I guess that is just surprising, exercise is treated as the de facto treatment for type 2 diabetes (along with changes in diet) but the research I’m seeing shows that exercise is about 4x less effective than the first class of meds prescribed for diabetics. I’ve heard stories of people getting their diabetes under control with lifestyle changes, is there more to it? Is it more diet than exercise that gets blood sugar under control? How do these stories I’ve heard of people getting their diabetes under control via diet and exercise work if exercise (one of the 2 components of diet & exercise) is far less effective than medication?
It’s because it’s easier to comply with metformin (take a pill once or twice a day) than with exercise (10,000 steps a day/20 minutes of aerobic exercise).
Better results are seen with metformin because more people are taking metformin as prescribed than taking exercise as prescribed.
That’s a good thing. I could never safely get more than 6 feet from the bathroom on metformin which made any form of exercising difficult. I guess I could have done free weights while sitting on the commode.
Also, it seems this is about people with Type 2 and no other issues.
Those of us with actual physical problems, which reduce the amount of exercise of the needed type and amount of exertion much more difficult toi attain.
pohjonen, there is an extended release form of metformin called, surprising enough, ‘metformin ER’, which many people don’t get diarrhea from, but it is outrageously expensive.
Still, if you have better insurance than I, you might ask your doctor about it.
I’ve taken metformin ER for the last couple of years for diabetes type 2 with no side effects at all. Fortunately as I’m English and over 65 it’s free on the NHS.
First thing I should do is explain those percentages. A .5% reduction doesn’t sound significant, but it is. A1C measures what percentage of blood hemoglobin is glycosolated, that is locked in a hemoglobin-glucose complex. So a .5% reduction means a reduction from 7% to 6.5% which is significant. And a reduction from 7% to 5.5% even more so. When I was first diagnosed, my A1C was about 8% and, after a year of using metformin, with no change in the amount of exercise I got, dropped to about 6.5%, consistent with the study reported in the OP. But metformin has an interesting side effect. I lost about 20 lb over the next two years with no changa1e in exercise or diet. A couple years after that, I started on diet and lost another 40 lb and my A1c dropped to 5.5% and stayed there. And I get less regular exercise than I did then.
When my doctor started me on metformin, he advised me to start with one 500 mg pill every other day and then, after my bowels stabilized, to take one a day for a few days and go onto the regular dose of two pills a day. I never had the least problem. YMMV.
Well first off you need to recognize that the study looking at the efficacy of metformin was not matching participants to the studies that looked at diet and exercise. Comparing those cited numbers to studies on exercise is not valid. It is not clear to me whether or not the diet/exercise and control groups were also both on metformin or not and what the average starting HgbA1cs were in each group.
You need a matched head to head to really make the comparison you are trying to make.
Second my impression is that diet/exercise is more promoted both as an adjunct to metformin and prevent prediabetics from progressing into diabetes. I really don’t know how often true diabetics are able to treat their diabetes without progressing to medication as well.
In the lprediabetes into diabetes scenario we actually do have a head to head, and diet/exercise wins.
Now one might think that both together would be even better, but diet/exercise alone seems to, if anything, work better than adding metformin to the mix in reducing the risk of prediabetes advancing to diabetes.
Of course the side effects of diet and exercise are weight loss, increased lean body mass, more strength and greater endurance, along with decreased risk of depression. That’s a pretty big list compared to just diarrhea!
(Mind you I am intrigued by metformin as an intervention with broad benefits beyond its blood sugar impacts. But that has been other threads.)
Cool.
My endocrinologist now tells me I need to treasure my Metformin ER-it is much more efficacious than she first realized. She is quite enthusiastic about it now. It used to be just for keeping the peaks and valleys under control. Weight loss, lower A1C, keeps hair on my toes :), etc.
I fortunately didn’t know about the stomach problems it might cause so to me it is just another pill. Glad to hear it is so effective.