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[IP] Facilitating Weight Loss using Glucophage??



Have been a happy pumper for the past 5 weeks now.  Before pumping and
carb counting i was injecting ~100 units per day (Regular & NPH).  Even
though i was going to the gym 2-4x week for close to 2 years i was
unable to lose any weight, and in fact put on 10 pounds during that
time.  Considering my previous regimen, i was in very good control
albeit all of the associated high/low spikes.  However, i was getting
dillusional about the fact that regardless of how much i exercised, i
could not lose ANY weight.  As of January, in preparation of the pump,
my CDE taught me to count carbs and dose using Humalog & NPH combo along
with trasitioning away from the food pyramid guidelines and into a carb
per meal plan.  Although the transition during the first 2 weeks were
very tough on me (clinical food depression), everything seems fine and
normal to me now.

That initial training brought down my daily insulin dosages down to ~80
units a day, and currently on the pump i am infusing about ~75 daily.
Since then the weight loss has been phenominal!  11 pounds in 5 weeks
alone.  Along with rationing my carbs, i have abandoned my gym routine
and instead take 5 mile (90 minute) hikes in my local state park.
Through this weight loss my Insulin:carb ratio has changed somewhat;
peviously it was 1:6 at breakfast, 1:8 all other times.  As of now i
still need the 1:6 in the a.m. but have lowered it to 1:10 for all other
meals, however my basal needs have gone up by about 2 units/ 24 hour
period.

At my latest Endo appt., she recommended maybe using Metformin to help
lose more weight since it helps in reducing insulin resistance, thus
lowering overall needs.  I scoffed at the idea because the whole reason
i got the pump was to level out my readings (it has!) and the thought of
going onto unpredictable Type 2 meds seemed to be counterintuive to that
goal.

Fast forward to tonight.  While perusing through Bernstein's book, this
very topic comes up.  On the topic of insulin resistance he say that
although the body's use of insulin for lowering blood glucose is
inhibited by being overweight, and thus resistant, insulin's affect on
metabolizing glucose into fat is NOT!  This was a big-time revelation to
me since i always thought that it was a linear relationship between its
two uses; and thus explains my recently found ease at weight loss.

Although i have lost only 11 lbs (out of 30-40 that i want), i have not
been able to lower my daily insulin needs below about 75 per day;
(~50/50 basal:bolus).  The use of Metformin might actually have some use
to me after-all.  So now i am at a point, where IF i see myself leveling
off in terms of weight loss i will seriously consider its use in order
to help me reduce my overall resistance, and thus lower my daily
needs...and thus lose even more weight!..what a viscious cycle, no?  :)

Questions:
Does this regimen make sense IF & when i see the need to pursue it
further?
Are there any pumpers out there currently using such a regimen
(successfully)?
Are the associated gastro-intestinal problems very severe across the
board?  Do they level off after prolonged use?
Does the Metformin spike like Humalog/Regular/NPH?
Or does it act as a blanket dosage throughout the day
(Lente/Ultralente)?


Thanks to all!

Harry


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