#70 Metformin use in kids with Type 1 Diabetes

While preparing for the upcoming Think Like a Pancreas Book Club series that launches this summer (June 2022), I read a lot about medications (other than insulin) that are often used to manage blood sugars in both type 1 and type 2 diabetics. I noticed that most of them were meant for type 2 diabetics and all but one were only approved for use in people over the age of 18. The one exception was Metformin which is approved for use in children ages 10 and up. That got me wondering, are there any pediatric type 1 diabetics who have been prescribed metformin?? If so, why? And how is it working for them? Eventually I found today's guest, Amelia, whose 12 year old daughter was diagnosed with Polycystic Ovarian Syndrome (PCOS) at the age of 8 and Type 1 diabetes at the age of 10. Just a few months ago she was prescribed Metformin due to significant insulin resistance and was placed on a Tandem pump. Listen in as Amelia explains all about their type 1 journey and how managing diabetes is now compared to even just a month or two ago. It's pretty fascinating! Enjoy!

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Transcript

Katie: 0:00

This is episode 70 of the sugar mommas podcast. And my guest today is another kick butt type one. Mama who's 12 year old daughter. Not only takes insulin to manage her T1 D but also takes Metformin. Metformin is an oral medication. That's more commonly associated with adults with type two diabetes. The way that Metformin works is basically like this. It lowers glucose production of the liver, and it also lowers blood sugar by increasing the body's sensitivity to insulin. It also decreases the amount of glucose that our bodies absorb from the foods we eat. While I was preparing for the upcoming thing, like a pancreas book club series. I was reading the chapter that summarizes all the medications that both type one and type two diabetics can take to help manage blood sugars in addition to insulin. And I caught myself thinking. This really doesn't seem like something I need to talk about since most of my listeners are parents and caregivers of type one diabetics. And because most of these other medications are for adult type two diabetics, but just to make sure I looked them up because I wanted to see what the minimum age. Was that these meds could be prescribed at. And I found that Metformin was the only one approved for children at 10 and older. So that got me curious. I wanted to know if there were any pediatric type one diabetics out there who were actually taking Metformin. I wanted to know why they were taking it and how it was working for them. And that my friends is eventually how I found today's guest. You are really going to enjoy her mama bear attitude and her family's story. All right, let's get started. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks.

Amelia: 2:23

My name is Amelia. I have three kids, 14, 12, and 10. My 12 year old daughter is my diabetic kiddo. She was diagnosed on October 30th, 2020. It was scary. She, we were just shy of DKA. But I was an EMT before I had my kids. So a bunch of things kind of snapped together in my head and I went uh, so my aunt brought her glucometer over to my mom's house. Checked her sugar. She was sky high, hadn't eaten for six hours. So I said, okay. I called my mom, my aunt, my one of my other aunts came over and I took her straight to the emergency room. And here We are a year and a half later.

Katie: 3:04

We have similar stories. It sounds like my daughter was diagnosed in August of 2020, and she's my middle child as well. Yours is a little older, two years older than mine, but I'm curious to know, as an EMT, did you ever respond to calls for somebody that was having like a hypoglycemic event?

Amelia: 3:20

Oh, yeah. Yeah, that was, yeah. Diabetic calls were actually. I don't, I don't want to see a majority of the calls we had, but they were pretty common,

Katie: 3:29

Hm. Was it type one type two boat?

Amelia: 3:32

both, any, and all, all ages.

Katie: 3:36

Wow. Was it, was it when you would go answer the call, like when you guys would arrive on the scene, did you typically know that that was what was going on or were there times where it was missed, you know, like misdiagnosed as maybe something else? Or how did that.

Amelia: 3:50

Not really misdiagnosed, but maybe there wasn't somebody there that could tell us that the person was diabetic. A lot of times, if somebody called, if we get a nine 11 call, they would be able to tell us, you know, this person is having trouble with X, Y, Z, but with diabetics, sometimes they're not making a whole lot of sense. So. They would just tell us possible stroke possible diabetic episode if they've had that person before calling with diabetic issues. So, but if there's a family member there that can tell us, then we'll know ahead of time and they're a medic would meet us there and be able to give them an IV of glucose or. Insulin which whatever they would need to get them stable enough that we could transport them. There, if the medic was stuck somewhere like construction or something, and wasn't going to be right there with us we would raid refrigerators and pantries to find juice And peanut butter and bread. So we could, and we would put sugar in the orange juice and stir it up and give it to them if they were able to drink from a straw. And we've even, we even had places where people didn't have straws and we would cut like oxygen tubing to make them a straw so that they could get it in fast. And it's, it's really amazing how fast. Things kick in, whether it be through an Ivy or just them drinking juice, you can watch the light and not the cognitive ability returned to their faces. And. Also a lot of them, the first place we would check too, was the refrigerator because a lot of them would have they looked like red pill bottles, but it would actually be have their medical information contact information for family members and their conditions and their medications and everything right on there. So that's how well we handled those things.

Katie: 5:55

So interesting. I I've heard of some people too, like, you know, parents will call, like if their kids are having a really awful episode and then by the time the medics get there, you know, the parents have already given glucagon. So the kid has really kind of come to, were there ever any situations like that where you actually didn't even end up transporting somebody to the hospital? Because they had kind of recovered to the point where they were stable.

Amelia: 6:16

well, we give the parents the option because a lot of times they don't know why their child is. Responding or not responding the way that they should to either the glucagon or insulin. So we would give the parent the option of whether they wanted us to transport them any way to get checked out, just to be on the safe side, because especially with kids, they can, they can go downhill really, really fast and slide into seizures or just be unconscious. cause you never know how they're gonna, if they're gonna stay up or just drop straight back, down really quick. So that was up to the parents, but if they were at school or something, it was, it's pretty much an automatic. Hey, you're going to the hospital. Your parents can meet us there.

Katie: 7:02

Oh, for sure. I feel like the teachers would be like you are not, you got to go. I'm sorry. That would, they would need a minute to recover any way the teacher is gracious. Oh my gosh. Oh, okay. Well, okay. So being an EMT is not what I had Amelia on the show for today, but that's so interesting to me. And thank you for answering my questions. Just out of curiosity, do you still do that?

Amelia: 7:23

No, no. I'm a single mom on reason my kids, and I actually ended up having a severe back injury on the job. So

Katie: 7:31

Yeah. That's super physical job.

Amelia: 7:33

the mind is willing, but the body is not able anymore. but my daughter actually plans. That's what she wants to do when she grows up is that's what she wants to go to school for.

Katie: 7:43

Okay, well, that's awesome. Tell her to work hard. I know it's not easy to get into that.

Amelia: 7:47

You gotta be a special kind of person to, I mean, I'm not special. I didn't mean it that way. I just mean your brain has to be wired for it.

Katie: 7:55

Yeah, no, I totally know. You meant, like you've got to, you have to have the right attitude and mindset take on that sort of it can be traumatic, you know, and you have to be able to hear. For sure. Okay. So you already told me when your daughter was diagnosed October of 2020. We talked a little bit about her diagnosis story. Do you guys have any family history of type one diabetes or auto-immune disorders?

Amelia: 8:18

Auto-immune disorders? Yes, very much so. I have PCOS and fibromyalgia. Adley was actually diagnosed with PCLs when she was eight. She had she had a burst cyst. I have aunts with auto-immune issues. I have my dad's sister is actually blind and had to have a kidney transplant, even though her diabetes. She was right on top of it and everything, but she still ended up going blind. Both of my dad's adoptive parents. I mean, they don't count genetically, but just that this is my family is just full of it. Whether through adoption or not, they both died from complications when my dad was a child. So, but it's definitely on both sides.

Katie: 9:00

That's a strong, a strong history right there for sure. Yeah. So P well, I'll ask you a little bit this more more about this later in the show, but PCO can make you super insulin resistant, right?

Amelia: 9:11

I am very, I'm very insulin resistant. I'm on two medication, two pills plus insulin.

Katie: 9:18

Hmm. Wow. Yeah. For those that don't know, PCO S stands for polycystic ovarian syndrome. I read, I learned about that and the I've heard people say PCs a lot and. Was it just kind of like meeting, making mental notes, like go up, go look, go look up what that is. And then the author of the book think like a pancreas mentions it a couple of times. So I was like, okay. Figured that one out. Very good. Okay. So when your daughter was first diagnosed she was like, what was her insulin program? Like? was she on injections for a really long time? Is she still on injections? What's kind of the history of your insulin.

Amelia: 9:51

well, they started her off on NovoLog and Lantus pens from right from the get-go. And she was. On a sliding scale. And she started out with a ratio of one to 27 for carbs. But we quickly found out that that wasn't going to work for her. So her insulin. needs got adjusted accordingly. I had to. For a pump and do a doctor change because our last, her first endo was not, was not good. It was just, it was, it was a hard situation with her. But as soon as we got, I got her into a new endo, he went, I don't know why she's not on a pump. This is makes no sense. And he brought her right on a pump and it was absolutely amazing because she went from 0% in range to four days later being 97% in range

Katie: 10:46

That's amazing. Holy cow, what pump did she get on?

Amelia: 10:50

She's on? a tandem T slim with control IQ.

Katie: 10:55

Man that is phenomenal. I why was her other endocrinologist? So opposed to her getting on a pump, did they, he gave him give Hershey. She even give you a reason.

Amelia: 11:03

She gave me five lies. She, she told me that the insurance wouldn't allow it. Even though she had told me six months, then she can get on a pump. We hit the six months. She says, well, the insurance is not going to lie. Well, I called my insurance. They're like, no, this is not how this works. And then she told me, well, it's it's hospital policy called no, that's not hospital policy. And then she's, she just kept feeding me lines. And I finally said, you know, what, if you're not going to do what's best for my daughter, then I will find a different endocrinologist for her. And I told her I wasn't, wasn't going to be involving her in my daughter's care anymore. And I had already been calling around about finding another endocrinologist and working with our insurance. And she actually called CPS on me and told them that I was neglecting my daughter and her diabetes care. Yeah, it was absolutely last summer was hard

Katie: 12:01

I was going to ask you when that was. So it was last summer that you were dealing with all this.

Amelia: 12:05

It was, it was the end of the school year and into like the very beginning of summer. And. I S she had an in pen at that point. So all of her doses and all of her carbs and everything were recorded right on the app in my phone. So all I had to do was pull up my phone and gold book and I had, I had even asked for recommendations for anybody that might be in my area of endocrinologists in our type one moms group. And I had that for proof that I had already been looking for a new doctor for her and I, yeah, it,

Katie: 12:43

Did they look at all this, all the evidence that you presented. So they had to look at it all.

Amelia: 12:47

Yep. And my daughter even showed them her bruises because she bruises with the shots in her arms.

Katie: 12:54

So this was like meetings with social workers and attorneys and everything.

Amelia: 12:59

Social workers. Yes.

Katie: 13:01

Well, I am so sorry. That sounds horrific. I, th I bet you were terrified. I would have been terrified if somebody called,

Amelia: 13:08

I was more

Katie: 13:09

social services, mommy.

Amelia: 13:11

more angry because I knew I was doing everything that I could, and I knew that the doctor was not. Yeah. there, there are no words because I, if she did that to me, how many other parents did she do that? To the ones that dared to stand up to her? I mean, I'm, I'm my daughter's advocate. I have to.

Katie: 13:31

Yeah. Unfortunately, I feel like there's a lots and lots of people that just kind of. You know, take it for what it's worth and go, what, there you go with whatever their doctor orders. And, you know, I think as parents, we, in our gut, we know what's best for our kids. So good job mama standing up for your, for your daughter. I know that wasn't easy. My goodness gracious was how was the process of switching to a different endocrinologist? Cause I, I know for us, like. You know, we're in a really big city, but there's actually really only one option in terms of pediatric endocrinology. There's like a big specialty hospital and they have like a team of pediatric endocrinologists. So I guess we could switch within the group of endocrinologists, but I don't know me being a person who absolutely hates conflict. I feel like I wouldn't be okay with that. Like I'd need, I would just need to go to a whole new practice altogether, which for, for us, I would have to drive a good, almost two hours to get to the next. Pediatric endocrinologist. So what was that like for you? Was it easy for you to guys to find someone else.

Amelia: 14:29

Actually, no, it wasn't easy. And the first I live in the middle of nowhere, I love it, except for the lack of services. The. Endocrinologists we started with at the hospital. We started with was over two hours away. What I had originally did, endocrinologist that I had found next was down in Hershey, which is six hours away. And I was willing to drive her that far just to get away from the first endocrinologist and get her better care. But I ended up our regular doctor's office her primary. Ended up recommending a doctor. That's an hour away in New York. That's still within our system. That's in our area. Our local hospital. It's not, it's not a big hospital. It's not a children's hospital. They actually do not do pediatric endocrinology at this hospital at all. They send them down, down to where she was originally sent when she was first diagnosed and Geisinger. But he was, I can't even tell you how much I love this doctor. He, from the get go he's very, you can tell he's a kid's doctor. He's very, soft-spoken, he's very, he doesn't sugar coat, anything, but he just. He was amazing. And he sat there and he listened to me and he listened to my daughter and he asked questions. He talked to us, not at us. And he treated her with respect. And that is huge to me because she may be only be 12 years old, but she's very mature for her age. And she doesn't like being talked to like a baby. She wants, she wants somebody to talk to her. Like she's a person, not that babies aren't people, but Yeah.

Katie: 16:09

I know what you mean, and I'm so glad you found that. Considering the situation you were coming from, like. It doesn't sound like it was, you know, if like this guy didn't work out, it obviously would have been a challenge for you to find someone else considering how far away these endocrinologists are. So I'm so glad you found somebody that you, that you love.

Amelia: 16:28

Yeah. I am so thankful for that office. Just the nurses and everybody were.

Katie: 16:32

Goodness. What a mess. My goodness. Okay, so. Amelia. The reason I wanted to have a million today is she, your daughter is on Metformin. She was prescribed Metformin. I was reading through think like a pancreas, just getting prepared for this book club series that I'm getting ready to do. And it, I was on the chapter. Oh, I think it was chapter three or four, but it was listing all the diabetes medications and it was listing them all for type one and type two diabetes. And I was kind of reading through and I was like, well, I'm not. I'm not really going to talk much about, I had made the decision not to really talk much about the type two medications. Just because most of my listeners are parents and caregivers have type one diabetics. But then I was like, are, are any of these medications even. Approved for use in children, you know, like younger than the age of 18. So I just kind of briefly looked him up. And the only one that was approved for children ages 10 and up was Metformin. And I was like, well, I wonder if I, I'm just curious to know if any kids out there are actually prescribed Metformin or type one diabetics, you know, cause I know type two diabetes is, is becoming a bigger problem in children also. But I was curious to know if any type one diabetics had. Prescribed Metformin and just kind of what that looked like. So that's when I got on the Facebook group, I asked the question and Amelia was the only one that responded. So I, that just kind of tells me that it's probably rare, for Metformin to be prescribed, but so just tell us kind of, how did your endocrinologist and you guys kind of come to the decision of, Hey, maybe we should give this a try. Hey guys, it's Katie interrupting for a hot minute to tell you about a few really easy ways that you can support the show. This podcast grows primarily by word of mouth And, you know what they say sharing is caring. Well, they ain't lying in the past six months. So that would be just the first half of 2022. The podcast has had as many downloads as it did in the first year alone. That is amazing. so if you've already been sharing, thank you. It's working. If not, would you consider texting a friend, a link to an episode you really liked? Maybe talk it up at your next endocrinology appointment, or perhaps mention it over coffee. The next time you have a T one D meetup, it really does help the show. and when the show is growing, that means. I can reach and help more type one families like yours. Now, if you want to take your relationship with the show to the next level, would you consider supporting the podcast through buy me a coffee, buy me a coffee is a way for awesome listeners like you to give a one-time or monthly donation that goes towards all the things that get this show recorded. Edited hosted and published each and every week, I will leave a link in the show notes to buy me a coffee so you can find out more. Thank you so much. And now back to the show and my chat with. how did your endocrinologist and you guys kind of come to the decision of, Hey, maybe we should give this a try.

Amelia: 19:37

we were having a hard time getting her down to where she needed to be. This was while we were still waiting for her pump to get here because you know, everything takes forever when you're talking diabetes. So he said, Hey, why don't we try this? And at first I hesitated because I had actually been on it. Just before I got pregnant with her and it made me very sick. It just. I couldn't take it. And I was afraid because she's so much like me. I was afraid that it would hurt her, her but we finally, he said, look, if she shows any signs of it, messing with her stomach, messing with anything, making her feel sick, he said, stop giving it to her and give me a call. It did end up making her sick but. That's not everybody. And he said, okay, we have another option, which I never knew about. There is a slow release Metformin and that has been the Trek, I guess the other one just kicks in too hard, too heavily at right away. But this one has, has done the trick. She's doing really well on.

Katie: 20:44

Yeah. So are they both, both the types that she had tried? They were, they were oral medications. Right? You take them by mouth.

Amelia: 20:52

Yes there a pill.

Katie: 20:54

It's just like a once a day pill or, okay. Okay. And I, you know what, I, I knew this I'm going to have to go back and look at my official notes, but. I meant to say, what Metformin does. Do you know, off the top of your head, how it helps.

Amelia: 21:12

The short, the short answer to that is it helps your body be more sensitive to the insulin. So you don't require as much. That's where with type two diabetics, it, it helps make your body, the insulin, your body is making be more effective.

Katie: 21:31

Okay. That's that's perfect. Okay. So the slow release worked really well. I mean, was it immediate, did it take a little bit of time for it to like build up in her system? Or did you guys see a big difference? Like the next.

Amelia: 21:43

Yeah, no, it works pretty quick, but it, it takes a few days to build up in your system to become fully, fully effective. But yeah, no, the next day I could tell because. I didn't have to give her nearly as much insulin as I had been.

Katie: 21:59

Wow. That's that's crazy. Yeah. So you, you said that she, I guess got nauseous with the first one and this one did not have any side effects, but I just wanted people. I was going to read the side effects of Metformin. Of course, you know, whenever you're listening to commercials and they start to list off the side effects, there's like a million things. They're not coming. They're not common in everybody, but they can happen, but nausea, vomiting, stomach upset, diarrhea, weakness, or metallic taste in the mouth. So other than just the getting sick, did she have any of anything else like that?

Amelia: 22:30

She had the stomach pain. I don't, I don't think she had, she didn't mention anything about the metallic taste or anything like that. I know. It just generally made her feel like she had a stomach bug and it made her, made her a.

Katie: 22:43

Did her diagnosis of PCO S play a role you think, and just her, you know, her numbers just not wanting to come down. Cause I know that can make you really insulin resistant.

Amelia: 22:53

I absolutely believe that has everything to do with it just because of how my body is. And knowing how I react to things. It's, it's very frustrating when you have something that you've dealt with your whole life. And now you're watching your daughter go through it and you can't fix it. I mean, it's something I'm used to, but I'm just glad that her doctor knew about the slow release Metformin, because I didn't, I knew nothing about it. I didn't know what existed. And I'm just very thankful that he did know about it and that she's on it. And it's making things so much better for.

Katie: 23:26

Did you ask him, like, does he prescribe that to, you know, a lot of his pediatric patients or was that something that was pretty rare?

Amelia: 23:34

I don't think it was as common. I think that he, if I remember correctly, he had actually called up to Rochester to the big hospital up there and talked to a couple of colleagues to see what they thought. Because they, you know, he. Doesn't work in a huge place. So they in they're in a teaching hospital, a big teaching hospital where they're getting the newest information and everything all the time. So he was definitely being very proactive in her care.

Katie: 24:01

that's great. I love it. I mean, I, do you know anybody else, any other, type one kids that are taking Metformin? I don't.

Amelia: 24:08

In our mommy group, their act. Oh, I think there might be at least one other one in our mommy group, because I know Ashley's not the only one that's insulin resistant. Cause I know there's a couple of other moms, but I think there might be one other one, but otherwise, no, I don't.

Katie: 24:24

Okay. Yeah, I don't either. I think it's, but it's so interesting to me, you know, there's, it's like, you know, all w for most of us just are like, well, insulins it, you know, that's, that's our only option. But if you're seeing a lot of insulin resistance in your kid, there could be something else going on. That's causing insulin resistance and maybe some other medications that could help with that I, for a while. And I'm still. Questioning it, but Sarah is only 10, my daughter and she just seems. When I listened to other people talk about how much insulin they give their children that are, you know, same age as Sarah, kind of the same, like body weight. I just feel like Sarah's on so much insulin in her insulin to carb ratios are like insane to me. Like her breakfast ratio is one to seven. That's that just seems like so much insulin for a ten-year-old girl. That's tiny, you know what I mean? But, but she needs it and that's okay. You know, it's, it's it's I sh I definitely don't feel shame about the fact that she needs that much insulin, because again, it's just what her body needs and that's what works for her, but it is like Crazy difference to me when I hear other people talk about the amount of insulin their kids take. So I kind of have had in the back of my head of like, maybe she's maybe she's insulin resistant. But then another thought is she only will wear her Omni pods on her thighs right now. And she's super muscular. Especially in her thighs, she's got really muscular thighs. And so I just feel like the absorption of the insulin is not great there. And I do feel like it just takes more to kind of get into her system. So there's that.

Amelia: 25:53

Yeah, Adam won't wear her pumps site, her infusion sites anywhere, but her stuff. I can't get her to. And you were talking about your daughter's ratio is, was one to seven. When, just before she went on the pump, she was one to three and she was taking 93 units of Tresiba a day.

Katie: 26:13

Are you serious? I've never. Well that's okay. You win. That's way more.

Amelia: 26:18

Oh, no, I wasn't trying to compare it. I was just, I was agreeing with you that it's crazy how much some kids need.

Katie: 26:26

Oh yeah, no, I know you weren't, we weren't trying to compete, but I'm just like, yeah. To put it in perspective, like Sarah was on I want to say like maybe 15 units of Tresiba when we had to take our most, when we took our most recent pump break, we went back to Tresiba for a little while and that's, I think that's where we landed. But wow, 93 units. That, that is a lot. That is, I bet the endocrinologist to. I guess we'll just keep going up.

Amelia: 26:50

Yeah. Yeah. He didn't. That's why. That's another one of the reasons why he wanted to try her entree or on Metformin. Because he was worried about the amount of insulin she was taking because it's not sustainable. It's just, it's hard on their little bodies, but Yeah. it, and I know, I know there was another kiddo in our group where the mom was. Upset because her son is taking so much insulin, but it does. She said she felt like it was water because it wasn't working. And I said, Hey, my daughter is on just about the same amount your child is. And that made her feel a little bit better because even though this is something that we can control, we as moms, we still feel. Why can't I fix this?

Katie: 27:36

Right, right. And I hope you don't think my reaction was like, oh my gosh, you know what I mean? It's just, it's not a bad thing. It's just what they need. And it's just surprise, you know, you hear all these moms who have like, you know, oh, my kids ratio is one to 40 and I'm like, what? Okay. I know. Right. It's just, you know, surprising when you hear that, how much of a difference there can be between children of the same age or similar age. So I'm just curious, and I know it doesn't translate because, you know, pumps don't, you don't, you're not using the long acting anymore. You're using the basal rate, but now that she's on you know, the Metformin and she's on an insulin pump, do her Bazell rates, are they still really high or is, and you don't have to tell me numbers, but I'm just curious to know. Does it seem like she needs less insulin overall? I'm assuming? Yes,

Amelia: 28:24

Yeah, I have to change her cartridges every day because she still goes through quite a bit. But that's increasingly getting smaller little bit by little bit because she was actually recently put on again, I didn't know. It was a thing until I was told it was a thing. So she's on cumulative. You are 500

Katie: 28:45

Oh, you are 500. Okay.

Amelia: 28:46

in her pump and that has taken it up a notch. it's made her insulin needs less.

Katie: 28:54

That's good. Yeah, I think I'm not, I'm no certified diabetes educator, but I, I just went from what I read, I think like with you 500, I think so the, the insulin that's in Sarah's pump is you 100, which I'm assuming is probably what your daughter started out on. But so if you like taking one unit of you, 500 would be, I think the same thing as taking like five units of you, 100, right? It's just five times more. Okay. I didn't even know. You could put concentrated insulin into a tandem pump.

Amelia: 29:26

It's working good

Katie: 29:27

Okay. Don't don't tell the tandem people.

Amelia: 29:33

did either, but it's, it works.

Katie: 29:36

Okay. I won't tell anybody except for everybody listening to this podcast. Hey, if it, if it works at work, so that's great. I know I was, when I was reading the. Omnipod manual. I do remember that, that they were like, you can only use. You 100 insulin in this pump and it can only be, I think, NovoLog and Humalog, which, I mean, I know there's people out there that use fiasco and other things with their Omnipod pump. So yeah, if, I don't know, I guess if you have questions about, Hey, could we give this a try? You could talk to your endocrinologist, maybe there's, things that work that aren't necessarily listed out in the pump handbook. So think outside the box a little bit.

Amelia: 30:14

I kind of wondered with those things too, if they didn't have kind of like a, I don't want to say sponsoring contract or something with, with insulin companies or I don't know that thought had crossed my mind cause I was going well, why can you only use these two different kinds of insulin? They're all liquid.

Katie: 30:33

right. Yeah. Good question. And I don't know the answer to that, but that is a good, good thought. I bet you. on track with something there. Let's see. Yeah. Okay. So I think that's all the questions I had for you about Metformin. Did I miss anything? Like, is there anything else you think would be interesting for listeners to know?

Amelia: 30:51

Gosh, I don't know? Not that I can really think of.

Katie: 30:55

Okay.

Amelia: 30:55

I just, I mean, just ask their doctor if, if their child is having issues with getting in range. Not going to hurt anything to ask their doctor about it. I mean, what's the worst that they're going to tell, you know,

Katie: 31:09

right.

Amelia: 31:09

just always, always advocate for your child. Use your mommy. Got we have them for a reason.

Katie: 31:15

Yep. And I, I think this is going to be really helpful to listeners because I bet you there's somebody out there listening. That's going, oh my gosh, they're describing my kid. Like my kid is so insulin resistant. So I think this will be helpful for some people to know, like, okay, I'm going to ask my doctor about this and see what they say.

Amelia: 31:30

She actually went from when she went on her pump, her A1C was nine. No, it was 10.1, I think. And now she's down to seven, month

Katie: 31:48

Oh my gosh. That's amazing.

Amelia: 31:50

of being on the pump and with the Metformin.

Katie: 31:52

You know what I, well, I was assuming it was last summer. Cause you said that's when you were kind of dealing with all this, but when did she officially get on the pump and then get on Metformin?

Amelia: 32:01

April,

Katie: 32:01

Oh, of this year.

Amelia: 32:02

she was on the Metformin before she was on the pump, but the two, the two together would be in April.

Katie: 32:09

Okay. So really recently, just a couple, just a month or so ago.

Amelia: 32:12

Yeah, that's just the two together. She's been on Metformin for probably five months.

Katie: 32:17

Oh my gosh. In her A1C dropped three points in one month. That's crazy. That's awesome. Okay. Well, thank you so much, Amelia. Thank you for taking time out of your day. Thank you for taking time, especially when your kids are home and not feeling well. I know that's a huge sacrifice, so hopefully I didn't stress you out too much.

Amelia: 32:35

Oh, no, not, are you kidding me? No, this is like a vacation.

Katie: 32:39

Right. We talk in, what else can we talk about? Just even when we're done recording, just tell your kids like close the door and just anytime they knock, be like, I'm still recording, you know, you can just you know, lie, lie to them, tell them that you're still on the podcast recording.

Amelia: 32:55

Well, I had thought about going in the downstairs bathroom and shutting the door, but then I'm going to just going to be banging on the door. I can't, are you kidding me?

Katie: 33:04

I know, all right. Well thank you so much. Thank you again. Have a great day.

Amelia: 33:08

Yeah, no problem. Thank you.

Katie: 33:10

You're welcome. Bye.

Amelia: 33:11

Bye

Katie: 33:15

That's it for our episode today. I hope you guys enjoyed that conversation with Amelia personally. I thought it was fascinating to hear about her daughter's experience with insulin resistance and how they landed not only on Metformin, but also with a completely new Indo team. Hey, you gotta do what you gotta do to get your kids the right treatment. All right guys, as always, thank you so much for listening and until next week, stay calm and bolus on.