Type 2 4.1 HBA1C and metformin

Rufous

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I was diagnosed type 2 last November with 18.5 HBA1C prescribed 500mg metformin daily and immediately moved to a low carb diet

HBA1C reduced to 4.1 in three months

12 months on and HBA1C is still 4.1 but now I struggle with sugars crashing when I exercise, should I even be on medication?
 

DCUKMod

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I was diagnosed type 2 last November with 18.5 HBA1C prescribed 500mg metformin daily and immediately moved to a low carb diet

HBA1C reduced to 4.1 in three months

12 months on and HBA1C is still 4.1 but now I struggle with sugars crashing when I exercise, should I even be on medication?

Gosh, Rufous, that's a low HbA1c. Fair play.

If you say your sugars are crashing when exercising, what does that actually mean? What do they crash to?
 

VashtiB

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Hi and welcome,

People with way more experience than me will reply shortly. However, in the mean time if you are just on metformin and a type 2 you generally don't have to worry about sugars crashing. You may be experiencing a false hypo where you body being used to higher levels throws a tantrum at more n normal levels. Metformin. will not cause true hypos.

Do you have a meter? If not you should get one and measure when you get that feeling so you know what your levels are. It is possible that you are actually not a type 2 but you would need other tests to confirm that If you have a meter and test regularly and you do have a hypo you would need to get medical attention and get other tests because that is not usual for type 2s not on medication other than metformin.

Good luck.
 
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DCUKMod

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Hi and welcome,

People with way more experience than me will reply shortly. However, in the mean time if you are just on metformin and a type 2 you generally don't have to worry about sugars crashing. You may be experiencing a false hypo where you body being used to higher levels throws a tantrum at more n normal levels. Metformin. will not cause true hypos.

Do you have a meter? If not you should get one and measure when you get that feeling so you know what your levels are. It is possible that you are actually not a type 2 but you would need other tests to confirm that If you have a meter and test regularly and you do have a hypo you would need to get medical attention and get other tests because that is not usual for type 2s not on medication other than metformin.

Good luck.

Vashti - If Rufous' A1c is 4.1, this equates to an average blood sugar reading of 3.9, as shown by the calculator on this site. https://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html :

upload_2019-12-6_21-11-58.png


Bearing in mind this is the same score as 12 months ago, false hypos may seem very much less likely.
 

EllieM

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My understanding of metformin is that it inhibits the liver's production of sugar, which is fine in a typical T2 who can't process that sugar. But if you are actually suffering from too low a blood sugar, then you've got to wonder whether that's a good idea.

@Rufous, you should discuss this with your doctor/team, since we're not allowed to advise on medication here (we are not doctors etc etc:):)).

But that's an amazing reduction in hba1c, well done.
 
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Rufous

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Gosh, Rufous, that's a low HbA1c. Fair play.

If you say your sugars are crashing when exercising, what does that actually mean? What do they crash to?

I shoot a compound bow at various archery tournaments and I now understand that my field of view and focus changes during a shoot..

I start a day fasting 5’ish before breakfast and 250mg tab, shooting last week grazing on raisins and cashews felt unwell and had a kitkat finished shooting 1hr later with 5.9 makes me think I need to carb load or skip tabs?
 

DCUKMod

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I shoot a compound bow at various archery tournaments and I now understand that my field of view and focus changes during a shoot..

I start a day fasting 5’ish before breakfast and 250mg tab, shooting last week grazing on raisins and cashews felt unwell and had a kitkat finished shooting 1hr later with 5.9 makes me think I need to carb load or skip tabs?


As a Type 2, not taking aggressive blood glucose lowering medication, medically concerning hypos are very rare. Have your medical team explained why they still have you on Metformin?
 
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Rufous

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As a Type 2, not taking aggressive blood glucose lowering medication, medically concerning hypos are very rare. Have your medical team explained why they still have you on Metformin?
Joined the forum today as just had a review this evening but the clinic nurse tells me Metformin will never cause low blood sugar and I should not be self testing, but as I tried to explain if I am starting from a low before serious exercise I will end on a low low?
 

bulkbiker

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Joined the forum today as just had a review this evening but the clinic nurse tells me Metformin will never cause low blood sugar and I should not be self testing, but as I tried to explain if I am starting from a low before serious exercise I will end on a low low?

We can't diagnose or advise on meds but ...were I in your shoes I'd ditch the pills for a week and continue monitoring and see what happens. If your bloods go up a bit then great problem solved and you can always restart the meds when you like.
Not medical advice of course just what I would be thinking about.

Edit to add with an HbA1c at that level you have plenty of wiggle room.
 

Energize

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@Rufous

My understanding is that, although not usual nor common, Metformin CAN cause SOME people to hypo.

Also, I totally agree with @bulkbiker - in that, although we can't give advice, given the information you've given, if it were me, I'd definitely consider not taking the Metformin but would also carefully monitor and see what happens. It's your body and, especially with careful monitoring, you know your body best ;)
 

VashtiB

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My apologies- DCUKMOD is correct- if you've had the same HbA1C for a year they won't be false hypos. I agree that you may want to consider asking your doctor why you are still on metformin. I agree that you know your body best and your medical team should be listening to what you are saying. If you are taking regular readings like your posts suggest have you shown them to your doctor? Actually seeing the numbers may make the doctor reconsider why you are on any medication at all. If they do consider you need medication they should be able to explain why you need it and what it is doing for you.
 
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Tophat1900

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Joined the forum today as just had a review this evening but the clinic nurse tells me Metformin will never cause low blood sugar and I should not be self testing, but as I tried to explain if I am starting from a low before serious exercise I will end on a low low?

Do Test, and in your case it sounds like testing is very important due to you potentially crashing to levels that make you feel unwell and then needing to eat sugary junk to get your levels up. Don't let anyone tell you NOT to test.

I seriously wonder why you are on metformin still.... I'd take that up with your doctor asap based on your levels.
 
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ringi

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Have you had a resent full blood count?

One reason for a low A1c (4.1%) is red blood cells not living as long as normal, if it was me I would be asking questions about what is going on. (Internal bleeding is also a possibility)

A Freestyle for 2 weeks is likely to give useful data an comfirm what your BG is doing, if its "predicted HBA1C" match the A1c then you know its not the life of your red blood cells giving a low reading.

If your BG is truly that low, I expect you are getting no benefit from the Metformin.

Your doctor not asking many questions about what is going on with such a low A1c concerns me.