Dr. Keith Roach DEAR DR. ROACH: My blood sugar level is around 150 mg/dL on average without medication.
With metformin, I have diarrhea 24 hours a day. I am 82 and very active. I walk about six miles a day on average.
I tried to tell my doctor about the severity of my problem, and with a smile, he said, “Metformin can do that.” I insisted on a replacement medicine, and he prescribed Trulicity. The cost was terribly high.
The first three months was realistic, then I went into the donut hole. Should people like me just suffer the consequences of high blood sugar? — R.C.
ANSWER: Your doctor did not treat you well, and I’m sorry about that. Metformin is the most commonly used first-line treatment for Type 2 diabetes. It is inexpensive and effective, and it reduces the risk of diabetes complications better than other agents.
However, it often causes diarrhea, which can be reduced by lowering the dose or using a long-acting formulation. Taking metformin with food also reduces the nausea and diarrhea that often accompanies it. If you haven’t tried those strategies, please do.
Unfortunately, some people still can’t tolerate it despite trying these common strategies. There are many other options, and although dulaglutide (Trulicity) is a very reasonable treatment, it’s not a good choice if you can’t afford it. Your insurance company very likely has a preferred oral treatment for Type 2 diabetes that should be both effective and affordable.
Your doctor or pharmacist sho.