Some Advice on Metformin dose

sdgray22

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Could someone give me advice. I am three months in from diagnosis. I started at fasting 12 and was spiking to 18 after some meals I am now after a medium low carb diet 80-90 carbs and 1 500mg metformin each evening with dinner down to 6s and 7s at night before bed and 7s and 8s in the morning fasting although I can spike up to 10 after lunch. Obviously this is getting better but not quite there.

My question is I have my annual check (after three months!) with the doc in a couple of weeks. Obviously I want to talk about how to get my readings down another point really. I find I cannot each much breakfast and lunch as I spike but OK to eat dinner and then I take my metformin tablet with dinner in the evening that obviously must make some difference as I do not spike then. I know that they will probably want to up my dose of metformin to 2 x 500mg to bring the spikes down and hopefully my food tolerance in the first half of the day. My question is (because I am sure the dr will not know - they are not particularly expert it seems at my surgery) Do you take the metformin one on the morning and one in the evening to even out the long term slow release bit of the tablet. I am hoping the answer will be yes so that the first half of the day becomes slightly easier for me. I cannot eat anything but a slice of apple or 1 rich tea biscuit until about midday this has actually the same effect as if I had ate nothing, I stay about whatever the fasting number is in the morning even if I eat nothing. If i try to eat anything else I will go to 10 and above and cereal, porridge, fruit, toast whatever sends me high. By lunchtime I can eat something with about 15-20 carbs and be not too bad about two points up, yet in the evening I can have 40 to 50 carbs in a meal and be OK only rising a couple of points. I am hoping that taking a tablet in the morning with some food may be the answer. What do you think out there I want to be aware when speaking to the Dr as it gets very confusing when they give you bad advice. I am thinking of testing my theory before the appointment as I have a lot of tablets at the moment and could try it.
 

DavideB

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Hello sdgray22

I have just been diagnosed and my doctor put me on 2 a day telling me to take one after lunch and one after dinner..It is only my second day but Monday I will ask it I can take i n the morning and then at night
 

LittleGreyCat

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sdgray22 said:
<snip> I cannot eat anything but a slice of apple or 1 rich tea biscuit until about midday this has actually the same effect as if I had ate nothing, I stay about whatever the fasting number is in the morning even if I eat nothing. If i try to eat anything else I will go to 10 and above and cereal, porridge, fruit, toast whatever sends me high. <snip>

Just checking - do scrambled eggs, cold ham, cold chicken etc (low/no carb protein snacks) send you high if you have those for breakfast?
Not sure from your post if protein sends you high, or just the usual suspects that you listed above.
 

ButtterflyLady

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I often eat the wrong things for breakfast but when I'm being good, all I have is 1-2 boiled eggs, seems to work well for me.

I take Metformin after lunch and after dinner. If I take it without food I get nausea and dizzyness.

You could try splitting the tablet between lunch and dinner, if you want to stay at the same dose.
 

sdgray22

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thankyou good idea about splitting the tablet. I will try that

I am quite tolerant of protein as far as I know. But cant say I fancy eating it early in the morning. I found out how intolerant I am in the morning when I ate porridge which everyone seems to think is OK I spiked up about 6 points.!!

Everyone is different.
 

ButtterflyLady

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True, everyone is different, but I thought that in general the less carbs the better? I'm a newbie though so could be wrong on that.

Not sure why people think porridge is ok - it's carb-based, and if it has milk or cream with it, there's the sugar in that.

I must admit I love protein for breakfast - eggs, sausages, bacon, milk, yoghurt, you name it. What about low protein, (relatively) low carb breakfast foods like mushrooms, green peppers, and asparagus... I think tomatoes are probably high GI (I don't eat them so never looked into it). Same with baked beans.

I think that anything you can eat later in the day could be eaten for breakfast, if you're willing to give it a go.
 

sdgray22

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Yes low carb is better porridge is supposedly lower than cereal. Anyway that was an earlier scrape I now eat to my meter if its OK with the meter ie I do not spike I count it OK. I am not super low carbing I am steady at about 70 - 90 carbs. I will have to widen my tastes I think.
Thanks for the help
 

Daibell

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Hi. It looks like you are on Metformin SR? It really doesn't seem to matter whether you split the dose or not. My script is to split it but the leaflet says take it all at breakfast. I read a paper recently which said it didn't make any difference to the outcome.
 

ButtterflyLady

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Daibell said:
Hi. It looks like you are on Metformin SR? It really doesn't seem to matter whether you split the dose or not. My script is to split it but the leaflet says take it all at breakfast. I read a paper recently which said it didn't make any difference to the outcome.

Good point. Sorry, I didn;t notice it was SR. Shorter acting met can be split, and that's how I started taking it, at a lower dose. SR tablets are usually designed in such a way that if you split them you lose the SR feature.
 

Truffle

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I take 1 metformin with breakfast and 1 in the evening and this seems to even it off. I also find it a problem to eat breakfast but now I eat a small packet of peanuts or walnuts and that seems to do the trick. Just keep experimenting - if I have enough time I cook bacon but as I start work at 7am I don't always have time.
 

lindainsomerset

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I have a bowl of porridge and a slice of burgen bread for breakfast everyday without fail. I take 1 x metformin after it, again after evening meal. No problems.