Originally Posted by
sillywabbit
Combining insulin(whether it be pump or injection) and metformin is a common and accepted practice. Metformin's mechanism of action actually has nothing to do with lowering blood glucose levels directly. Metformin works by increasing the sensitivity of your receptors to insulin. This can actually help you lower the amount of insulin needed to achieve your glucose control.
well...yeah but
partly that is the case. metformin main action is a decrease in glucose uptake in the gut. take 2000mg metformin daily for a week...then drink gatorade while doing a serious hard ride. you will end up dehydrated and have the trots from hell after 50 miles. metformin does 3 things...helps prevent glucose hitting the blood in the first place...keeps it in the gut (and that requires water)...punches the liver to slow it's output, and increases insulin sensitivity in the cells. all great things to keep a sedentary person who doesn't wish to micro manage the diet in good bg control, but tough and unpredictable to manage for an endurance athlete. if a person were to eat mostly fats and protein they could cut some of the metformin way back.
everyone gets a different result from metformin. if it was me I would work my butt off to do whatever it takes to get off the meds, plain and simple. insulin is the only thing that is really 'clean'...but of course some type 2's have such insulin resistance they need to take huge TDD...sometimes 3 or 4 times as much as a type 1...so in those cases insulin is paired with meds.