Newly diagnosed, Should I start taking Metformin?

NoCrbs4Me said:

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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JoKalsbeek said:

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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Sapien said:

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.

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Bluetit1802 said:

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 said:

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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