psychologist ( PTSD) in order to force other doctors to do what they should be doing. But now you can't even use that route because of the in fighting at the hospital.
Dennis
It is relatively easy at the VA to switch to a different primary care physician without prejudice. It requires a written request.
That being said at the VA a patient with diabetes has two physicians, plus a nurse (usually a nurse-practicioner) specializing in diabetes control. Then they assign a dietician.
When the primary care physician prescribes Metformin, before issuing the prescription the patient is assigned to a pharmacist, who explains that nausea is one of the side effects. Then the pharmacist goes over the hand-out on the drug, item by item. When the drug is issues the VA provides a hand-out on Metformin, and in that handout in large letters is the sentence concerning nausea.
They also have programs to explain diets, medications and to help the individual patient manage diabetes in every hospital. As a matter of fact, the VA model for evaluating and treating diabetics is the best of any hospital I know (and I know about three dozen intimately). The primary care physician and the endochronologist. All are involved in the care of a patient. Contrary to what I hear on the discussion boards I have never met a VA physician or nurse who doesn't care about or who is not intensely interested in the well being of a patient. They may exist, but I haven't met them.
I frankly do not believe the hearsay about "the doctor at the VA not caring or refusing to consider another medication".
Metformin should be taken with food, of course.
The VA prescribed Glyburide, Metformin, and Lantus without problems, however on ocasion may authorize other medications upon consideration by a hospital panel.
That being said at the VA a patient with diabetes has two physicians, plus a nurse (usually a nurse-practicioner) specializing in diabetes control. Then they assign a dietician.
When the primary care physician prescribes Metformin, before issuing the prescription the patient is assigned to a pharmacist, who explains that nausea is one of the side effects. Then the pharmacist goes over the hand-out on the drug, item by item. When the drug is issues the VA provides a hand-out on Metformin, and in that handout in large letters is the sentence concerning nausea.
They also have programs to explain diets, medications and to help the individual patient manage diabetes in every hospital. As a matter of fact, the VA model for evaluating and treating diabetics is the best of any hospital I know (and I know about three dozen intimately). The primary care physician and the endochronologist. All are involved in the care of a patient. Contrary to what I hear on the discussion boards I have never met a VA physician or nurse who doesn't care about or who is not intensely interested in the well being of a patient. They may exist, but I haven't met them.
I frankly do not believe the hearsay about "the doctor at the VA not caring or refusing to consider another medication".
Metformin should be taken with food, of course.
The VA prescribed Glyburide, Metformin, and Lantus without problems, however on ocasion may authorize other medications upon consideration by a hospital panel.
Why stick with a doctor who has no interest in ones well being? Has your friend considered discussing changing doctors with a patient representative/advocate? I got this from a VA discussion board, "Just go to the Administration section of the Hospital/clinic or the Pt represenative and tell them you want a new doctor.."
Your friend needs to educate himself on these other oral diabetes medications then discuss them with his "new" doctor. http://www.mayoclinic.com/health/diabetes-treatment/DA00089 Also, the likelihood of injectable insulin might be considered appropriate along with the new oral medication to help lower his 300 mg/dl levels.
Your friend needs to educate himself on these other oral diabetes medications then discuss them with his "new" doctor. http://www.mayoclinic.com/health/diabetes-treatment/DA00089 Also, the likelihood of injectable insulin might be considered appropriate along with the new oral medication to help lower his 300 mg/dl levels.
He has contacted his doctor many times about this over the last year or so.. But so far they ( the VA ) are refusing to switch his medication.
Dennis
Dennis
"He is wondering if any other diabetics have had this problem with the metformin?"
Yes, one nasty side effect of Metformin is nausea. He should have been aware of this from reading the pharmaceutical paperwork that accompanied the Metformin bottle, or by his Pharmacist. Keep in mind, not everyone can tolerate the same medications. What he needs to do is notify his doctor asap as there are other oral diabetes medications that can be Rx'd.
Yes, one nasty side effect of Metformin is nausea. He should have been aware of this from reading the pharmaceutical paperwork that accompanied the Metformin bottle, or by his Pharmacist. Keep in mind, not everyone can tolerate the same medications. What he needs to do is notify his doctor asap as there are other oral diabetes medications that can be Rx'd.
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