Metformin...maybe needed? Honeymoon over :(

[ErniB]

I was wondering what your experiences were with Metformin - I understand it can cause some discomfort in the tummy/digestion/etc - but I've also heard of the XR version.

I'm thinking I need to have a good old chat to my DE and Endo... I've become increasingly insulin resisitant in few weeks.... THe only thing I can put it down to is that my honeymoon days are over..... :(

Normally, I have excellent control ranging between 4-8, and if it's a bad day, occaionally a 9 or 10. Recently however, I've been spending a lot more time in the double digits and it really feels so awful, especially when I've been much lower since diagnosed 18mths ago, and it's harder to control now that bubba is here.

For example, after having bubba 12wks ago, my TDD was about 40-60u... then that slowly crept up to about 80-90u.... and now, it's around 170-180u a day... A few weeks ago, I was on about 4u/hr for my basals.,.... now, I've increased that to 7.5u/hr. THat means , that by 8am, I've already had close to 50u novorapid...... I'm changing my cartridge daily as I'm going through so much insulin too.

I'm devastated :( No wonder I am struggling to lose this baby weight with all this extra insulin being needed. I'm at a point now where I'm so down about it... I'm not comfortable in my own skin anymore :( I feel like it's a bad cycle that I can't shake: carrying more weight equals insulin resistance.... yet more amounts of insulin cause more weight. It's a real struggle to get out and exercise every day, but I do try to walk with bub in the pram. It's hard, coz she just screams when she's put it in :(

Please share some advice and encouragement - I'm not usually down about it all (I just deal with it), but now it's on my mind a lot. I'm worried I'm just going to burst into tears when I see the doctor, and I don't wanna look like a loony :(

[Jen (nli)]

Erin - please do see your DE and / or endo because this seems like a very large and somewhat sudden change in insulin requirements. Given you've given birth not long before, I think it is important to get these things checked by a doctor. I know you're not asking for medical advice - I'm not in the role of moderator at the moment... just concerned reader! It has been a very long time since I left my honeymoon, and honeymoons vary considerably among people, but although things got tougher for me to maintain a low hba1c - it wasn't as dramatic as you've described.

Is it possible that your insulin has become less effective for some reason? Pump working? Definitely get it checked out. I wouldn't necessarily assume it is a honeymoon thing.

BIG HUGS. And - you know - you most certainly wouldn't be the first person to burst into tears in a doctor's office shortly after having a baby!!! I felt like taking shares out on tissues! Seriously, I had a lot of problems after giving birth and I was constantly in tears (and constantly in doctors' offices). I think those first few months after having a baby is very intense, and add to that this - you've got a lot on your plate! I think having a conversation with an endo about what is behind the high levels might help.

By the way, my little one hated prams and cots and used to scream madly when I went to take her for walks (or tried to put her in bed)... I found it quite distressing. Eventually that settled down a bit (once she was old enough to look around she really loved the pram). Baby carrier? Mind you - my little one hated the Baby Bjorn I had when little as well ... she was happiest if I was holding her, which was fine but I wish I could have given birth to an extra pair of arms, as well as the baby.

The great thing about kids is that they tend to go through phases... so what happening right now may not be a problem in a few weeks time - or at least that is what I've found.

Again, big hugs and please, do get it checked out. It sounds really difficult and I think if you can get a solution to that you'll feel more on top of things. I really just wouldn't assume it is a honeymoon thing.

[artemis]

Hi Erin, I totally agree with Jen. Go and see your DE or endo and get this sorted out. It doesn't sound 'normal' or as 'normal' as you get with T1.

As far as metformin goes, I tried it, gave it a really good trial, around 9 months, but ultimately gave it up because it wasn't making any difference that I could see to my levels. I know that others on here have had really good results. I thought it was working for a while, but in the end it didn't work well enough for meto continue with it.

I hope you get all this sorted out - and soon. Hugs from me.

[Cassie_B]

Hey Miss Erin - BIG HUGS!

I can't help you with the metaformin thing, but do just want to give you a big hug and offer support!

If you're right and the honeymoon's over, be gentle with yourself. It's a sh*te time, and for me (and for other's I've talked to) it was when the real reality of having T1 really seemed to come crashing down with extra force. Levels are hard to manage. Things aren't as easy as they were. Having diabetes really sucks! For a 'perfectionist' who was quite proud of that initial 'excellent control' I had before that stage, I found it quite hard to take and adjust to. I guess the good news is that the adjustment did happen eventually.

Please, please try not to put too much pressure on yourself to 'just deal with it' - and don't feel loony if/when you do burst into tears. My experience is that adjusting to the next level of your diabetes relationship can be really hard - emotionally, physically, psychologically - You're entitled to a good cry - it really is a lot to deal with! (And you're going through phase changes on several fronts at once too!).

I can't remember how my insulin needs changed exactly after my honeymoon period, but being just ahead of you on the bubba-having track I can definitely sympathise with you more than a little there. If it's any consolation, honeymoon-or no honeymoon you're definitely not alone! I saw my Endo the other week and (even though my levels seemed fairly messy to me, with extra hypos and random highs) he said they were some of the best he'd seen in a breastfeeding, T1 diabetic mother (and this is Michael D'Emden, so I'm thinking he's seen a fair share!). Since I didn't think my levels were that great, this makes me think that really maintaining a proper order with levels at this point is really generally very hard. I've tried to remember this since then, especially since for the last couple of days I've been yo-yo'ing from repetitive lows to persistent high-teens almost constantly. My baby weight's not going anywhere either. You're definitely not alone!

It sounds like, practically, you're on the right track and trying to do the right things where you can. Give yourself credit for that, even if things aren't working out as they 'should' - you're trying/aiming in the right place. It's proof that you are capable of managing/adjusting to things, even if your diabetes (and sometimes bubba) won't play the game at any given time. I agree with the others - go see your DE and Endo for that good old chat, maybe they can tweak something or give you some advice to help smooth things out a little.

Ultimately though, really don't be too hard on yourself if things don't go back to the way they were. I think it's natural for all of this to be weighing on your mind a lot right now - diabetes sucks, having to learn to deal with it differently sucks, having it at all sucks - give yourself the time to process and adjust to whatever phase/new stage you're stuck in/heading into and even if things are never the same as they were before, your inherently resilient nature will hopefully have you back 'just dealing with it' before too long.

It's a tough ride but at least here you're definitely not alone - Hang in there!

[abs]

I'll give my experience with Metformin...

Beforehand, I was using about 5u Novorapid for every 15g CHO - with Metformin, its down to about 4u. So its given me a 20% drop.

It doesnt give everyone tummy problems... and usually it goes away once you are used to it. I've been using it for several years now of 500mg tablet after each of the 3 main meals. Though I think I started one half a tablet to begin with whilst getting used to it.

Good luck with finding out whatever is causing you the issues.

[ErniB]

Thanks everyone... I appreciate your comments and thoughts. I was having a rough emotional day, but I've since made an appoint to see my DE on Friday morning. I don't think she'll be very happy as I haven't been recording things properly in the book, let alone entering things in accurately into my pump. It's it's tricky with bub here. I can't risk bolusing for a meal and then have that interrupted by Savvy crying.

Also I'm skipping steps in recording; and rushing things like carb counting; and eating more takeaway meals (healthier options like subway).... I've also been having a few tricky things going on with my pump (silly, unexplainable 'not primed - no delivery' alarms), so I've replaced the battery & cartridge cap as suggested by the hotline.

Hopefully, I'll just be honest with myself and my DE on Friday, and hopefully we'll be able to but things out a bit. Today has been a good day (low-normal bsls and insulin usage), so maybe I'm not drowning just yet! I'm still concerned about the massive change in insulin usage though, so I definitely have to sort something out! I read back through the Total Daily Dose thread here, and I'm crazily wayyyyyy more than many other ppl.... It just doesn't sound right!

Thanks again for listening and sending me virtual hugs!

[Topcat]

Metformin XR concurrently with other D drugs did nothing for me. Yep, I know I am not T1 but I am (supposedly) in the group that those drugs should have worked wonders for, this is the reason I commenced insulin.

Different drugs work differently in each person, the suggestion to visit DE and Endo is a really good one.

[Jen (nli)]

Great that you have an appointment with your DE on Friday Erin. Try to go in there with a clear head. You don't have to have it all under control - because if you had it all perfectly controlled - why would you need a DE?? I think it is perfectly understandable that you've had to 'speed things up' with regards to your diabetes management. I had to do this as well, and that has remained (demands of a family and working full time...). I hope your DE is able to really listen to where you are coming from and what you are finding. You might need to work out new ways of doing things, and a DE may be able to assist you with this.

Best wishes for Friday!

(Maybe ask about the pump as well? I just wonder if everything is going well with your pump given what you've written...).

[Kezza]

Erin I just want to echo Jen - I almost never keep records or enter everything into my pump correctly because I find it a right pain and it drives me crazy. Not doing that when you have a new baby to look after - be kind to yourself. You aren't wonder woman, you can't do everything. Hopefully your DE understands that.

[carolyn]

Sorry to go slighty OT for a minute but I never wrote down readings, or entered them into my pump - until after a vehicle crash (single vehicle, my fault, no injuries). Because I couldn't prove it wasn't D related - I'd tested 15 minutes before but my meter got lost in the wreck - my licence was suspended for 6 months (I got it back after 4 when I could show recorded good control) so perhaps maybe just take that few seconds to do it just in case. I imagine it could be very difficult getting around with a new baby without a drivers licence.

[Catapult]

How did you go with the DE today Erin?

BTW I started metformin as a trial some years ago and it has worked fantastically. From 130 units protophane to 70 units protophane in one week! Total Lantus is now 27 units a day. No tummy problems, have had the plain 1000mg and the XR version too, no difference.

Cat.

[saints8]

When I first started taking metformin, I had to be very careful to ensure I took it with food, otherwise I'd feel very sick. But have no problems at all with it now.

If your baby isn't cooperating with a pram, could you consider walking on a treadmill at home? Getting some exercise is very important to my 'emotional well being', even more so when feeling stressed or under pressure. And exercise also helps to keep my insulin requirements down. However I'll admit that it does sometimes introduce an extra element to consider when trying to control my levels.

Trial and error ...... I strongly believe that if things aren't working, try something new.

[Torie]

I was really reluctant to start metformin too - for fear of upset stomach. I've had no probs whatsoever but always take it with food. I'm on it primarily to ovulate, but my endo also thought I might be a bit I ailing resistant. My total daily dose has not changed markedly, but my pump settings have so it is down overall, as is my hba1c. I couldn't be certain it's directly related to the metformin because of so many other changes I also made.

Good luck!

[ErniB]

Thanks for all your reponses! I've just had a super busy and emotional week, so I haven't been able to really jump on RC that often this week.

So, I saw my DE last week - she too is concerned about how much my insulin needs have gone up. I cried about how I'm struggling to lose this extra baby weight, even though i'm exclusively breast feeding, and all my other b'feeding friends were back to their pre-preg weight (or less!) in only a few weeks after having thier babies, but I'm 13wks post preg and still 8kgs over :'( :'( I also cried about the stupid cycle that diabetes and insulin is: use more insulin, harder to lose weight, need more insulin etc etc.... She suggested I see my GP to get a referral to the Endo I was seeing publicly during pregnancy, who has now got his own private practice.

My DE hasn't made any changes to my rates really (a slight reduction around luchtime, as I was dropping under 5 before lunch, which I don't really mind). She's overall extremely happy with my levels etc, but is surprised and a little concerned about how much insulin this is taking to get there. By 8am in the morning, I have already about 50u of novorapid in my basal rate - no bolus yet at all! She also set me up for an appointment with yet another dietitian - this will be my 4th or 5th one since being Dx 18mths ago - not one of them have really been useful = they've not seen a problem with my food intake; or they tell me to eat more carbs (um, no thanks); or they tell me to eat less fruit and more dairy (which I can't now = dairy free and egg free due to Savvy's inflammation in her gut, intolerance to the cow's milk protein in all the dairy (plus egg) I consume, which then I feed through to her)....I've also seen dietitians to teach me to carb-count - they were useless too, so I ended up teaching myself. So, as you can see, I am not very interested in seeing another dietitian, that I can't really afford in the first place...sorry, I'm rambling...

Went and saw my GP and I expressed my concerns about the insulin usage (granted he knows next to nothing about D, and he openly admits that, but wrote the *indefinite* referral to see my Endo), but he also explained an analogy to me "if you were on blood pressure medicine, and you reduced that because it was more than what your friend was using, and you had a stroke, you would really be kicking yourself, right?". So basically he just explained that the amount of insulin i'm using is obviously the amount i need, and if i'm to reduce that too much then I will run into problems sooner or later.... This did made me feel a little bit better, but I will certainly be bringing it to the attention of my Endo when I see him, hopefully soon!

Thanks again for your concerns and kind words - hopefully it all gets sorted out soon.

[abs]

for once, a clever GP in my eyes !! (I'm up around your insulin intake, so I fully understand - also with an a1c in the 5's)

[ErniB]

Thanks abs - I feel slightly more human now! I'm still a little concerned about the amount I'm using, but I'm going to see my Endo soon... hopefully he has some tips!

[Jos]

ErniB:

I have two kids - my little boy is nearly 4 and my daughter has just turned 1. With both of them, it was not until (a) I stopped breastfeeding and (b) they stopped waking up through the night, that I lost the baby weight and my insulin requirements returned to something close to pre-pregnancy levels (so basically within the last month or so for bubs no 2). My theory is that the stress hormones caused by constantly interrupted sleep plus the breastfeeding hormones basically messed up my whole endocronological system until both those elements were gone. It can get pretty depressing being stuck inside with them or in crazy shopping centres and I found a bit of fresh air really made me feel better - even if just 15-20 minutes. Zoe hates the pram still, but is getting better. I found she was happier in the pram if I took her first thing in the morning (after that first breastfeed), if you can handle getting dressed to go outside at that hour. It does get better and easier, I promise. Good luck!

Jos
Medical advice removed. Please stick to personal experiences only. Thanks, Kait (on behalf of mods)

[ErniB]

Sooo in a weird twist of events, it seems as though my basal needs have reduced dramatically over the past few days...like, almost half. I'm not doing anything out of the ordinary really, except I've been dairy free for about a week; and bub must be having a bit of a growth spurt as she's been feeding a little bit more. I've been just about hypoing before every meal, so i've been suspending my pump several times a day for the past few days, as well as setting up temp basals - but I decided this evening to actually reduce the basals overall.

I'm putting this down to a change in my hormones - perhaps things are settling down a bit more since I had bub (15wks tmrw). At this stage, and I don't want to jinx myself, all i can say is YAY!