Why is fasting blood sugar still high after being on 1000 mg metformin

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HappyMom posted on Fri, Mar 25 2011 12:42 PM

I was told I had diabetes Feb. 15 and started taking metformin on that day. I take 500 mg of metformin with my breakfast and 500 mg at bedtime. Normally I take that pill around 9 pm. My fasting bs was running about 147 to 155 until this week. The past 2 days it has been 202 and this morning 232. I caught a stomach virus Sunday and finally started feeling better today...except for my morning bs of 232. I was just wondering if maybe the metformin has stopped working or if my illness could have caused my bs to be high. I returned to my daily walking of 3 miles yesterday. I am just discouraged right now and frustrated! I have really been trying to eat good foods. This is such a difficult disease to deal with. Also, I have high blood pressure which it has been running 123/80 or even a bit lower. I am a 49 yr old female. Thought maybe someone had some words of wisdom!! Thanks!

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Madman replied on Fri, Mar 25 2011 1:51 PM

Couple or three things are contributing to your morning blood sugars. 

first off, any kind of illness will raise blood sugars.  Stomach flu will definitely do that.

second, you are on a lower dose of metformin then you may need.  The typical dose seems to be 1000mg BID (twice daily).  You are taking half of that.  Your dr. will probably increase your dose by 500 mg at a time.  Trust me, don't try to rush getting to a higher dose with metformin, unless you enjoy living in the bathroom.

third, there's something called the dawn effect.  We all have it, and it effects some people more then others.  In the early morning hours, the body starts producing more of certain hormones as preparation for awakening.  These hormones have the effect of raising blood sugars, which for a non-diabetic, there's enough insulin to deal with.  Since we are diabetic, this causes our blood sugars to go up in the morning.  One way to combat thise, believe it or not, is to have a small snack with about 15gms of carbohydrate just before going to bed.  This helps to keep the liver from running out of glucose and going into gluconeogenisis (fancy term for making sugar).

 

 

 

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Simi_Papa replied on Fri, Mar 25 2011 3:35 PM

Madman's advice is very good.  I would also point out that Metformin is supposed to be taken with food and may cause stomach problems when not taken with food.  I am on 1000 mg BID that I take with breakfast and dinner. 

Bill

"May the Force be with you!"

Diagnosed in 1997; Off all meds except Metformin!! Smile

www.nvhealthy.com

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HappyMom replied on Fri, Mar 25 2011 5:48 PM

Thank you for your information! I go back to the doctor around the 11th of April. I was so discouraged this morning when I took my fasting and it was in the 200's. Hopefully, I will get lined out soon!

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Hello HappyMom! 

Please don't be discouraged.  It takes a while to get into a diabetes program that works for you.  I've been around the block experimenting with different meds, and insulins.  I agree with everything that's been said, in particular, that your Metformin dose is probably half of what it could be.  I understand a typical dose to be 1,500-2,000.  Plus, if you are a Type 2, you may want to try a combination of Januvia and Metformin.  Januvia was designed to work together with Metformin in the body - the extent to which, they are now packaging the two drugs together:  "Janumet".  You can read more about here:

http://www.janumet.com/sitagliptin_metformin_HCl/janumet/consumer/index.jsp

Yes, being sick will throw off blood sugar.  Just KEEP TESTING so you can show your doctor all your numbers.  Your blood testing device stores all your numbers, and gives you a 7-day average, 15-day, and 30-day average of all your tests.  These numbers can be used to (approximate) your A1c.  I posted a handy A1c chart into my profile in this blog.  You can check it out by going to my profile page.

I want to say one more thing and I don't want to be negative.  I hope your doctor is a true diabetes specialist.  Diabetes can be such a frustrating condition to understand and treat.  Many Primary Care Providers <think> they know how to treat it, but aren't the best.  Please see an endocrinologist or a diabetes educator.  Someone who really knows their stuff.

Be well and keep in touch!

-Dana

Dana
Juvenile type 2, living with diabetes for 28 years. Novolog user.

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HappyMom replied on Sat, Mar 26 2011 5:05 PM

Thank You, Dana for replying to my post! I will check out the web pages you suggested! I try not to get discouraged, but as you very well know, this is such a frustrating disease! I'm planning on finding some diabetes classes to attend and I've been reading some books on how to manage diabetes. It's always nice, though, to visit with people that are in the same situation that I'm in! Take care! 

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Any time!
Im sure you'll be okay.

Cheers!

Dana
Juvenile type 2, living with diabetes for 28 years. Novolog user.

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momcat4g replied on Sun, Mar 27 2011 9:30 AM

Dana, all meters do not give averages, etc. I use a one touch ultra mini, it does have a memory, but that's all.

Nancy

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Tor replied on Mon, Mar 28 2011 5:52 PM

You've been given very good advice above.

The only thing I might add, from my own experience, is the option of switching to a low carb or no carb diet when you are ill. What raises BG levels during illness is that the liver releases its emergency supplies of blood sugar (glucogen) into the blood stream in order to provide energy for the body to fight whatever has been invading it. That compounds a problem where another factor, as you mention, is that you can't keep up with your usual exercise regime. In order to prevent elevated BGs something has to give, and the easiest to regulate is the intake of the primary source of blood sugars : carbohydrates like bread, pasta, rice and potatoes. Given that when someone is ill they tend to rest and expend a lot less energy, you are not going to miss that extra source of fuel.

Tor

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