Will Metformin work for me? Why won't my doctor won't prescribe it?I'm a 24 year old female. I had a blood test done recently and my insulin level was higher than normal. My LDL cholesterol and sodium were also borderline high. I love food especially carbs. Sometimes I will eat a whole tub of ice cream or a whole pizza. I also eat at least 10-15 candy bars a week. I also get no exercise whatsoever. My weight is normal though, I'm 5'0 & 102 lbs. My doctor says I'm insulin resistant and pre diabetic. I have a strong family history of diabetes. Both my parents have it even though they're in great shape and skinny but like me, they have a bad diet, and are physically sedentary. I know the treatment for insulin resistance is Metformin but my doctor will not prescribe it to me because my BMI is normal. My blood sugar levels are normal too. But I'm worried about getting early diabetes and thats whats going to happen to me if I don't do anything about it. Would Metformin work for me?
Helpful answer below
-FLYBOY
If your blood sugar level is normal, medication will do nothing for you. What you have to do is change your eating habits. and start to exercise.
I know it will be hard to do this but if you want to stay well you have to do it.
-emucompboy
If you're worried about diabetes, stop eating junk food, and take a 15-minute walk immediately after breakfast. It's better to control your diabetes without drugs. If you lose your health coverage for any reason, you won't be able to buy new health coverage with diabetes on your record.
-john e russo md facm faafp
Metformin hydrochloride does not reduce insulin resistance. Your question should be whether or not you should be started on a medication at this time. I do not use terms such as pre-diabetic or borderline diabetic as I believe that these terms miss the point entirely. There is an approximately 10 year lead in time of damage to multiple organ systems before the glucose becomes elevated. The loss of insulin producing or beta cells in the pancreas is the most often discussed but the problem is far more pervasive. Pancreatic alpha cells do not 'sense' circulating blood glucose correctly. The liver does not store glucose properly. Glucagon levels are altered which may cause the liver to release glucose. Insulin resistance most expecially is muscle cells is seen as you have alluded to. Incretins in the gastrointestinal tract do not function properly. There are further flaws but I think this will give you an idea that there is a lot going on in your system. I do not know if your physician measured a C-Peptide or an insulin level but if either is elevated it suggests that you are a type 2 diabetic. Early on type 2 diabetics may not require pharmacologic intervention. This is because taking medications may drop the glucose too low. Also even if medications are utilized they will not work as well unless you work with them. This means a change in diet and daily exercise. I tend to sub-type type 2 diabetes as 2A and 2B. 2A is a type 2 diabetic with a body mass index less than 25 kg/M2 which is your case. 2B is a type 2 diabetic with a body mass index above 30 kg/M2. Although 2As and 2Bs share similar flaws they tend to be biased in different directions as to which flaws pre-dominate. When pharmacologic intervention becomes necessary I prefer to start 2As on insulin and skip oral medications. For 2Bs I typically begin with metformin hydrochloride, add pioglitazone (Actos) when necessary, and finally add sitagliptin phosphate (Januvia) when necessary after which I add basal insulin and finally bolus insulin as required. Would metformin work for you? Without knowing your fasting glucose, post-prandial (after meal) glucose, and your 90 day mean (average) glucose it is not possible to say whether or not you require pharmacologic intervention. If you do there are many treatment options as suggested above. Whether or not pharmacologic intervention is required a change in diet with the addition of exercise would appear to be essential. The younger the age at diagnosis the longer a person will be exposed to the negative health consequences of diabetes. I hope that you will take this very seriously and not simply expect that a pill will compensate for a poor lifestyle. Even when well controlled diabetes remains a progressive disorder. I wish you the very best of health and may God bless.
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