metformin dose goes up A1C stays the same - Page 3

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metformin dose goes up A1C stays the same - Page 3


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Old 08-30-2013, 22:29   #21
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I was hoping someone had a similar experience with upping their met dose. Since I see people answering that are on over a 2000mg dose I know they didn't start there. I was hoping to hear how upping a met dose helped or didn't help someone's A1c.

As far as I know, for the last year, grain to me is only that stuff growing in a field, I don't eat it but once a month maybe. My main carbs are all veggies and some milk. I eat less carbs than what the dieticians told me. Since I already ate breakfast and lunch and I know what the plan for dinner is I know I will finish the day at 5 carbs - 75g. What do you eat for a 30g day, I can't do that on veggie intake alone.

I am 42 5'5" and 150lbs I have no family history and I was 165lbs when I got diagnosed. For me this is also a search for the why all my indicators don't say type 2 but my bs does.
Let your A1c keep going up and you will get the "indicators" - frequent urination, insatiable thirst, hands and feet tingling from neuropathy, eye problems, kidney problems, heart disease, etc. These do not happen immediately upon being diagnosed, they happen over a period of time from the indicator you have now - high blood sugar. If you do nothing about it to keep your bs down they will surely happen. They say diabetes is a progressive disease and it surely is IF you do nothing to keep your bs down. Keep it down and don't let it progress, the high blood sugar is what's bad and does the damage. Think of diabetes as a broken cruise control on your car, you are in charge of controlling the speed your car goes. If you step on the gas too hard and go too fast you could get a speeding ticket or have a wreck. You are now in charge of controlling your blood sugar and there is no taking it to the shop to get it fixed. They can only tinker with it but it is still broke.

Edit> I meant to add, my A1c was 8.8 and metformin didn't bring it down. I didn't pick up the metformin to bring it down, I cut way back on the source of the high blood sugar. I eat better now than I did before. No bread, potatoes, rice, grain, pasta, cake, ice-cream, cokes. I miss biscuits for sopping up the egg yolk when my wife doesn't overfly the eggs. Most of these things have alternatives that are as good or better than what I quit eating.

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Old 08-30-2013, 22:43   #22
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Good luck to you jbrown, looking for your miracle. More metformin didn't work for you. IF it worked for someone else, that does you no good.

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Old 08-30-2013, 22:47   #23
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So, jbrown, what are all the "other indicators" you speak of, and what are their levels compared with what you want them to be? You've not said yet, and that might help.
My diagnosis was just a blood test that came along with a physical, I had no symptoms. I was origionally 12.1 and am down to a 7.2. The indicators my doc was looking at were weight, age, and family history. I probably ate like crap back then, I know that if you own stock in anywhere that makes French fry's you lost money when I was diagnosed. I am just trying to look at one thing at a time which since I just got my first A1c results back since I increased the met dose I am interested in other peoples experience with increasing metformin.

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Old 08-30-2013, 22:52   #24
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Thanks to all those beating me up about the way they got their A1c down. If you don't have a met experience to share just ignore me. I don't know even if the original 500 dose did me any good since that is the time period I started eating better and loosing some weight.

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Old 08-30-2013, 23:05   #25
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So I looked up Shottlebop's day and added the carbs from some quick internet research. Of course he doesn't post the qty's of most items so I assumed the standard "serving" It all adds up to 73g I expect my day since I still use the apparently broken system of carb servings, where I round up, to end up at 5 servings or 75g. He has 30g in avocados alone.

Breakfast: avocado(12g), two Applegate uncured hot dogs, fresh collard greens (11g), 1 oz.double cream brie, coffee with coconut cream

Lunch (Matisse Bistro): bunless burger with cheddar, sliced tomato and avocado(12g), side salad (6g)(greens, shredded carrot, cherry tomatoes, olive oil)

Dinner: BLT salad (1/2 small avocado, 6 slices turkey bacon, several (12-15) cherry tomatoes(7g), crumbled feta)(side salad+1/2 avocado=12g), 3 oz. organic Sonoma Valley pepperjack, low-carb chocolate ice cream (13g)
Why do you say he hasn't posted the quantities? For things that aren't automatically a serving like link sausages, he has included the ounces for your perusal. Yes, Shottlebop has 30g of avocado, and you know how many grams of carbohydrate that is? Three grams, two of which are fiber. For people who use net grams for counting, that means his 30g of avocado got him all of 1g of carbs. So he's fudging the numbers, is he? I think I know who's fudging the numbers.




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Old 08-30-2013, 23:13   #26
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JB did you understand Shottlebops post. He weighed out 30g of Avocado which has 3g of carbs. I just think there is some misunderstanding in what your asking and what is being answered.

You would like to know the experiences of others who had their Met dose upped and what it did to their A1c, right?

Remember a lot of those whose Met dose was titrated up were at the same time lowering their per day carb counts until their BG and A1c was in an acceptable range.

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Old 08-30-2013, 23:20   #27
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JB? Since you are so insistent that we answer the exact question you asked, I'd like to know why you haven't answered the exact question I asked you. Are you testing? When you came here, you insisted you couldn't possibly poke yourself with a lancet. I have to assume that is still your predicament, or you wouldn't be relying so heavily on your A1c numbers. So ANSWER THE QUESTION.




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Old 08-31-2013, 00:21   #28
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Jbrown,

I, like so many (probably most, if not all) who follow the standard advice given saw an initial drop in my A1c after being Dx'd and starting to take metformin. But over time, the numbers start creeping up. Even with increasing the dosage, they can still creep up, which is exactly what you saw. And the reason is that your diabetes is not being controlled, and it is progressing. That is just the natural thing to happen when following the typical advice given by today's medical profession. And ABSOLUTELY KEY to this progression is your intake of carbs above a certain level. However, everyone's level for tolerance of carbs is different. And for you to find what is your acceptable level, the ABSOLUTE KEY is to test, test, test. Test before and after every meal to see what you BG is doing, and to see how the different foods and different number of carbs affects you.

While I didn't see any replies responding to precisely the question you were asking in the way you wanted, there was a lot of good advice, but the problem is you're not able to see how the carbs are in fact the reason for your increasing your metformin dosage yet seeing higher numbers. If you're not willing to test as mentioned, and not willing to reduce your carbs to the level necessary, then your only option is for your doctor to continue to increase your dosage, put you on insulin, etc., all the while seeing your disease progress. I know, I followed my doctor's advice for 8 years under the exact same scenario I just outlined. My disease kept progressing at each visit, and my doctor kept upping the dosage, adding new drugs, etc. Sometimes the numbers would come down, but overall they just kept going up, despite being put on more and more drugs and stronger doses. Finally about 4 months ago, my doctor started me on insulin, which was a real wakeup call for me. I realized just how serious my situation was, and that it simply wasn't going to get better by following my doctor's advice. I needed something more. And when I started researching on the internet what to do, luckily I eventually found this forum. I started doing exactly what everyone was saying I needed to do, and which I reiterated already in this post, which is to test, test, test, and eat according to my meter. Eat only the foods that don't spike me, and eat a minimum number of carbs that will cause my spike to be at a minimum, under my target goal. I was initially advised by my nutritionist to be eating something like 300g of carbs per day. It wasn't until I drastically reduced that number that I started getting good control. Initially I thought I could do 30g of carbs per meal, without snacks, so meaning 90g per day. But even that was too much, though much better than where I was. I've now narrowed my intake, step by step, down to only 20g per day. At each decrease, I see an improvement in my numbers, and feel I'm probably getting close to the maximum I can do. But still looking for any ways to get it lower if it's possible. Just how good you want your numbers is going to be a personal decision that you have to make, and it also depends on each individual as to what they can accomplish. Some are very lucky such as me and can get our diabetes under complete control, while getting completely off insulin, metformin, and all other drugs. I accomplished that in only 4 months. Others though struggle for years and still need their medication, but they are able to get it controlled, even if not as well as they hope for, by following a proper diet that limits carbs as much as possible according to their meter.

Now if you're only using your 3-month A1c tests to judge how well you're doing, then you're making a HUGE mistake. I know, as I was the same. I avoided testing to begin with, thinking I would just follow the advice I was given, and hope for the best, because I believed my doctor knew what was best for me. Boy, I couldn't have been more wrong. Without testing before and after each and every meal, you simply have absolutely no way of knowing which foods/quantity are good and which are a problem. And the A1c is only an average. It tells you nothing about how high you're spiking, how quickly it goes up and down, and all sorts of things. Furthermore, and again ABSOLUTELY KEY point with respect to your question, is that A1c is supposedly a 3-month average of your BG, but it is not really accurate. At least not accurate for everyone. It's dependent on the assumption that the blood cells die off and are replenished on average every three months. But everyone is different, and even the same person can be different at different points in their diabetes progression/control. So while the A1c test is what your doctor probably goes by, it's actually not such a good indication, and especially for you, yourself. Your doctor isn't with you 24/7 and isn't seeing your testing results, to know if you're cheating or not, or doing improper testing or not. Even if you log all your numbers, they're going to go by the A1c simply because they have the most faith in it, given some patients' propensity to lie or cheat in recording their daily testing, or not testing enough or at the right times. But you, the individual, do have your own testing as the best way of knowing what is going on with you personally. Testing all the time is really the only good indication you can get to know what's really happening. Without that you have no idea how accurate the A1c is, and whether it going up or down is significant or not.

Ok, one final reason why you may have gotten the result you did of seeing your A1c increase while your metformin was increased....I saw you post your weight, but don't know if you're male or female, so don't know whether you're quite thin or still some overweight. But metformin I've heard is mostly effective for patients who are obese, and who have high BG numbers. For people who are thin and/or have fairly good control, the metformin may have little or no impact. And even for people who are obese, everyone reacts differently to certain medications. For some people, even if ideal candidates for metformin, may simply not be affected by it. It may just be like water to them. For what reasons, who knows, but that's just the way us humans are with respect to our various diseases and medications designed to control them. Your 7.2 vs 7.3 A1c are statistically insignificant. It's effectively the same number. So in your case, it sounds very plausible that the metformin is not doing you any good. And/or your previous dosage was doing you good, but increasing it doesn't give you any additional benefit. Until a couple weeks ago, I was continuing to take my metformin, until I decided to stop it and see what happened. You know what...absolutely nothing changed after stopping my metformin. My BG numbers are still the same as they were before. In getting my weight down to near normal, and getting my BG under control, the metformin stopped having any effect anymore on my BG. I have no idea on where your weight was initially, vs. where it is now, and what your ideal weight is, but if you had any similar pattern to me in that respect, it may be that the metformin initially helped, but due to weightloss, it's now not effective. And of course a whole slew of other possibilities as to why it may not be effective any longer.

Just to repeat again in closing, if you're not willing to test, test, test before/after every meal, and not willing to adjust your carbs and what you eat according to the result, then people here really cannot help you. You will just need to accept the advice that your doctor is giving you, and to take the medication he prescribes, and along with that accept the inevitable outcome. That's what the vast majority of diabetics seem to do. If you're serious about getting your diabetes under control, then you're going to have to bite the bullet and do what we're saying you need to do. The choice is yours.

P.S., I went back and read your initial post after replying and see you mentioning about "fitting into a 20 year old boy scout belt", so guess you're male and quite thin. Given that, I guess I wouldn't at all be surprised if the metformin is having zero or very little effect on you.

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Last edited by Aaron1963; 08-31-2013 at 00:26.
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Old 08-31-2013, 02:17   #29
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Aarron thanks for the reply, it is hard for me to guess if the origional dose ever did any good since that was the time period I was getting my diet and weight in better shape.
As far as testing goes, I have a needle phobia in my head that I don't know how to get past, which makes diabetes the perfect disease for me. Normally an a1c test ends with me passed out. I can only test when I am at home, my wife is a nurse, some how when she does it I can handle it, still break out in a cold sweat though.
I think others missed the point on my carb example. I was sent to a post of an example of a low carb diet, I added the (carb) count to a copy of the origional post that wasn't the qtys consumed. For an example I will use the avacados. A simple google search for "avacado carbs" says 1 avacado is 12 total carbs and this day the post said he had 2 1/2 avacados so that is 30g of carbs in just avacados. I was given this link as answer to my question of what you eat for this 30g of carb day, and when I look up the total cabs on everything this individual reports eating, assuming with things like the low carb ice cream that they ate 1 serving, per the serving size on the package, that adds up to a 73 carb day. This was the 30-50g of carb example that was given to me and it doesn't add up. Someone mentioned subtracting fiber from total carbs, I was taught to use total carbs and make at least 2/3 of your carbs green veggies so if I subtract fiber from my day I am right there with the 30-50 carb folks. Someone else look up the carbs for this days meals and post your count and total.

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Old 08-31-2013, 02:21   #30
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I've heard it several times here In the forum that metformin doesn't work well with a high carb diet. Can anybody provide a link to the source of that? I've never needed to verify it because I went LCHF when I was switched to metformin.

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