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April 29, 2017

daveThe first line therapy for type 2 diabetes has long been metformin, and nowadays we are using it for patents who have prediabetes; it is also used “unofficially” by a lot of Weight Loss clinics. A lot of patients who are on metformin progress to insulin, and for many years the common practice was to stop the metformin when the patent started insulin. This never made a lot of sense to me, and when I worked in practice with some local endocrinologists we would always restart the patient on metformin as soon as we got the referral.

In the primary care office it was different and I spent many an hour convincing the prescriber to restart metformin on their insulin patients, and most every time the patient showed either an improvement in glucose levels or a lowering of insulin dose.

When it came to working with type 1’s it was a harder sell, as the common theory has been that metformin would not be of much help, but every time we added it to a type 1’s regimen we got improvement.

This week we have a large retrospective study that looks at how the use of metformin affected patients’ A1c, BMI and and insulin dose.

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We can make a difference!

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Dave Joffe

Editor-in-chief