Nausea from Diabetic Gastroparesis or from Metformin? (daily basis, x-ray, blood)

[rlrl]

Does anyone have experience with gastroparesis?

In early 2007 my a1c was 6.0 so i was put on 500 mg of metformin. In the spring of 2008 my a1c went down to 5.6. at the end of 2008 my a1c rase a bit to 5.9, and i was taken off metformin

in early 2010 my aic went up to 6.3 so i was put back on metformin this time to 1000 mg. when i had to serve jury duty for a few weeks and my schedule became disrupted i noticed i was very lethargic and sluggish. in may 2010 my a1c went up to 6.7 so i was added amaryl.

in sept 2010 they discharged amaryl (possible weight gain) and increased the metformin to 2000 mg

my a1c has decreased to 6.3 and i just had another a1c test yesterday.

recently i have been complaining about nausea attacks at work. they either come on when i am asked to do something in addition to whatever else i am already doing (which is too much anyway!) OR in response to nothing in particular

the nausea gets so bad and accompanied by heart palpitations, dry mouth, weakness, occasionally dry heaves (but never actual vomiting) and a feeling of difficulty precisely where the nausea is coming from (stomach or upper esophageal area)

occasionally it is precipitated by a hypoglycemic feeling of intense hunger, shakiness, then it reverses itself and the hunger quickly reverses to nausea

attacks are certainly not on a daily basis (one last week only) and once the nausea lifts i seem to feel really good, in fact have plenty of energy and spirit thereafter

in fact, i have actually found that eating a meal actually combats the nausea so that's a good thing

some have told me to cut up the metformin into quarters and take 500 mg at breakfast, 500 at lunch and 1000 at dinner when i'm at home relaxed. i have been doing that and it seems to help slightly

yesterday i had follow up with my GI doctor (he wants me to have a liver biopsy soon because i have fatty liver) and i discussed the nausea attacks with him.

my GI doctor does not think the metformin is causing the nausea. he thinks it could be diabetic gastroparesis but he's not certain and did tell me about tests that could confirm it. could also be a blockage of some kind. he was of the opinion that all these years of walking around in a pre-diabetic state (sugars in the high 80's/low 90's for the past 16-17 years) could be doing it

my primary care doctor by contrast thinks the metformin IS causing it and is of the opinion that with a1c's as low as mine gastroparesis is not likely

i notice i am not nearly as hungry when i eat as i used to be and have lost 13 pounds since the year started which is great.

again not sure if this is gastroparesis or just appetite reduction from the metformin

any experience with gastroparesis from anyone?

[Cavaturaccioli]

Go off the metformin for a few days and have a gastric emptying study. If your gastric emptying half-time is much over 110 minutes, you're paresis is not secondary to metformin.

[rlrl]

you swallow a pill and have a little computer around your neck?

[Cavaturaccioli]

Originally Posted by rlrl

you swallow a pill and have a little computer around your neck?

There's a nuclear medicine test. You eat a couple of scrambled eggs with a couple of drops of a radioactive substance (not toxic and a very small amount; you'd get much, much more radiation from a chest x-ray) called Technetium-99m Sulphur Colloid. Then you spend about an hour or so under a gamma camera (which detects the radiation, it doesn't emit any.) They do a time-activity curve over the region of the stomach to compute how long it takes for your stomach to empty itself of half its contents.
I've done this test a hundred times, on infants in the first month of life (but with baby formula, not eggs of course) as well as adult patients. It's boring, but no big deal otherwise.

[rlrl]

a hospital outpt procedure for insurance?

[rainroosty]

Listen to your doctor and don't listen to stupid advice telling you to not take your Metformin. Not taking it will hurt you.
I am a diabetic and I almost died from it. Now I am doing great. Get your bloodwork done often and do as the doctor says.....and eat and drink correctly! I do.
DM me anytime....the advice here is not accurate all the time.

[Oildog]

I just had this test for the same reason as the OP. They gave me a persciption, but I need to take it 3x a day and before I eat. Missed for a day or so then vomiting (sometimes from the other end as well) came back.

Test was boring-eat a cup of eggs, lay on scan table for 90 minutes, trying to be still.

[sholomar]

I developed gastroparesis, I always assumed it was from some food poisoning I got, but I recently caught prediabetes in myself after having 'normal' fasting glucose levels in the 90's the last 3 years at the annual health screening. I can tolerate moderate amounts of carbs, say 75-100 grams when mixed with proteins and fats and stay under 140 mg/dl completely, (at 30 minutes, one hour, two hours, etc) but if I eat much more then that after one sitting I'll get higher. I measured myself at 250mg/dl after thanksgiving dinner. That's when I first found out I had it. I tested my a1c and it was 5.7, but this was already a week or two into low carbing with salads and keeping my levels under 120 mg/dl. I've always been one to eat one or two large meals a day, with a lot of carbohydrates, so I have no doubt I must have been sending my sugars into 200's, if only for an hour or so, quite a bit. Thing is, gastroparesis was my only real symptom.

So now strict blood sugar control is in order, I will not let my sugars rise above 140 mg/dl period. Hopefully combined with alpha lipolic acid, evening primose oil, and vitamin C, I can see some reveral in this horrible disorder I would never wish on anybody.

In my opinion anybody with fasting levels in the 90's needs to test themselves after they eat. I have not been satisfied at all with the medical industry when it comes to diseases like this and the anxiety that goes along with it. It's like they don't take you seriously or trivialize the illness, or they go with the most obvious things as causes and won't dig deeper until you force it on them, even with excellent insurance. They are too quick to just prescribe drugs and send you on your way. When it comes to healing a broken leg doctors do fine, but it's no surprise so many chronic diseases like cancer are not caught until way later. Doctors are too quick to diagnose the obvious or easy answer. I do understand though there's no easy treatment for gastroparesis... it could be argued that there is no cure..