That was a long time and a lot of doctors ago. Perhaps he did, I don’t remember. We thought it was necessary at the time.
Yes. I had forgotten about that. I went on Metformin ER at the end there. It did help. For a while.
I still have weird digestive problems that nobody seems to be able to figure out.
All I know is that my chronic diarrhea started shortly after I started on Metformin, and continues off and on, to this day. But I took it for a long time.
My advice,( which is worth exactly what you’re paying for it), is to discuss it thoroughly with your doctor, and possibly give it a try to see what it does for you.
Banging the drum yet again that the scale as the goal is a set up for failure. Your goal is health and function. Keeping yourself from developing diabetes is a part of that.
Goals need to be the things you have direct control of.
You control that you are eating a healthy diet in a sustainable manner, and you have verified with a qualified nutritionist that what you are doing is fine on that count. Okay maybe a few more vegetables but by description you are far better on this count than most.
You control your activity level including activity planned as exercise. You have added in brisk walking, and it sounds like you are getting at least 150 minutes a week of that. And you have mentioned some strength training too. That is seriously great.
Progression in your exercise plan will be important also. As you increase fitness what you currently do will become easier and ideally you will find ways to make it not that much easier. (Keep it below sweat level since you hate sweat. Still progress.) Walking faster? Carrying a weighted backpack, very light to start but gradually adding more? Finding a way to include stairs or inclines on your walks? Any all or other.
Weight might change. Or not. “Not” is not failing. Getting to a BMI of 25? Highly unlikely and completely not necessary to achieve success on the big goals of health and function. More likely than much weight loss is that you will lose a modest amount of visceral fat and gain a modest amount of lean body mass. If you do eventually add the weighted backpack your bone density will improve. The strength training helps with that too. The odds of becoming diabetic drop dramatically. Cancer risks drop. Heart disease risks drop. All likely more effectively than by starting metformin. You will become stronger and able move faster farther. You will become more likely to book it through an airport carrying your bag to catch a connecting flight. And to stay that fit and functional until a very short time before you die of old age.
Heh, my current fitness is good enough for that. I hate airports, and have a bad habit of booking short layovers. I’ve done a LOT of running through airports (okay, walking very briskly) while carrying my bags. My carry-on is frequently a backpack and a soft-sided bag that meets the “smaller airplane in Europe” carry-on standard, but it doesn’t have wheels, so I’m carrying both of them.
Yeah, I’ve been doing strength training for about 10 years, since recovering from a shoulder problem and having my physical therapist tell me he couldn’t keep seeing me. My goal isn’t to get stronger, it’s to maintain what I’ve got. Sadly, I’m at the age where if you don’t use it you lose it. But last time i tried (a year and a half ago) i was able to move the 100lb bags of concrete that the contractor left in the way. So my strength is okay for a 60+ lady.
And i have a lot of intermittent aerobic exercise in my schedule because of my dance hobby. But the cgm tells me that’s not quite enough to lower my blood sugar, and walking to the corner grocery and back is. So… Yeah, that’s under my control, and actionable.
You are at a functional fitness level that should be inspirational for many of our age group. Particularly impressive is the combination of activities. You are hitting all the boxes, aerobic, strength, and at least as important, the social aspect of your dance activities.
FWIW the benefit of exercise is NOT just the decrease during and immediately afterwards. It is throughout the day and week.
Also while adding more brisk walking is fantastic, I would not be very concerned about your 5.7 hgbA1c.
Among participants with HbA1c levels of 5.7% to 6.4% at baseline, 97 (9%) progressed to diabetes, 148 (13%) regressed to normoglycemia (HbA1c, <5.7%), and 207 (19%) died. Of those with IFG at baseline, 112 (8%) progressed to diabetes, 647 (44%) regressed to normoglycemia (FG, <100 mg/dL), and 236 (16%) died. Of those with baseline HbA1c levels less than 5.7%, 239 (17%) progressed to HbA1c levels of 5.7% to 6.4% and 41 (3%) developed diabetes. Of those with baseline FG levels less than 100 mg/dL, 80 (8%) progressed to IFG (FG, 100-125 mg/dL) and 26 (3%) developed diabetes.
Okay, those with prediabetes are at greater risk of developing diabetes over the next several years than those who have normal results, but they are still more likely to get better future results than they are to get worse.
Sure it is a good heads up and proactively upping your aerobic activity a bit more in response to it is good for many reasons. But as those authors state: “prediabetes may not be a robust diagnostic entity in older age.”
A study looking specifically at the arms of metformin (MET), multi component exercise (MEX), and both (MEXMET) in T2 diabetics over 60. So not prediabetes but still relevant I think.
Best results in the exercise alone group.
The MEXMET group surprisingly showed an increase in glycaemia by 6.7%, which may be explained by lifestyle choices; that is, since the participants are taking metformin to control the diabetes they expect full benefits from the medicine, without limiting other risk behaviours. Contrarily, MEX therapy diminished glycaemia by 12.3%, highlighting the clinical benefits of exercise as the best strategy for glycaemic control, minimizing the effects on an aggregate composite of macro-microvascular and nonvascular end points, similar to what is produced with an intensive pharmaceutical intervention
the results of the present study revealed very promising gains of 18% in CRF in both MEX and MEXMET groups. An interesting study [37] showed that MET decreased the peak VO2 and the ability to work, unlike exercise, which not only improved the CRF when used alone, but also cancelled the negative effects of MET in the MEXMET group. In fact, these conclusions are in line with our results, and the physiological mechanisms underlying aerobic exercise, including cardiac output and the arteriovenous oxygen difference, may explain the unchanged CRF in the MET and the improvements achieved by the MEXMET group in our intervention.
I don’t know about you, but I want a body that functions well. I’m not so concerned about my weight. I don’t ignore it entirely, but I think being able to haul my groceries up a flight and a half of stairs once a week on my own to be more important that the exact number on the scale.
If I were in your position I’d opt for more walking, and whatever other exercise you can add on to that as time goes by. I get the sweat causing rashes thing - I have the same problem. You don’t have to be sweat-drenched to exercise in a useful manner.
That can be the net result over time but Metformin doesn’t lower blood sugar directly if your blood sugar is high. If your BG is 300, for example, taking Metformin won’t bring it down; insulin will, directly.
Or, if your body’s insulin sensitivity isn’t too bad AND your own pancreas is still making insulin, then exercise will bring your BG down.
Metformin lowers BG indirectly over a period of time (i.e., lowers a1c) by:
Reducing glucose production
Metformin decreases the amount of glucose the liver produces. It does this by inhibiting the mitochondrial respiratory chain in the liver, which activates AMPK and reduces the expression of gluconeogenic enzymes.
Increasing insulin sensitivity
Metformin increases the body’s response to insulin, a natural substance that controls blood sugar. It does this by enhancing insulin sensitivity via effects on fat metabolism.
Increasing glucose utilization
Metformin increases glucose utilization in the gut. It also alters the gut microbiome.
So, you are saying that it indirectly lowers blood sugar in a way that can be helpful to people who have a working pancreas. That’s “lowering blood sugar” for a lot of people.
I’m not as put off in terms of its relevance to you by the fact that the subjects were all “early stage T2” diabetics (mean hgbA1c < 7.5) rather than with prediabetes, as by the likelihood that few of the subjects had as much exercise as you do at baseline. Although baseline activity level was not reported (unless I missed it).
The biggest ROI with exercise is with the doing the first modest amount. These people possibly going from near nothing to essentially your level of a multi component exercise plan, and seeing big health gains, does not prove that someone already engaged in a reasonable moderate multi component exercise plan will see similar gains by upping their game more.
But it is the level of evidence we’ve got. Likely adding a bit more aerobic exercise will do a better job overall than metformin will. And as also noted in the discussion, a very slight weight loss, just even a mere 1% of body mass, talking just a kilogram, can make a significant difference. The idea that someone needs to achieve a BMI of 25 or less, or that such should even be a goal, in order to see major health gains, is, I believe, counterproductive.
Of course, i recently lost 10 pounds and my blood sugar has gotten worse. (I was 190 for decades. Dropped to 175 in the pandemic. Settled back at 180 after i started socializing again.)
Getting old sucks. Or maybe it was getting covid, which can mess with your metabolism. But neither of those are actionable.
Exactly. And again prediabetes is a a fine call to action but not only may never progress, may go the other way. The actionable can be the only focus.
Question: what was the weight loss the result of?
If it was the result of a conscious effort to eat healthier and in more modest portions coupled with increased activity then your numbers getting worse still surprise me, even with Covid and age to blame.
OTOH if you’ve been stressed and losing weight? Makes lots of sense.
No reason and it just dropped? Eyebrow gets raised and would wonder about something else going on, getting thyroid checked and those things internists look for.
Well, it wasn’t an attempt to eat healthier. But i stayed home and only ate stuff we cooked. I didn’t do any social eating. We didn’t buy any junk food. The only sweets in the house were the pie i baked each week, and my pies aren’t all that sweet. And dried fruit, which i bought online. We were shopping once a month, and shopping very deliberately, without a lot of impulse purchases. And we didn’t visit people who put out cookies and stuff.
Now that I’m back to socializing, i nibble on cheese at bridge games, and on cookies at square dancing. Both after I’ve eaten dinner. And i did regain 5 pounds.
I was concerned about the weight loss, and asked my doctor (who thought i was silly to be upset about losing weight … there’s a pattern there) but my son lost the same 15 pounds for the same reason. And nothing showed up in my blood tests. And my weight has been stable again for the last two years.
Yeah then I got little by way of explanation. Maybe that 15 pounds included muscle mass and the gain has been more fat? Dunno. I’m hesitant to blame everything on Covid.
I agree. In fact, my doctor at the time I started said that eventually, my pancreas might stop making insulin and then I would have to start taking insulin. 18 years later, it hasn’t happened and even the metabolic disease seems to have abated.