metformin concerns - newly diagnosed

rickydoo · May 14, 2021

Hi - I just got diagnosed this week and I am so glad to have found this forum! I would be grateful if you guys would be able to look at my blood sugar levels and advise me on my new medication.

I am concerned about my 500 mg Metformin for several reasons. I just started taking it 4 days ago but I am unsure if my blood sugar is dropping too quickly. I feel weak sometimes throughout the day and I am worried about next Monday because my doctor told me to start taking two 500 mg doses a day. Thankfully there are no other side effects.

I am including my blood sugar during the last four days below:

May 11th 11:09 AM:
156 mg/dL (in the morning before food)

May 11th 4:46 PM:
151 mg/dL (after 2 meals)

May 12th 9:46 AM:
147 mg/dL (in the morning before food)

May 12th 8:56 PM:
143 mg/dL (after 2 meals)

May 13th 5:24 AM:
123 mg/dL (woke up feeling strange had some orange juice)

May 13th 12:00 PM:
136 mg/dL (when I woke up before food)

May 13th 7:57 PM:
109 mg/dL (after 2 meals and some snacks)

Thank you!

Goonergal · May 14, 2021

Hi @rickydoo and welcome!

Have you changed what you eat?

Metformin alone is usually not enough to cause significant drops in blood glucose. Rather it works by increasing insulin sensitivity by reducing the amount of glucose the liver deposits into the blood stream.

None of those readings are especially low (or especially high!) the 109 is equivalent to 6.1 in the units used in the UK and the 123 that prompted the orange juice is 6.8. Neither of those are close to hypo territory (4 in mmols or 72 in your units). And if metformin is your only diabetes medication then having a true hypo is extremely unlikely, so I’d wager that the weak feeling might be due to hunger or a ‘false’ hypo where the body is adjusting to lower blood sugars and wouldn’t recommend using orange juice to overcome them.

It’s normal for blood glucose to be higher in the morning than for the rest of the day - have a read up on dawn phenomenon.

Finally, as you read around the forum, this tool may help you to see your own readings in context as most people here will be measuring in mmol rather than mg/dl

https://www.diabetes.co.uk/blood-sugar-converter.html

EllieM · May 14, 2021

Welcome to the forums @rickydoo . As @Goonergal said, your readings don't look particularly low or high, so if you are getting hypo symptoms it's more likely to be a false hypo rather than a genuine one, which is pretty common in people who have been used to higher blood sugars than normal for a while. As your levels normalise, you should find that the false hypos stop.

As regards the blood sugar measurements, to convert mmol/L (used by many on the forum) to mg/dL (your units) you either use Goonergal's link or if you're good at mental arithmetic, you can multiply or divide by 18.

Metformin really isn't supposed to cause hypos though I have very occasionally read a thread on here from someone who complains that they do.

rickydoo · May 14, 2021

EllieM said:
Welcome to the forums @rickydoo . As @Goonergal said, your readings don't look particularly low or high, so if you are getting hypo symptoms it's more likely to be a false hypo rather than a genuine one, which is pretty common in people who have been used to higher blood sugars than normal for a while. As your levels normalise, you should find that the false hypos stop.

As regards the blood sugar measurements, to convert mmol/L (used by many on the forum) to mg/dL (your units) you either use Goonergal's link or if you're good at mental arithmetic, you can multiply or divide by 18.

Metformin really isn't supposed to cause hypos though I have very occasionally read a thread on here from someone who complains that they do.

Thanks for this! Yes, I started eating less carbohydrates. Do you think I should still double dose on Monday, even though I’m already within my doctors blood glucose range?

rickydoo · May 14, 2021

EllieM said:
Welcome to the forums @rickydoo . As @Goonergal said, your readings don't look particularly low or high, so if you are getting hypo symptoms it's more likely to be a false hypo rather than a genuine one, which is pretty common in people who have been used to higher blood sugars than normal for a while. As your levels normalise, you should find that the false hypos stop.

As regards the blood sugar measurements, to convert mmol/L (used by many on the forum) to mg/dL (your units) you either use Goonergal's link or if you're good at mental arithmetic, you can multiply or divide by 18.

Metformin really isn't supposed to cause hypos though I have very occasionally read a thread on here from someone who complains that they do.

Thank you for your help! Not sure what it was, but it happened twice. Felt somewhat weak and sleepy, then had a bit of orange juice and felt better within half an hour.

ziggy_w · May 14, 2021

rickydoo said:
Thanks for this! Yes, I started eating less carbohydrates. Do you think I should still double dose on Monday, even though I’m already within my doctors blood glucose range?

Hi @rickydoo and welcome to the forum.

First of all congrats on your progress so far. Things are looking very good so far, so really well done. (I agree with the other posters that what you are experiencing are probably "false hypos," i.e. readings are lower than what your body has been used to. It may take your body a little while (maybe a week or two) to get used to this and no longer send out signals that levels are too low. However, if you give in and treat these lower levels (which are by the way nowhere close to real hypo territory) with orange juice or similar, this might prolong the time until your body adjusts.

As to your question of whether to increase metformin (as suggested by your doctor) -- why not give them a call, discuss your readings and see what they think?

Just as an aside -- while we can and do discuss pro and cons as well as side effects of different medications on this forum, we aren't allowed to make outright recommendations (as per forum rules).

Again, welcome to the forum.

Daibell · May 14, 2021

Hi and welcome. Metformin never has that much effect on blood sugar and each increase in dosage has a smaller effect so i wouldn't expect any problem with following your docs advice.

Alli g · May 19, 2021

Thanx for letting me join it it's to day I got told by doctor I'm diabetic

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