Should doc have increased my dose?

Go Back   The Diabetes Forum Support Community For Diabetics Online > Diabetes Forum Community > Diabetes Treatment

Diabetes Treatment As there is currently no cure for the chronic, Diabetes mellitus – the emphasis must be on treatment and management to avoid complications. Please use this section to discuss how you carefully control and manage your Diabetes. Please let us know what is and isn’t working for you. Feel free to discuss all areas of treatment and management of Diabetes including diet, exercise, weight loss, insulin usage, oral drugs and more.


Like Tree44Likes

Should doc have increased my dose?


Closed Thread
 
Shared Thread Thread Tools
Old 06-14-2013, 15:57   #1
Junior Member
 
Join Date: Jun 2013
Location: Georgia, USA
Posts: 4

Member Type
Type 2
Diagnosed in 2012

Default Should doc have increased my dose?

Diagnosed with diabetes a year and a half ago and was started on 850 mg twice daily. Didn't really take it seriously until year around three months ago. Started to consistently take my meds, joined a gym and do cardio and strength training, and completely revamped my diet to include low/fat free foods with healthy cards, lower proteins, and waaaay lower portions (Weight Watchers helps with keeping portions in check).

As a result, my blood glucose dropped from the high 200's (at initial diagnosis it was in the 400's but I'd been taking the metformin off and on for the year) to 120's when first waking up and before any meal, a 10-15 point spike an hour or two after meals, and a 10-15 decrease after exercise or really late at night. So I'd say 115-140 with the higher end after eating would be my range.

I gave this information to the doctor and expressed some concern that my fasting/morning glucose was higher than what I experienced throughout the day, and she upped my metformin from 850-1000. However, now reading through various posts and information gleaned through diabetes websites, I see that my range isn't considered wildly out of control. So my questions are:

1. Do you feel I should have had my metformin dose increased?
2. Any others (or theories) as to why my morning glucose is so high? I mean, I usually test right before I go to bed and some nights it will be as low as 103, but when I wake up it's 124 or 126. What gives?

unchienne is offline  
Old 06-14-2013, 15:59   #2
Junior Member
 
Join Date: Jun 2013
Location: Georgia, USA
Posts: 4

Member Type
Type 2
Diagnosed in 2012

Default

I meant to say that I did not take it seriously until 3 months ago, not a year and 3 months...is there no edit button? I couldn't find one except for the tags.

unchienne is offline  
Old 06-14-2013, 17:38   #3
Moderator
 
moon's Avatar
 
Join Date: Feb 2011
Posts: 6,158

Member Type
Type 2
Diagnosed in 2011

5835 likes received
3468 likes given
Default

Quote:
Originally Posted by unchienne View Post
2. Any others (or theories) as to why my morning glucose is so high?
Yes - this:

Quote:
Originally Posted by unchienne View Post
my diet to include low/fat free foods with healthy cards, lower proteins, and waaaay lower portions (Weight Watchers helps with keeping portions in check).
With low fat and low protein, what is left is carbs and I'm thinking you're eating too many of them. If you lower the carbs (the only truly healthy ones come from above-the-ground veggies ... no such things as 'healthy' grains for a diabetic) and up the (healthy) fats, then your numbers will drop, as will your need for more metformin.

Quote:
Originally Posted by unchienne View Post
1. Do you feel I should have had my metformin dose increased?
Based on your numbers, all things being equal, it was not a bad decision. Unfortunately, the best advice - to lower carbs and increase healthy fats - is not typically given. Instead, meds are. And that's a shame.

P.S. Welcome to the forum

Shanny and Mary, like this.
__________________
Dx'ed Feb 2011 w/ BS > 600
A1C: . . . . . . . . . . . . . . . Other Stuff
2/13/11 .. 14.7 . . . . . . Trig/HDL ratio .. 5.5 to 2.2 in 6 mo
5/23/11 .. 6.2 . . . . . . . Low-carb/high healthy-fat diet
9/8/11 .... 5.6 . . . . . . . No meds, No statin
2/24/16 .... basal/bolus insulin 2-3 days/wk due to steroids

moon is offline  
 
Old 06-14-2013, 17:47   #4
Senior Member
 
silvertiger's Avatar
 
Join Date: Nov 2011
Location: Saskatchewan, Canada
Posts: 3,861

Member Type
Type Pre
Diagnosed in 2011

4282 likes received
5061 likes given
Default

Moon is right on the money. Check out the Blood Sugar 101 site for more great info.

Taking Metformin isn't a horrible thing, as long as it doesn't give you intestinal issues.

__________________

View silvertiger's full Diabetes Forum profile here.
silvertiger is offline  
Old 06-14-2013, 21:35   #5
Junior Member
 
Join Date: Jun 2013
Location: Georgia, USA
Posts: 4

Member Type
Type 2
Diagnosed in 2012

Default

Hmmm...interesting about the carbs. I do try and limit them, preferring to get my carbs from veggies (broccoli, cabbage, okra, and whatnot), lower-sugar fresh fruits like berries and melon, and whole grains. However, the books I've read and the info from the American Diabetes Association says that carbs should still make a portion of your diet. I usually restrict grains to 2 slices of reduced calorie whole wheat bread or 1/4 - 1/2 cup of brown rice, quinoa, etc...depending on how dense it is. Though there's probably some lurking in other foods.

As for the protein, I have reduced that. But you've got to understand what I considered "normal" prior to my diet. Normal for me was a two cheeseburger, one coney dog with chili and cheese dinner or consuming a large pizza with an order of buffalo wings on the side. Now I try to eat no more than 4-6 oz of meat-based proteins each meal, buffering that up with some dairy (also in moderate amounts) because I am exercising and trying to build some muscle.

I do incorporate some sort of grain at almost every meal, but the resources I looked into stated that was o.k. Is this not right?

But the grains don't really answer the question of why my blood sugar rises in the mornings. Because after dinner at 7, my glucose spikes a little (usually 10 points) then drops until four or five hours later, my readings will be in the low 100's...103 last night. Then when I go to sleep and wake up, they're 120 something.

unchienne is offline  
Old 06-14-2013, 21:40   #6
Senior Member
 
Join Date: Jul 2010
Location: Missouri, USA
Posts: 837

Member Type
Type 2
Diagnosed in 1986

834 likes received
1807 likes given
Default

Read a little bit about the Dawn Phenomenon (liver spike). This could be the explanation. Most of the posters who eat Hf/Lc find that the fasting spike goes away after about a month of eating Hf/Lc. That is what happened to me although an increase in the amount of water I drink during the day also seems to have helped.

__________________
A1c 12/30/12 6.0
A1c 6/24/13 5.5 !!
A1c 6/18/15 6.0
A1C 2/25/16 5.8

Meds: Metformin 1000mm/2 times a day
71 years old
Other meds: synthroid (no thyroid due to cancer); verapamil, losartan, water pill, standard eye drops for glaucoma.
JT Reagan is offline  
Old 06-14-2013, 22:08   #7
Moderator
 
moon's Avatar
 
Join Date: Feb 2011
Posts: 6,158

Member Type
Type 2
Diagnosed in 2011

5835 likes received
3468 likes given
Default

In addition to after-meal numbers, there's an overall daily carb load - that is what is important in my own diabetes management.

Unfortunately, the ADA gives very bad advice about how many carbs most diabetics can eat, or which are healthy for a diabetic. Carbs are not a necessary nutrient.

Members come in here all the time saying they are doing what they were advised yet they continue having trouble with their blood sugar. Then, if they try eating the way many of us do, =eureka=! their blood sugar goes down, need for meds decreases.

All I can suggest is: give it a try and see what happens. You have nothing to lose.

__________________
Dx'ed Feb 2011 w/ BS > 600
A1C: . . . . . . . . . . . . . . . Other Stuff
2/13/11 .. 14.7 . . . . . . Trig/HDL ratio .. 5.5 to 2.2 in 6 mo
5/23/11 .. 6.2 . . . . . . . Low-carb/high healthy-fat diet
9/8/11 .... 5.6 . . . . . . . No meds, No statin
2/24/16 .... basal/bolus insulin 2-3 days/wk due to steroids

moon is offline  
Old 06-14-2013, 22:26   #8
Senior Member
 
Mary,'s Avatar
 
Join Date: Mar 2013
Location: USA
Posts: 6,071

Member Type
Type 2
Diagnosed in 2013

5574 likes received
5676 likes given
Default

As moon and the others have said, if you throw out the traditional ADA advice and cut your carbs to low carb vegetables, your FBS should drop within a short time. We know that carbs increase blood sugar, so carbs, including the "healthy grain carbs," still wreak havoc on your blood sugar. Lose them, and I will bet you're see the difference you're looking for!
Welcome!

< didn't mean to repeat what Moon said, she & I were typing at the same time >

__________________

View Mary0110's full Diabetes Forum profile here.
Mary, is offline  
Old 06-14-2013, 23:32   #9
Active Member
 
choirsinger123's Avatar
 
Join Date: Mar 2013
Location: Princeton NJ USA
Posts: 28

Member Type
Type 2
Diagnosed in 2010

34 likes received
18 likes given
Default

I, too did not take my diabetes seriously, at first the Metformin kept the BS low, so I did not really change my eating habits. That lasted about a year, then began to creep up over 160 regularly. My doctor switched me to Glimepiride, which brought them down and elminated the GI trouble, but only for a while. Suddenly, my readings were in the 200-250 range. I came on this forum, read the Blood Sugar 101 site, got rid of the Glimepiride,started taking the Metformin ER ( much less GI issues!) and thought all would be fine.
Well, the readings did not go down easily as I expected, and I reacted by totally going out of control.I was angry, and felt the "why me" syndrome of self pity. My BS climbed up to 425, I had hideous rashes, thirst was unbearable, could barely drag myself out of bed, and my feet were tingling. I was a wreck!!
Came back on this forum, and began to eat responsibly and with great thought. Now, a few months later, my BS is close to normal, under 140 most of the time,even under 120. I count the carbs, eliminated most of the carbs, and all of the added sugar and processed foods I used to eat. I have lost 17 lbs, and feel like a different person.
Only thing that scares me is the upcoming doctor visit-the A1c is going to be hideous! Oh well, I did this to myself-no one to blame except me! I really do appreciate the support and advice of the folks on this site-you have changed ( and perhaps lengthened) my life!
Listen to these people, unchienne-they can really help! Good luck to you.

silvertiger likes this.
choirsinger123 is offline  
Old 06-15-2013, 15:03   #10
Senior Member
 
3babygirls's Avatar
 
Join Date: Jun 2012
Location: Texas
Posts: 163

Member Type
Type 2
Diagnosed in March 2010

125 likes received
1 likes given
Default

I remember when I was newly diagnosed, I read every book in the library on diabetes, and they all said the same thing: carbs raise your blood sugar, and your diet should consist of around 50-60% of carbs!

I could not understand that! How does that make sense? Carbs raise your BS, so be sure to eat plenty of them? For around 2 years I tried to lower my BS, I was on the highest dose of metformin, and soon added glipizide, and yet my BS was still over 200 nearly all the time, in spite of restricting carbs to "healthy carbs" and reducing portions, and walking two miles a day.

I gave up for about a year, then I found this forum. Finally someone who made sense! Reduce your carb level to a level you can handle! Carbs are not the essential all important part of our diet like we have been told!

Once I reduced my carbs to around 30 per day, I saw results! I started having hypos! I dumped the glipizide, and have recently added a basal insulin for more control. For the first time since dx, I have seen FBS at 117, rather then 180! If I eat too many carbs that day, I see it in my morning blood sugar: this morning was 147. :-(

JT Reagan, silvertiger and fangirl like this.
3babygirls is offline  
Closed Thread

Tags
metformin; dosage

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Metformin dose TTM Diabetes Treatment 15 05-30-2013 03:11
Should my Metformin dose be raised? Anna1971 Diabetes 11 05-02-2013 17:29
Missed Lantus dose medlam Diabetes Forum Lounge 6 12-30-2012 21:01
Double dose Niki83 Diabetes Forum Lounge 8 03-11-2011 19:45
Basal Insulin Dose breezeonby Diabetes Treatment 5 05-29-2010 13:43

LEGAL NOTICE
By using this Website, you agree to abide by our Terms and Conditions (the "Terms"). This notice does not replace our Terms, which you must read in full as they contain important information. You must not post any defamatory, unlawful or undesirable content, or any content copied from a third party, on the Website. You must not copy material from the Website except in accordance with the Terms. This Website gives users an opportunity to share information only and is not intended to contain any advice which you should rely upon. It does not replace the need to take professional or other advice. We have no liability to you or any other person in respect of any content on this Website.


All times are GMT +1. The time now is 07:38.




Powered by vBulletin®
Copyright ©2000 - 2020, vBulletin Solutions, Inc.
Search Engine Optimization by vBSEO
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.
User Alert System provided by Advanced User Tagging v3.1.0 (Pro) - vBulletin Mods & Addons Copyright © 2020 DragonByte Technologies Ltd.