Newly diagnosed, Should I start taking Metformin?

Sia!

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Diet only
Hi, my name is Sora, and I'm from Canada. I was diagnosed with gestational diabetes during my pregnancy on June 2018. I controlled it through exercise and diet. Unfortunately, it stayed with me and I was recently diagnosed as diabetic through Glucose Tolerance Test. However, my glocuse level is still around 4.3 for fasting, and less than 6.7 after 2 hours of having meal. I just saw an endocrinologist, she is insisting that I should start metformin. I know that I am controlling my BG through low carb diet (21 gr carbs per meal). I was wondering if there is any benefit of starting metformin now? if I can control my BG through my lifestyle, can I get to the point that I cannot control it by diet anymore? or get any diabetes complication? Thanks in advance.
 

JoKalsbeek

Expert
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5,937
Type of diabetes
I reversed my Type 2
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Diet only
Your finger prick tests look fine to me, to be honest... Did they have an HbA1c for you? Once you've had gestational diabetes you're likely to develop T2 later on, but if you're looking after your diet (low carb/high fat), I don't really see a need to start metformin already... Especially as the possible side-effects are rather heavy. As long as you don't revert back to a carb-heavy diet, I think you're doing fine as-is. If your bloodglucose starts going up, just cut more carbs. That's what I'd do, anyway... I'm no doctor though... And I'm sure others, who are more knowledgable, will chime in soon enough.

But personally... I'd say, go with your gut on this one.
 
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NoCrbs4Me

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3,700
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Other
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Vegetables
Were you low carb prior to the tolerance test? If you were, you can get a false positive result since your body is not used to carbs. Normally the doctor will tell you to go back to eating carbs for a few days prior to the test.
 
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Sia!

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Diet only
Were you low carb prior to the tolerance test? If you were, you can get a false positive result since your body is not used to carbs. Normally the doctor will tell you to go back to eating carbs for a few days prior to the test.
Thanks for the quick reply. I started not very strict low carb diet about 8 years age (after I lost my dad through diabetes) just because I was scared of getting diabetes one day. After gestational diabetes I started measuring my BG, and I found if I have 3 slices of pizza, my BG is high after 2 hours.
 

Sia!

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Diet only
Your finger prick tests look fine to me, to be honest... Did they have an HbA1c for you? Once you've had gestational diabetes you're likely to develop T2 later on, but if you're looking after your diet (low carb/high fat), I don't really see a need to start metformin already... Especially as the possible side-effects are rather heavy. As long as you don't revert back to a carb-heavy diet, I think you're doing fine as-is. If your bloodglucose starts going up, just cut more carbs. That's what I'd do, anyway... I'm no doctor though... And I'm sure others, who are more knowledgable, will chime in soon enough.

But personally... I'd say, go with your gut on this one.
Thanks, my HbA1C was 5.1, but the doctor said it's not important as I failed the Glucose Tolerance Test.
 

Rachox

Oracle
Retired Moderator
Messages
15,810
Type of diabetes
I reversed my Type 2
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Tablets (oral)
Hi Sia! and welcome to the forum. You seem to have plenty of knowledge of low carb diets and diabetes control but I’ll still post a link of useful info we give to newbies to the forum. You may find it interesting:
https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/
As for starting on any medication, any health care professional is there to advise and inform not to insist. You start meds if and when you are ready. Do your homework, as you are doing and make up your own mind.
 
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JoKalsbeek

Expert
Messages
5,937
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Thanks, my HbA1C was 5.1, but the doctor said it's not important as I failed the Glucose Tolerance Test.
That's.... Not even a prediabetic HbA1c. They loaded you with glucose and you "failed" the test, meaning you're right to be on a low carb diet to stave off the development of T2. They're just used to putting people on metformin rather than their patients being proactive and tackling their BG themselves.

You rock. Just leave it at that. ;)
Jo
 
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Sapien

Well-Known Member
Messages
140
Type of diabetes
Prediabetes
Treatment type
Diet only
Thanks, my HbA1C was 5.1, but the doctor said it's not important as I failed the Glucose Tolerance Test.

When you say you go high after eating pizza, how high is high and for how long? How high was the GTT result? Pre-diabetic or full-on diabetic?

My HbA1c was 5.0 but I had a fasting glucose just into the pre-diabetic range. I definitely have some problems with glucose regulation. After fasting test lab test, I started testing myself. To my surprise I saw spikes up to 10.0 with a lot of certain carbs. The spike usually come down relatively quickly into a normal range by two hours and with some exercise down around 4.0. I nevertheless decided to cut out or greatly reduce the portion size of those carbs.

Eating low carb has brought my self-tested fasting down from about 5.6 to 4.5 in about two months. I don’t know yet if it has helped any with improving glucose tolerance.
 

Sia!

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Diet only
When you say you go high after eating pizza, how high is high and for how long? How high was the GTT result? Pre-diabetic or full-on diabetic?

My HbA1c was 5.0 but I had a fasting glucose just into the pre-diabetic range. I definitely have some problems with glucose regulation. After fasting test lab test, I started testing myself. To my surprise I saw spikes up to 10.0 with a lot of certain carbs. The spike usually come down relatively quickly into a normal range by two hours and with some exercise down around 4.0. I nevertheless decided to cut out or greatly reduce the portion size of those carbs.

Eating low carb has brought my self-tested fasting down from about 5.6 to 4.5 in about two months. I don’t know yet if it has helped any with improving glucose tolerance.
It was 8.9, 2 hours after having pizza. I did GTT test 2ice after pregnancy, one was in pre-diabetic range, and the second one was 12.1 (at diabetic range), that's why the doctor is insisting to start taking Metformin. Do you take any medicine? or you just control it with diet?
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
As mentioned above, health care professionals are there to advise, they are not there to insist. The decision whether or not to take Metformin is yours, and yours alone.

In my opinion your HbA1c and finger prick results are good and not diabetic. If it were me I would certainly not be taking any diabetes medication. When I was diagnosed T2 in 2014 with an HbA1c of 53, Metformin was never mentioned, and hasn't been since. I was sent away for 3 months to change my lifestyle. This to me makes sense - better to save the medication route until further down the line if all else has failed. However, the decision is yours.

Apart from anything else, Metformin doesn't do very much blood sugar-wise. It has limited effect. It is more useful to the obese/overweight as it is an appetite suppressant, and it helps to a small extent with morning fasting levels as it helps reduce the amount of glucose the liver produces.
 
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Sapien

Well-Known Member
Messages
140
Type of diabetes
Prediabetes
Treatment type
Diet only
It was 8.9, 2 hours after having pizza. I did GTT test 2ice after pregnancy, one was in pre-diabetic range, and the second one was 12.1 (at diabetic range), that's why the doctor is insisting to start taking Metformin. Do you take any medicine? or you just control it with diet?

I haven’t had a lab GTT. My doctor says I don’t qualify to order one. (I will probably start looking for another doctor.) He told me that I had impaired fasting glucose and “there is no medicine for that”. (I didn’t ask about medicine and I prefer to not take medicine that isn’t necessary.) I bought a meter and started testing which food spikes my blood sugar, as well as testing the fasting BG each morning and after meal readings.

I have mostly stopped eating foods that spike my blood sugar at all. In some cases, I just eat less. (Half a cup of sweet potato instead of two cups makes quite a difference.) I had thought “healthy whole food” shouldn’t pose a problem, but the meter surprised me in some cases. In testing, I never saw above 11, but a few foods in large quantity brought me to 10 at 30 minutes and still near 8 at two hours.

After a couple months of moderate low carb (between 60 to 140 grams a day), my fasting blood sugar is down to about 4.5-4.6. The after meal rise is to not more than about 6.1 at one hour and 5.6 at two hours. My target is to lower that further.

I would suggest eating so one doesn’t exceed 7.8 at peak (likely 30 minutes to one hour except when the carbs are with lots of fat like pizza) and 6.7 at two hours. If for some reason one can’t achieve that with a change in diet, Metformin seems a reasonable option although I have no experience with it personally.
 
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Sia!

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Diet only
As mentioned above, health care professionals are there to advise, they are not there to insist. The decision whether or not to take Metformin is yours, and yours alone.

In my opinion your HbA1c and finger prick results are good and not diabetic. If it were me I would certainly not be taking any diabetes medication. When I was diagnosed T2 in 2014 with an HbA1c of 53, Metformin was never mentioned, and hasn't been since. I was sent away for 3 months to change my lifestyle. This to me makes sense - better to save the medication route until further down the line if all else has failed. However, the decision is yours.

Apart from anything else, Metformin doesn't do very much blood sugar-wise. It has limited effect. It is more useful to the obese/overweight as it is an appetite suppressant, and it helps to a small extent with morning fasting levels as it helps reduce the amount of glucose the liver produces.
I haven’t had a lab GTT. My doctor says I don’t qualify to order one. (I will probably start looking for another doctor.) He told me that I had impaired fasting glucose and “there is no medicine for that”. (I didn’t ask about medicine and I prefer to not take medicine that isn’t necessary.) I bought a meter and started testing which food spikes my blood sugar, as well as testing the fasting BG each morning and after meal readings.

I have mostly stopped eating foods that spike my blood sugar at all. In some cases, I just eat less. (Half a cup of sweet potato instead of two cups makes quite a difference.) I had thought “healthy whole food” shouldn’t pose a problem, but the meter surprised me in some cases. In testing, I never saw above 11, but a few foods in large quantity brought me to 10 at 30 minutes and still near 8 at two hours.

After a couple months of moderate low carb (between 60 to 140 grams a day), my fasting blood sugar is down to about 4.5-4.6. The after meal rise is to not more than about 6.1 at one hour and 5.6 at two hours. My target is to lower that further.

I would suggest eating so one doesn’t exceed 7.8 at peak (likely 30 minutes to one hour except when the carbs are with lots of fat like pizza) and 6.7 at two hours. If for some reason one can’t achieve that with a change in diet, Metformin seems a reasonable option although I have no experience with it personally.
Thanks for taking time and explaining the details. For sure, I'll check my BG after 1 hour to see how it varies with different meals.
 
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