Metformin

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I need some advice about this drug.

I started pilot training in 2009 weighing about 245 lbs (20% body fat) and newly diagnosed with prediabetes. My A1C was 5.9 and fasting blood glucose was 105. I was able to get my third class medical and I completed my private pilot certificate one year later. In late 2010 I learned that my A1C had risen to 6.3 which was alarming enough that my doctor put me on Metformin at 1000mg per day. He explaining that it would help prevent the onset of diabetes and help me to lose weight. He also explained that Metformin had been used in longevity studies and generally helps people to live longer.

I started the Metformin along with a low[ish] carb diet and weight/cardio program. In November of last year I weighed 200 lbs at 14% body fat. My A1c was 5.0% and fasting glucose was 80. I decided to discontinue the Metformin and see how I did with just diet and exercise alone. I just received my bloodwork a few days ago (5 months Metformin-free) and my A1C rose to 5.3% and fasting glucose rose to 85. I have also gained 10 pounds since I discontinued the Metformin.

I haven't been flying since the prediabetes diagnosis and I'd like to get back into aviation. However, I want to start taking Metformin again (for both the weight loss and longevity benefits). I'm not sure how this will affect my medical or if I need to disclose this to the FAA since I don't have diabetes.

How do I approach this subject when I eventually renew my medical?

Would the FAA approve me taking Metformin even if I don't have diabetes?

Thanks in advance for advice.
 
Dr. Bruce would be the one to answer the metformin question but my advice is to lose the weight by restricting carbs and exercising regularly.
 
Loosing weight is tough and requires commitment and life style change. Join Weight Watchers (for men if you are a guy) and stick with their program. It works! Period!

Exercising does not shed weight in most instances. It actually makes you hungry and you can eat more. Exercise is certainly important for heart health and conditioning, but as a weight loss technique .. not so much. Exercise to stay in shape, not to lose weight. Changing what and when you eat is the key. WW baby, a great way to go. ;)

As far as living longer by taking this drug, I'm calling BS. Eat right, maintain your weight, exercise, take care of yourself and you'll do the best your body was designed for. You are gonna die anyway. ;)
 
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WW works for Geico, great. But no single weight loss program works for everyone. There can be medical reasons that prevent people from using one of the commercial programs. Ask your physician 1 - is it appropriate for me and 2 - do you recommend one?

As an example of someone who cannot go this route, I'm highly allergic to sugar substitutes and certain spices. I learned to read labels long before it became fashionable.

Wait for Dr Bruce.
 
Geico is correct that exercise alone is not very effective for weight loss as most people will increase intake of calories. Exercise still has health benefits even in the absence of weight loss. The combination of diet and exercise can be very effective. Many of those who frequent this forum know that I lost over 60 lbs since October using this strategy.

Type 2 diabetes is a consequence of the fact that our bodies were not designed for continuous over-consumption of simple carbohydrates (especially sugar) and metformin only partially compensates for this. The longevity benefit for this medication would probably be limited to a few months at best.
 
I'm thinking I answered this on another board. FAA considers that "metabolic syndrome" and diabetes (type 2) are the same thing and will regard Metformin as a marker of either condition.

If you have the marker, you need a recent (<90 days) HbA1c, and a recent (<90 days) letter from your doc stating you have no office evidence of retinopathy, nephropathy, neuropathy, or known coronary disease, and have not reported hypoglycemias.

You get a special issance (any class for which you qualifiy) a year at a time which is renewed with the next 12 month's HbA1c and letter.

Some AMEs are capable of issuing this one in the office. The ones who are not, condemn you to a ~100 day wait for approval.
 
bbchien said:
The ones who are not, condemn you to a ~100 day wait for approval.
Click to expand...

Got darn lucky with my original issuance. Because of your help and guidance, I got my cert in ~45 days from the AME visit. He wasn't willing to call, but I was locked and loaded to send in everything you told me to and visited the Post Office immediately following the visit.

2nd year coming up this month. Need to get the primary doc scheduled soon.

BTW; say I can't get into the AME before month end and I show up for the exam in June. Does my current May 31 clock move forward to June 30? Or do we stick with May?
 
Mike, it'll move, but it'll return to May 31 in the end due to the end of the six year AME assisted authorization. It can move to June but in the end you get stuck with a short year= ?2016 I can't remember the dates exactly in your isusance.
 
Wow Bruce! Good memory! 2010 was the initial issuance.
 
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