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on Metformin but HbA1C has increased

RollerGirl

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I have been taking Metformin now for around 4-5 months, and my recent HbA1C came back as 9.8, and increase, from the previous 8.9, and 8.7 before that. When I was first diagnosed Type 2 earlier this year, I was losing weight, eating healthy and exercising, hence the 8.7 readings. However the last 4-5 months, I have not been eating well and have gained weight.

My fasting glucose levels last week were 12.8 on waking, which of course is very high. I have since taken this all very seriously, and am trying hard to eat better and have started exercising again (just brisk walking). The last few days they have come down to 10.5. I wanted to hear from anyone else, who is in the early days of using Metformin and if they have had to increase the dose, or start taking other medications.

I am px 500mg x 2 morning and night

Thanks
RG
 
Hi RollerGirl and welcome to the forum :) When I started Metformin I had no problems at all with my levels and the dosage didn't need changing. I take 2 x 500 and I hardly ever feel hungry. I suggest you go back to your doctor/DN about this. I am sure that other members will come along and share their experiences with you.

Here is some basic information that we give to new members - I hope this info will be useful to you. Ask as many questions as you like as there is usually someone who has an answer.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS


Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
RollerGirl said:
I have been taking Metformin now for around 4-5 months, and my recent HbA1C came back as 9.8, and increase, from the previous 8.9, and 8.7 before that. When I was first diagnosed Type 2 earlier this year, I was losing weight, eating healthy and exercising, hence the 8.7 readings. However the last 4-5 months, I have not been eating well and have gained weight.

Hi RollerGirl,

Sorry to sound negative, but (from what you have written) the increase in HbA1C is probably down to the fact that "[you] have not been eating well and gained weight" in the last 4-5 months.

Metformin is great, but it only takes your BG levels down by a point or so. It isn't a magic bullet that means that you can not eat well and still get good results. Even on insulin you have to moderate your diet to some extent. I'm not aware of any diabetics that get good results and are able to eat whatever they want.

Look at the positive side, you started to see results before, and you can do it again. Once you start to get those readings down, the feeling of well-being that you'll achieve will be reward enough in itself.

Good luck!

Stephen
 
I Have been on Meformin for a year 1x 500mg twice a day and my results have gone up so they have increased to 1x 1000mg, and 1 x 500mg a day. So far my levels testing have gone down great in the day. But still feeling the new effects of the increase with stomach issues. The good thing is i dont want to eat at all, but that can make you go to low. So will watch.
 
I lost weight upon diagnosis. I had been gradually loosing weight before but then the "cant eat anything ever again" panic set in after dx and about a month later I had another Hba1c which had dropped from 9.7 to 6.7.
In total I have lost 4 stone. My GP always wants to keep me on the Met, telling me how her dx and Met prescription has done all this good.

My Endocrinologist said bluntly that the weight loss was completely responsible for the better BG results.

However I too have noticed a fasting level of 6-7 rather than the 5-6 I used to get. I have also noticed I have had a few glasses of red wine and beer more recently and I started eating chocolate during the week rather than leaving it to a few chunks of dark on a Saturday night.

So I am going to re-group and loose a bit more weight and get a bit fitter. I have heard others from these forums who have said the same. Weight gain = bad BG, weight loss= better BG.

Unless your one of those skinny type2s of a late starting type 1.
 
Hi RollerGirl

Are you on any other medications? If so they may be responsible for your weight gain and higher BS levels.

I was put on Amitriptyline for IBS, this had the result of me putting on weight and making my BS higher.

Having found out I am wheat intollerant, cutting out bread has been the best thing that I have done, as it cuts the amount of carbs that I eat.

You may need to talk to your HCP and have introduced another medication.
 
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