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After Normalizing BG, Should Metformin Dosage Decrease?

Discussion in 'Metformin/Biguanides' started by maxell, Jan 1, 2010.

  1. maxell

    maxell · Member

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    I've been largely successful in normalizing my BG through diet, exercise, and Metformin. Since 6/2009, when I was diagnosed with T2 diabetes, I started taking 1,000mg of Metfrmin under the care of a general practioner. Since November, I started seeing an endocrinologist and we increased the dose to 1,500mg.

    Meantime, I seem to have largely stabilized my BG: my HbA1c fell from 8.4% to 6.4% (no result yet from my test a few days ago but I know it will be in the low 5s). My premeal BG is around 5.3-5.6 and my postprandials are 6.1-6.7. I would like to lower these numbers (especially the premeal) to the extent possible, but I think I've largely "normalized" my BG. My fasting BG is around 4.8.

    I eat low carb (about 60g net carbs) and exercise 2-3x a week (burn 750 calories each time), and am moderately active. I've lost about 35 pounds in 2 months and am now within the normal biomass index range. All of my metabolic and lipid panels show normal levels.

    Having achieved all this, shouldn't my Merformin dosage go down? I must have been insulin-resistant prior to my diagnosis (fasting BG of 11.7 and frequent breaches of 14). It seems I am reasonably insulin-sensitive as long as I diet. In 11/2009, my endo asked me to increase my dose to 2,000mg. I tried but couldn't because of gastric distress. We compromised at 1,500mg but I'm not sure if this reflects my new conditions.

    Now, one curveball with my T2 diabetes is that my C-Peptide is low-normal. It's not out of the normal range but is pretty close to the lower-bound number. In fact, this seems to raise some questions about my T2 status, since most T2s produce high insulin. But what does this indicate regarding Metformin? It seems, then, that trying to increase insulin-sensitivity may be a viable treatment option since I produce little insulin. I'm trying to make sense out of what my endo is telling me to do here.
     
  2. sugarless sue

    sugarless sue · Master

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    I would discuss this with your Endocrinologist.

    If you think that you can keep your numbers down by reducing the Metformin then you should discuss this with the Endo then maybe try a reduced dose for a month and see what happens.

    If your numbers go up then you may need the dosage you are on already. If you can hold good blood sugar readings on the reduced dose then you may be able to come off Metformin and control your BG levels by diet only.

    Only time, and trial and error, will tell.
     
  3. greyposter

    greyposter Type 2 · Well-Known Member

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    Time and trial is a good way for me.I've stopped taking Metformin (1x500,three times a da)My fast test was 5.6 this morning/6.1 after breakfast.
     
  4. viviennem

    viviennem Type 2 · Well-Known Member

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    I too take 1 x 500, 3 times a day. I've lost about 65lbs weight since diagnosis, and my BG levels are almost always within the normal range.

    I tolerate the Met well, and as I refuse to take statins I shall hang on to the Met as long as possible. It gives some protection against stroke/CVD, and recent research indicates protection against some types of cancer too. Also I still have weight to lose (about the same again :( ), and I do think it helps me restrain my appetite.

    Hope this helps

    Viv 8)
     
  5. Sid Bonkers

    Sid Bonkers Type 2 · Well-Known Member

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    It may be worth just taking even one a day as that way you will still get free prescriptions, unless you are exempt for other reasons :thumbup:

    Also as Viv says they are useful for guarding against other problems, they are generally considered to be beneficial.
     
  6. paragliderpete

    paragliderpete · Well-Known Member

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    Hi You will find that you can normalise your blood glucose levels by diet, i.e we reduce our carb intake to balance with the amount of carbohydrate that our body can cope with. This means that we can normalise our fasting , random and hba1c levels.
    Unfortunately you will probably find that your tolerence to glucose has not reduced, and associated with this your insulin resistance.

    I've been in this situation for about 18 months, everything appears to be normalised until I do an oral glucose tolerence test. I find that this has not improved at all. this seems to be area that identifies us as diabetic , and thus cannot reverse our condition. There does however seem to be a mid point where someone can become fully normal again. Ive not been able to find any indication of how long this is likely to take, and feel that anyone who can be cured , would have to be careful with thier diet, in order to prevent a recurance at some time in the future
    Apart from the benefits that others have highlighted with Metformin, I'm sure that you will also find that it is helping to keep your blood sugars under control.
    I hope you are one of the lucky ones who can be cured, we all live in hope. I think it's what keeps me going
     
  7. carty

    carty Type 2 · Well-Known Member

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    Hi I cut my met from 1000mg x2 to 1 per day in consultation with GP to help me to gain weight but my HbA1c went up from 47 to 60 so I have gone back to 2 per day I will have another HbA next month but according to my own BG testing I should be back to near my previous readings Hope this helps
    CAROL
     
  8. greyposter

    greyposter Type 2 · Well-Known Member

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    Re: After Normalising BG, Should Metaformin Dosage Decrease?

    My prescriptions are free due to age as well.I've been asked to go for further tests ie fasting blood and early morning urine.In the meantime I'll play safe and take my metformin.
    Thanks for the guidance.
     
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