Controlling type 2 diabetes with metformin and other medications

Many people with type 2 diabetes are prescribed tablets to help control their blood glucose levels. Metformin is the first-line medication for diabetes in the UK but there are many more types of medication for type 2 diabetes discussed below.

At first Mike took metformin but for several years now he has controlled his diabetes with diet…

Age at interview 64

Gender Male

Age at diagnosis 59

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Most people had tried initially to control their blood glucose with a regimen of diet and exercise before being given oral medication. Many people took metformin alone to control blood glucose, and some were taking metformin and gliclazide. Both medications help to reduce blood glucose but work differently. Metformin reduces the amount of glucose produced in the liver, and also makes muscle tissue absorb more glucose; gliclazide increases the amount of insulin produced by the pancreas.

Malcolm explains how the amount and strength of medication he takes has increased over the last…

Age at interview 54

Gender Male

Age at diagnosis 39

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Alex was put on metformin and gliclazide to get his blood glucose under control.

Age at interview 54

Gender Male

Age at diagnosis 51

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While people found that the medication they took had helped reduce and control their blood glucose, many had experienced side effects. Metformin can cause diarrhoea and other digestive problems and many people went back to their GPs for advice.

Helen changed her medications several times before she stopped getting side effects. She found…

Age at interview 63

Gender Female

Age at diagnosis 60

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Some people felt concerned about the risks they might face from certain drugs after reading negative reports in the media (see ‘Misunderstandings about diabetes’). Rosiglitazone has been linked to an increased risk of heart attack and stroke.

Since these interviews were conducted in 2008, there has been growing concern about the potential harmful effects of rosiglitazone (Avandia, but also contained in Avandamet and Avaglim) and from September 2010 in the UK and Europe, new prescribing of this drug has stopped, and most people who were taking the drug have been changed to alternative medication.

Andy discussed the pros and cons of Avandamet with his GP.

Age at interview 52

Gender Male

Age at diagnosis 52

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Hyacinth found that rosiglitazone didn’t suit her and asked her GP for something else.

Age at interview 63

Gender Female

Age at diagnosis 30

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Most people we interviewed had been prescribed higher dosages of medication to control their blood glucose as their diabetes got worse over time. Some people had transferred to insulin while continuing on metformin (see ‘Coping with Insulin’)

Preventive medications

People with type 2 diabetes have an increased risk of developing heart disease, a stroke and kidney disease and so may be advised to take other medicines to reduce the risk.

Many people we interviewed were also prescribed a statin preventively to reduce their blood cholesterol. Several people found this confusing, though it is standard practice for doctors to prescribe statins to people with type 2 diabetes even if their cholesterol levels are within the healthy range.

Mike questioned the need to take a statin but his doctor persuaded him.

Age at interview 64

Gender Male

Age at diagnosis 59

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Chris dislikes taking so many pills and wonders why he needs a statin when his cholesterol levels…

Age at interview 61

Gender Male

Age at diagnosis 56

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Gareth doesn’t always want to be monitored or to take so many tablets but knows he must.

Age at interview 61

Gender Male

Age at diagnosis 50

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Some people thought that that taking preventive medication such as statins might raise their insurance premiums.

He believes that being on many different medications has increased his insurance costs.

Age at interview 52

Gender Male

Age at diagnosis 38

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Many people with type 2 diabetes also take a low-dose aspirin tablet (75mg) daily but recent studies have not shown that this produces the previously expected level of protection against strokes and heart attacks.

Managing type 2 diabetes with insulin

Although many people diagnosed with type 2 diabetes will be prescribed tablets (e.g. metformin) eventually many people will be transferred to insulin. Insulin cannot cure...