Is this normal?

[Kamadeva]

Hi all.
I recieved my official T2 diagnosis two weeks ago. HbA1c of 104 mmol/mol, which if the calculator I used can be believed is equivalent to around d 16 mmol/l on a finger-prick test. Pretty sky high. The nurse was _very_ keen to get me on Metformin ASAP.

From the first blood test, I thought a diagnosis was looking likely, so I switched to a low carb diet (aiming for 30g of total carbohydrate per day - sometimes I exceed this a bit). By the time I saw the nurse (one week on low carb) my first fasting finger-prick test was 11.2. The next two days were 8.6 and 8.4 just on diet alone. I started the Metformin and over the following three days I had 7.3, 6.9 and 6.4 - the Metformin was brining me into target range. Woo-hoo, good times.

However, ever since (the last 7 days) my fasting finger-prick results have gone back up. They range from 7.3 to 8.2. I'm aware of the morning affect and I've taken all these tests at roughly the same time in the morning after 12 hours with no food.

I thought I was doing so well but it's a bit disheartening to see this rebound. I've tolerated Metformin well and ramped up to the prescribed dose quickly (by day two of taking it). I should probably contact the nurse to see if I need to take more but thought I'd check to see if this is normal before bothering them.

Any thoughts?

 

[Mark Rawlinson]

Hi all.
I recieved my official T2 diagnosis two weeks ago. HbA1c of 104 mmol/mol, which if the calculator I used can be believed is equivalent to around d 16 mmol/l on a finger-prick test. Pretty sky high. The nurse was _very_ keen to get me on Metformin ASAP.

From the first blood test, I thought a diagnosis was looking likely, so I switched to a low carb diet (aiming for 30g of total carbohydrate per day - sometimes I exceed this a bit). By the time I saw the nurse (one week on low carb) my first fasting finger-prick test was 11.2. The next two days were 8.6 and 8.4 just on diet alone. I started the Metformin and over the following three days I had 7.3, 6.9 and 6.4 - the Metformin was brining me into target range. Woo-hoo, good times.

However, ever since (the last 7 days) my fasting finger-prick results have gone back up. They range from 7.3 to 8.2. I'm aware of the morning affect and I've taken all these tests at roughly the same time in the morning after 12 hours with no food.

I thought I was doing so well but it's a bit disheartening to see this rebound. I've tolerated Metformin well and ramped up to the prescribed dose quickly (by day two of taking it). I should probably contact the nurse to see if I need to take more but thought I'd check to see if this is normal before bothering them.

Any thoughts?

See what the nurse has to say about going high dose so fast on metformin first
morning results can be all over the place at times (well mine are even now)
otherwise well done indeed

 

[Rachox]

Hi @Kamadeva and welcome to the forum. Congratulations on tackling your diagnosis head on and on your progress so far. Many members find that their morning fasting test is the last to settle down completely. Can I suggest you take your morning test at a more consistent time, preferably immediately after waking, before you even get out of bed? You are then comparing like with like.
We can’t recommend changing your dose of meds, this is something you need to discuss with your nurse.

 

[Resurgam]

@Kamadeva The low carb diet is more likely to have reduced your blood glucose levels than the Metformin.
I could not tolerate the medication and stopped taking the tablets.
After that I found that relying on diet alone really helped me to stick to low carb, and I went from HbA1c of 91 to 41 in 6 months.
Your higher fasting levels could be due to your poor hysterical pancreas finally getting some rest from high blood glucose and beginning to release less insulin, allowing your liver to begin to release stored glucose.

When I was checking my own levels I did the tests 2 hours after eating to see if my meals were what I could cope with. Once I was under 8mmol/l after eating things began to normalise with increased energy and reducing waistline being the most significant for me. I never did a fasting test as it was not something I could change.

 

[KennyA]

Welcome to the forum. You've made a good start.

I gave up on "fasting" tests fairly quickly as it wasn't really providing any useful info. Those levels are governed entirely by your liver and it can take months for your liver to adjust to the changes in what you're eating, plus the met. Having said that, the medical opinion - according to Bilous and Donnelly- is that metformin has only a limited impact on liver function and none at all on carb/glucose in your food.

The tests I regularly did (and do) are the "test immediately before eating/ test at +2 hrs" for food.

 

[helenb1979]

Hi @Kamadeva and welcome to the forum. Congratulations on tackling your diagnosis head on and on your progress so far. Many members find that their morning fasting test is the last to settle down completely. Can I suggest you take your morning test at a more consistent time, preferably immediately after waking, before you even get out of bed? You are then comparing like with like.
We can’t recommend changing your dose of meds, this is something you need to discuss with your nurse.

Great advice. I do this . My test is the first thing I do every morning.My concern about reading your post was the large dose of metaform so quickly.

 

[Daibell]

Be aware of the possibility of being Late Onset T1 and not T2. Mis-diagnosis is common. If your BS keeps going up then question this with the GP. There are tablets to help along the way. Note that Metformin helps BS but not by that much.