Hey Folks,
So, I was diagnosed last November with a A1C of 8.3. I am 5'6" and at that time, I was 186lbs. I immediately went on the defensive and went on the low carb high fat (lchf) diet after reading Dr. Bernstien's Diabetese solution book. Completely gave up on all grains except Soybean/tofu/TVP, which in moderate amounts is good for controlling blood sugar spikes. I am vegetarian (no meat, no eggs), so I primarily eat leafy and higher fiber, non-starchy veggies, tons of salads and a lot of cheese - about 60-100g per meal.
I had always exercised, for past 9 years, running 6miles 3x a week, and I bumped it up to Interval training, trying to keep my heart rate in the 90% target range for a good part of my run. Also added weight training to my routine the days I am not running.
Overall, I lost about 40lbs and came down to 145lbs and my second test showed an A1C of 6.2, which is not ideal and I don't know why it was not lower given 95% of the readings were under 120 and when they were higher in the beginning when I was diagnosed.
The reason for setting up all the context is that when I was diagnosed, the first doctor put me on 500mg regular (non extended release) metformin. She said that she was putting me on a low dose so I don't go hypo given my exercise. Now, having researched through the last 6+ months, as I understand, Metformin has extremely low chance of getting you hypo since it only metabolizes the insulin already present in your body.
Initially, with the metformin, my readings were around 95 fasting and < 110 at 75 minutes after meals. My blood sugar is at the max at 75 minutes after eating. I know this because I have experimented at many times after eating and also in the beginning, I was spot checking myself 6-10 times a day (now a days, only twice.. fasting and 75 minutes after dinner.) Now a days, however, my blood sugar is almost always between 105-110 at fasting, although 75 minutes after eating, it is still under 110.
I know about the Dawn effect (Somogyi) today when I met my doctor (a new one), he thought that I am hitting the Dawn effect.
Anyhow, my main question for him was, given that Metformin only metabolizes the Insulin that our body naturally produces, why does everyone not start at the full maximum strength of 2000mg and he said that, one should start at that... When I asked him, why the first doctor did not do that, and he said, "she should have" and really the reason don't start with 2000mg to begin with is because it can cause gastric issues, diarrhea but that 2000mg full dose is the right dose longer term to begin with.
To cut long story short, he did the following two things:
1. Put me on Metformin Extended Release, to help counter the Somogyi effect
2. Gave me a prescription for 2000mg daily and asked me to slowly ramp up to the full dosage.
I am not opposed to taking the 2000mg if it is actually better. Just that, I am still not a 100% certain on whether 2000mg is what I should having but thought I would ask when 500mg seems to be working mostly. Any other concerns in upping the dosage that should I be aware of?
Thanks
So, I was diagnosed last November with a A1C of 8.3. I am 5'6" and at that time, I was 186lbs. I immediately went on the defensive and went on the low carb high fat (lchf) diet after reading Dr. Bernstien's Diabetese solution book. Completely gave up on all grains except Soybean/tofu/TVP, which in moderate amounts is good for controlling blood sugar spikes. I am vegetarian (no meat, no eggs), so I primarily eat leafy and higher fiber, non-starchy veggies, tons of salads and a lot of cheese - about 60-100g per meal.
I had always exercised, for past 9 years, running 6miles 3x a week, and I bumped it up to Interval training, trying to keep my heart rate in the 90% target range for a good part of my run. Also added weight training to my routine the days I am not running.
Overall, I lost about 40lbs and came down to 145lbs and my second test showed an A1C of 6.2, which is not ideal and I don't know why it was not lower given 95% of the readings were under 120 and when they were higher in the beginning when I was diagnosed.
The reason for setting up all the context is that when I was diagnosed, the first doctor put me on 500mg regular (non extended release) metformin. She said that she was putting me on a low dose so I don't go hypo given my exercise. Now, having researched through the last 6+ months, as I understand, Metformin has extremely low chance of getting you hypo since it only metabolizes the insulin already present in your body.
Initially, with the metformin, my readings were around 95 fasting and < 110 at 75 minutes after meals. My blood sugar is at the max at 75 minutes after eating. I know this because I have experimented at many times after eating and also in the beginning, I was spot checking myself 6-10 times a day (now a days, only twice.. fasting and 75 minutes after dinner.) Now a days, however, my blood sugar is almost always between 105-110 at fasting, although 75 minutes after eating, it is still under 110.
I know about the Dawn effect (Somogyi) today when I met my doctor (a new one), he thought that I am hitting the Dawn effect.
Anyhow, my main question for him was, given that Metformin only metabolizes the Insulin that our body naturally produces, why does everyone not start at the full maximum strength of 2000mg and he said that, one should start at that... When I asked him, why the first doctor did not do that, and he said, "she should have" and really the reason don't start with 2000mg to begin with is because it can cause gastric issues, diarrhea but that 2000mg full dose is the right dose longer term to begin with.
To cut long story short, he did the following two things:
1. Put me on Metformin Extended Release, to help counter the Somogyi effect
2. Gave me a prescription for 2000mg daily and asked me to slowly ramp up to the full dosage.
I am not opposed to taking the 2000mg if it is actually better. Just that, I am still not a 100% certain on whether 2000mg is what I should having but thought I would ask when 500mg seems to be working mostly. Any other concerns in upping the dosage that should I be aware of?
Thanks
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