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Wine and Metformin?

Question:
I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? One report I came across (below) seems to indicate that as long as I have normal kidney and liver function that a little wine is highly unlikely to cause these problems. So, in the real world in which we live, do we have any T2's on glucophage having a little wine with their evening meal and very much alive to laugh about it or, as noted above, is it combination so deadly that no one dare's risk it? (If you are not alive I'd really rather not hear about it.) Any input GREATLY appreciated. Oh, I take 1000 to 1500mg daily. quoting from http://www.medsafe.govt.nz/Profs/PUarticles/5.htm Contraindicated in marked renal disease Ninety percent of metformin is excreted unchanged by the kidneys and lactic acidosis typically occurs in patients with renal insufficiency.2 Significant renal impairment (serum creatinine 0.16 mmol/L) is a contraindication to the use of metformin, and mild renal disease increases the risk of lactic acidosis. Metformin is also contraindicated in chronic hepatic disease because of the increased risk of metformin-associated lactic acidosis. Patients with diabetes frequently have abnormal liver function tests secondary to fatty liver which in itself is not a contraindication. Other contraindications include conditions associated with hypoxia (e.g. recent myocardial infarction, cardiac failure, pulmonary disease and surgery3) and alcoholism. Not recommended in pre & post-operative period Other risk factors for metformin-associated lactic acidosis include sepsis, high dosage, increasing age, and dehydration.4 In situations predisposing to dehydration such as fasting for surgery or contrast radiography, metformin should be ceased at least 48 hours prior to the procedure (or on admission for an emergency procedure), and not restarted until the patient has fully recovered and is eating and drinking normally. The glucose levels of patients in catabolic states, e.h. sepsis or in the post-operative period, should be monitored. Short-term insulin therapy is strongly advised.
Answers:
<JimT2~linkpage.org wrote in message news:3ec67236.95293655~news.earthlink.net... I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? <snip My old Endo. told me not to drink. Not ever! So that's what I did. But I've been seeing more and more studies showing that red wine is good for you, and some people had posted about finding lower morning fasting numbers when they had some wine before bed. Since high morning fastings are my problem, I decided to try it. I started with 1 oz. at a time. Upped it to 1 1/2 oz. and finally 2 oz. Got one lower number. Other than that, no change. I will probably have a little wine from time to time before bed. Probably not with dinner or with meals, unless I am using it to cook with. I haven't asked my current Endo. about alcohol. But I do know that my bottle of Glucophage always has a sticker on it saying not to take alcohol with it. -- Type 2 http://users.bestweb.net/~jbove/
Answers:
Since the metformin works by effecting how your liver processes things, and your liver is what processes the alcohol, it probably isn't a good idea. The warnings are there because during the trials, there were problems. Not a risk I would decide to take. JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? One report I came across (below) seems to indicate that as long as I have normal kidney and liver function that a little wine is highly unlikely to cause these problems. So, in the real world in which we live, do we have any T2's on glucophage having a little wine with their evening meal and very much alive to laugh about it or, as noted above, is it combination so deadly that no one dare's risk it? (If you are not alive I'd really rather not hear about it.) Any input GREATLY appreciated. Oh, I take 1000 to 1500mg daily. quoting from http://www.medsafe.govt.nz/Profs/PUarticles/5.htm Contraindicated in marked renal disease Ninety percent of metformin is excreted unchanged by the kidneys and lactic acidosis typically occurs in patients with renal insufficiency.2 Significant renal impairment (serum creatinine 0.16 mmol/L) is a contraindication to the use of metformin, and mild renal disease increases the risk of lactic acidosis. Metformin is also contraindicated in chronic hepatic disease because of the increased risk of metformin-associated lactic acidosis. Patients with diabetes frequently have abnormal liver function tests secondary to fatty liver which in itself is not a contraindication. Other contraindications include conditions associated with hypoxia (e.g. recent myocardial infarction, cardiac failure, pulmonary disease and surgery3) and alcoholism. Not recommended in pre & post-operative period Other risk factors for metformin-associated lactic acidosis include sepsis, high dosage, increasing age, and dehydration.4 In situations predisposing to dehydration such as fasting for surgery or contrast radiography, metformin should be ceased at least 48 hours prior to the procedure (or on admission for an emergency procedure), and not restarted until the patient has fully recovered and is eating and drinking normally. The glucose levels of patients in catabolic states, e.g. sepsis or in the post-operative period, should be monitored. Short-term insulin therapy is strongly advised.
Answers:
JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. I take metformin and try to drink 4oz of red wine daily. The prohibition of met and alcohol is for people who have hepatic insufficiency, and are therefore more prone to lactic acidosis. For those who suffer from unexplained hypos, both met and alcohol turn down the liver's ability to dump glusoce, so caution is in order. Jim -- Join us in the Diabetic-Talk Chatroom on UnderNet /server irc.undernet.org --- /join #Diabetic-Talk More info: http://www.diabetic-talk.org/
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Julie Bove <jnospambove~bestweb.net wrote: : <JimT2~linkpage.org wrote in message : news:3ec67236.95293655~news.earthlink.net... : I've just spent about an hour using Google to find old : posts about mixing a little wine (4 to 6 ounces) with : metformin and was not able to find any group discussions : here on the combination. Is this because we should take : the warnings regarding lactic acidosis as being deadly : serious and no one bends the rules? Or, I stopped : searching too soon? : <snip : My old Endo. told me not to drink. Not ever! So that's what : I did. But I've been seeing more and more studies showing : that red wine is good for you, and some people had posted : about finding lower morning fasting numbers when they had : some wine before bed. Since high morning fastings are my : problem, I decided to try it. I started with 1 oz. at a : time. Upped it to 1 1/2 oz. and finally 2 oz. Got one lower : number. Other than that, no change. I will probably have a : little wine from time to time before bed. Probably not with : dinner or with meals, unless I am using it to cook with. : I haven't asked my current Endo. about alcohol. But I do : know that my bottle of Glucophage always has a sticker on it : saying not to take alcohol with it. : -- : Type 2 http://users.bestweb.net/~jbove/ I talked to my endo about just this situation at my last visit. I wanted to have say a glass of wine a few times a week, partly because I enjoy it and partly because I had red that it helped raise HDL's . He said, the most common problem with metformin and wine is getting a flushed face. He suggested I try a half glass some time before I took my metformin. I did and no flushed face. When I take it at the same meal as the metformin (dinner) I once had the flushed face and have not had it since. He said that a glass is o problem, but they don't want to recommend "moderate" intake, as one person's moderate is another person's heavy drinking. It is a problem if there is kidney trouble, but then so is metformin. I spoke to my endo aftre I had received similar advice from my pharmacist, but more general. Wendy Baker
Answers:
JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? The small amount of alcohol you're talking about should be no problem. Alcohol suppresses the liver's ability to release glucose. Metformin does the same thing, but with alcohol there's a dose problem. You know how many tablets you're going to take, but how many ounces will you drink? It could vary. The concern is chiefly in insulin dependent diabetics who are more likely to need a liver dump in the event of hypoglycemia. Lactic acidosis is a concern when your kidneys aren't working fully and become unable to filter out enough lactic acid from your blood. The typical type 2 isn't as concerned as a type 1 about needing a liver dump for recovering from hypos. E
Answers:
On Sun, 18 May 2003 01:45:56 GMT, Eldritch <TiredofSpa_m~hotmail.com wrote: JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? The small amount of alcohol you're talking about should be no problem. Alcohol suppresses the liver's ability to release glucose. Metformin does the same thing, but with alcohol there's a dose problem. You know how many tablets you're going to take, but how many ounces will you drink? It could vary. The concern is chiefly in insulin dependent diabetics who are more likely to need a liver dump in the event of hypoglycemia. Lactic acidosis is a concern when your kidneys aren't working fully and become unable to filter out enough lactic acid from your blood. The typical type 2 isn't as concerned as a type 1 about needing a liver dump for recovering from hypos. As a type 2 with good kidneys and liver no cholesterol to worry about on metfartin I can say from experience that two glasses of good red wine certainly do me good. It helps the meal along nicely and has no detremental effect that i can detect. Last week I deliberately tested my BG after a 'good' meal [little or no carb] and found my BG to be slightly lower than expected. Also, I rarely drink any alcohol now - a decision I made and stuck to long before being dx'd - but do occasionally go to the pub. I usualy only have a couple of lagers and loose interest. My BG's have not been affected much. So what you say above seems to me to be spot on. Pete Pete - Diagnosed 20/03/03 Type II D&E + Metformin
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Doc says a glass or two no problem. I woun't tell him about the 7 martinies I had on the cruze ship. -- Waro
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Waro <waro~bellsouth.net wrote: : Doc says a glass or two no problem. I woun't tell him about : the 7 martinies I had on the cruze ship. : -- : Waro I think that's why they don't want to sy "moderate" usage is ok on the label. One persn's "moderate" is another's excess. Wendy Baker
Answers:
JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? One report I came across (below) seems to indicate that as long as I have normal kidney and liver function that a little wine is highly unlikely to cause these problems. So, in the real world in which we live, do we have any T2's on glucophage having a little wine with their evening meal and very much alive to laugh about it or, as noted above, is it combination so deadly that no one dare's risk it? (If you are not alive I'd really rather not hear about it.) Any input GREATLY appreciated. Oh, I take 1000 to 1500mg daily. quoting from http://www.medsafe.govt.nz/Profs/PUarticles/5.htm Contraindicated in marked renal disease Ninety percent of metformin is excreted unchanged by the kidneys and lactic acidosis typically occurs in patients with renal insufficiency.2 Significant renal impairment (serum creatinine 0.16 mmol/L) is a contraindication to the use of metformin, and mild renal disease increases the risk of lactic acidosis. Metformin is also contraindicated in chronic hepatic disease because of the increased risk of metformin-associated lactic acidosis. Patients with diabetes frequently have abnormal liver function tests secondary to fatty liver which in itself is not a contraindication. Other contraindications include conditions associated with hypoxia (e.g. recent myocardial infarction, cardiac failure, pulmonary disease and surgery3) and alcoholism. Not recommended in pre & post-operative period Other risk factors for metformin-associated lactic acidosis include sepsis, high dosage, increasing age, and dehydration.4 In situations predisposing to dehydration such as fasting for surgery or contrast radiography, metformin should be ceased at least 48 hours prior to the procedure (or on admission for an emergency procedure), and not restarted until the patient has fully recovered and is eating and drinking normally. The glucose levels of patients in catabolic states, e.g. sepsis or in the post-operative period, should be monitored. Short-term insulin therapy is strongly advised. The 4 to 6 oz should not be a problem. Moderation is the key. The only warning I have seen or been given warned against excessive or binge drinking while taking Metformin. BJ
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Just a brief "Thank you" to everyone for your input. It's good having others to bounce things off of so that I don't have to make every decision in isolation. My doc says a little wine is okay, but I still like to double check on her advice. On Sat, 17 May 2003 17:52:57 GMT, JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? One report I came across (below) seems to indicate that as long as I have normal kidney and liver function that a little wine is highly unlikely to cause these problems. So, in the real world in which we live, do we have any T2's on glucophage having a little wine with their evening meal and very much alive to laugh about it or, as noted above, is it combination so deadly that no one dare's risk it? (If you are not alive I'd really rather not hear about it.) Any input GREATLY appreciated. Oh, I take 1000 to 1500mg daily. quoting from http://www.medsafe.govt.nz/Profs/PUarticles/5.htm Contraindicated in marked renal disease Ninety percent of metformin is excreted unchanged by the kidneys and lactic acidosis typically occurs in patients with renal insufficiency.2 Significant renal impairment (serum creatinine 0.16 mmol/L) is a contraindication to the use of metformin, and mild renal disease increases the risk of lactic acidosis. Metformin is also contraindicated in chronic hepatic disease because of the increased risk of metformin-associated lactic acidosis. Patients with diabetes frequently have abnormal liver function tests secondary to fatty liver which in itself is not a contraindication. Other contraindications include conditions associated with hypoxia (e.g. recent myocardial infarction, cardiac failure, pulmonary disease and surgery3) and alcoholism. Not recommended in pre & post-operative period Other risk factors for metformin-associated lactic acidosis include sepsis, high dosage, increasing age, and dehydration.4 In situations predisposing to dehydration such as fasting for surgery or contrast radiography, metformin should be ceased at least 48 hours prior to the procedure (or on admission for an emergency procedure), and not restarted until the patient has fully recovered and is eating and drinking normally. The glucose levels of patients in catabolic states, e.g. sepsis or in the post-operative period, should be monitored. Short-term insulin therapy is strongly advised.
Answers:
JIM I just saw your post unfortunately i drink a lot of wine as I make the damn stuff It is probably my downfall and might even be contributing to a lot of my problems. i am on 2 x Metformin 500mg per day I just figure that i am not giving up my last vice 8 or so years ago i stopped smoking. As a result of diagnosis some 12 or so months ago i gave up my last food vices. I refuse to give up the last thing i really enjoy. Well not just yet anyway I suffer little ill effects thru it and have lost a stone in weight in about 9 months.....tho could have done better had i really tried. Sounds like my school report card!!! There may be some who will say in the long term it will affect me, right now I care little frankly, as I have given up many things I dont drink to massive excess, tho maybe more than I should You know what is sensible and what is not, thru research on here......I know I do......keep it sensible and you will be fine Bri Snail <JimT2~linkpage.org wrote in message news:3ec951cd.38739023~news.earthlink.net... Just a brief "Thank you" to everyone for your input. It's good having others to bounce things off of so that I don't have to make every decision in isolation. My doc says a little wine is okay, but I still like to double check on her advice. On Sat, 17 May 2003 17:52:57 GMT, JimT2~linkpage.org wrote: I've just spent about an hour using Google to find old posts about mixing a little wine (4 to 6 ounces) with metformin and was not able to find any group discussions here on the combination. Is this because we should take the warnings regarding lactic acidosis as being deadly serious and no one bends the rules? Or, I stopped searching too soon? One report I came across (below) seems to indicate that as long as I have normal kidney and liver function that a little wine is highly unlikely to cause these problems. So, in the real world in which we live, do we have any T2's on glucophage having a little wine with their evening meal and very much alive to laugh about it or, as noted above, is it combination so deadly that no one dare's risk it? (If you are not alive I'd really rather not hear about it.) Any input GREATLY appreciated. Oh, I take 1000 to 1500mg daily. quoting from http://www.medsafe.govt.nz/Profs/PUarticles/5.htm Contraindicated in marked renal disease Ninety percent of metformin is excreted unchanged by the kidneys and lactic acidosis typically occurs in patients with renal insufficiency.2 Significant renal impairment (serum creatinine 0.16 mmol/L) is a contraindication to the use of metformin, and mild renal disease increases the risk of lactic acidosis. Metformin is also contraindicated in chronic hepatic disease because of the increased risk of metformin-associated lactic acidosis. Patients with diabetes frequently have abnormal liver function tests secondary to fatty liver which in itself is not a contraindication. Other contraindications include conditions associated with hypoxia (e.g. recent myocardial infarction, cardiac failure, pulmonary disease and surgery3) and alcoholism. Not recommended in pre & post-operative period Other risk factors for metformin-associated lactic acidosis include sepsis, high dosage, increasing age, and dehydration.4 In situations predisposing to dehydration such as fasting for surgery or contrast radiography, metformin should be ceased at least 48 hours prior to the procedure (or on admission for an emergency procedure), and not restarted until the patient has fully recovered and is eating and drinking normally. The glucose levels of patients in catabolic states, e.g. sepsis or in the post-operative period, should be monitored. Short-term insulin therapy is strongly advised.
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I limit my beer to a case a month now, only problem I have is when I drink it all in one day and have a long dry stretch before the next month rolls around ;-) I'm not on medication though, and I gave up hard liquor last year. Seriously, it is hard to give up everything a person enjoys. I think moderation is the key. Cheri Bri Snail wrote in message ... JIM I just saw your post unfortunately i drink a lot of wine as I make the damn stuff It is probably my downfall and might even be contributing to a lot of my problems. i am on 2 x Metformin 500mg per day
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