
March 22, 2001
Pills for Diabetes
Question from Champlin, Minnesota, USA:
I was diagnosed at the age of 29 with type 1 diabetes, and had gestational diabetes with both children. At the time of diagnosis, I was “skin and bones” and continuing to lose weight. My fasting blood sugar was 680 mg/dl [37.8 mmol/L]. The doctors first tried oral agents which didn’t help. I was hospitalized after two days and put on insulin. My control has been horrible for the past 4 to 5 years, and my most recent hemoglobin A1c was 10.5%. I am starting to have some loss of sensation in my feet. I just found a new doctor (an endocrinologist) who wants to put me on metformin along with my insulin regimen. Research appears to show that metformin is contraindicated in type 1 diabetes. Should I be concerned? Is it possible that I was misdiagnosed originally and actually have type 2 diabetes?
Answer:
The strategy for using metformin is aimed at improving your response to the insulin you take without having you gain a lot of weight. When it is used in patients with type 1 diabetes, it is not meant to be a primary treatment. Rather, it is meant to supplement your insulin therapy. Sounds like you have type 1 diabetes with a genetic component of type 2 diabetes. This makes it more difficult for you to respond to the insulin you need. It is not an uncommon strategy.
JTL