Should I revise medication with doctor.Confused

gg1234 said:

Hi All
Today I went for the diabetic review test and they sai d my HBA1C was 6.6 .Earlier it was 6.3 and before that 6.5 .They have asked me to take 2000 g of metformin .The nurse seemed quite confused herself stating blood sugars are not that high to be advised such a high dose .Feeling quite confused myself.What you think ?

Regards

Gg

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Yes I would have a word with your GP, it does seem a lot!

Thats seems unusually high for that reading .Most people start of on 500 mg and work their way up .I'd certainly give the doctor or even better the Pharmacist a call before i started on that dose .

2000 gm of Metformin is quite a common dose. Although Metformin is a medication for diabetes, its effect on bgl is actually quite small. Normally it provides other health benefits such as cardiac protection, and is the safest medication for PWDs. As stated above, it is normal to start at 1x500, then build up over a couple of reviews up to max dose of 2x500 + 2x500 per day. The reason why it is done over time is so that you can be monitored to make sure you are tolerant of it (gastro intestinal problems can occur, but generally these diminishover a short time). However, some find the side effects too much to deal with, so then the med can be changed. Discuss this with your GP especially if you get stomach upsets.

The drug helps type 2 diabetics respond better to their own insulin, lower the amount of sugar created by the liver, and decreasing the amount of sugar absorbed by the intestines. - Source: Diabetes.co.uk

From what I have read about Metformin or at least the experience of those on other forums taking Metformin, it's almost as if 500gm/1000gm/1500gm does very little but then 2000gm has a much better effect on BG. I think it's difficult to say that a particular dose will have a particular effect, it's not like a particular dose of insulin. Especially as Metformin affects the way the body deals with the insulin that your pancreas is already producing or in some cases injecting. We must all have different insulin resistance, none of us are the same.
As mentioned, careful with how it affects your bowels, there's a Sustained Release (SR) version available, (AKA Extended Release (XR), Modified Release)). Lowering carb intake will also help if having problems with bowels while taking Metformin.

Whatever you do, for heaven's sake build up to the high dose OVER TIME. Add no more than 500mg a week, MAX. Otherwise truly horrid side effects will hit and you may never get to that dose. So go slow !!

I was on metformin myself to a period of 5 years. I was on the max dosage of 3000mg per day at one point. It looks to me that your 2000mg dose is doing the job of keeping your sugar level stable. In my experience, metformin didn't dramatically drop my sugar levels on its own. I had to continue with managing using diet also. I did have my very first hypo on metformin though, so be careful. Try various doses if needed. But if it you are getting adverse side effects like I did, try your best to assert that other meds need to be trialled. If you ever get to the point that meds just don't seem to help, request for the GAD and c-peptide tests to be redone. The reason for that is that some of us type 2's wind up with insufficient insulin production and oral meds just don't work when you don't produce enough of your own insulin. It looks like you're doing quite well though, I wish you the best.

Hi. The important thing especially if it's the plain Metformin and not the Slow Release (SR) version is to build up from 500mg over a few weeks to avoid bowel upset. It's a very safe drug so I wouldn't worry too much about the 2000mg but it possibly should have been smaller

I am on slow release 1000g and Sitagliptin 100. I have a slow release statin and my cholesterol is 3.5. I could not take any higher dose of Metformin. However it puts my bowel in crisis.

Lornylou5 said:

I am on slow release 1000g and Sitagliptin 100. I have a slow release statin and my cholesterol is 3.5. I could not take any higher dose of Metformin. However it puts my bowel in crisis.

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It seems it affects us all differently .i was running to the loo up to 15 times a day on 1000mg slow release .I've persevered three separate times now but finally my GP has agreed it's not for me .There are many meds out there Lornylou .Maybe time to give another one a try ?

I thought a measurement of 7 or under was the goal, so if you're getting less than 7 without meds, why start them?
I had lots of diarrhoea with Metformin, changed to sustained release and it's gone. Still flatulant!
Good luck with Dr.

Tillysmam said:

I thought a measurement of 7 or under was the goal, so if you're getting less than 7 without meds, why start them?
I had lots of diarrhoea with Metformin, changed to sustained release and it's gone. Still flatulant!
Good luck with Dr.

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A normal non diabetic fasting range is between 4 and 5.9 mmol/L. the limit of 7 is for a T2D fasting (upper limit). I would wait to see what the next HBA1c is then discuss it with the GP. You should be able to get it back down just by diet adjustments alone, so try it and then surprise your GP. As others have said, you may not need this drug, and probably not at the strength currently prescribed. Try it - Diet. Your target HbA1c is 6.5% or less according to the latest NICE guidelines for a T2 not at risk of hypo.

Prior to going on the DAFNE course I did add metformin to my injections of insulin but only for a short time. During the 31 years of being diabetic type 1I have had conflicting oppinions between my GP and diabetic clinic and I have resisted following the GP as they are not diabetic specialists.