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Discussion Starter · #1 ·
Good Afternoon,

4 months ago, I had a A1C test as part of my annual physical. My fasting blood sugar in the morning was extremely high (183). I had slightly elevated blood sugars for a while (high 120's fasting). My doctor diagnosed me with Type II diabetes and put me on Metformin (1000 mg twice per day). I had very severe side effects on the metformin. I went to 500mg in the morning and 1000mg at night. I cut it back to 500mg in the morning, and 500mg at night. The just 500 mg at night.

I recently got a Dexcom 6 and am monitoring my blood sugar continuously. I stopped taking the metformin to see what my blood sugar is normally.
Without the metformin, my blood sugar stays in the low 100's until after I eat, and then it goes up to around 160 and comes back down after a while which is normal.

On the metformin, my blood sugar drops so low at night, my Dexcom cannot even read it which is kind of scary...

My question, is with this one A1C reading, should I have been diagnosed with Diabetes at all... Or was there more tests I needed before getting this diagnosis? Or is this a common way to get diagnosed?

Thanks
 

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Hi, rtfox! Welcome to our community. I'm glad you've joined us!

A diagnosis of Type 2 diabetes is supposed to take a few measurements into account. A1c is a measure that pretty decently covers about three months of blood sugar/insulin balance. It also is possible to suspect diabetes if fasting blood glucose numbers are repeatably high (equal to or greater than 126 mg/dL on two separate tests). What was your A1c? And was another test taken to determine if the 183 was an outlier?

I will preface the rest of my post with the comment that we here are not medically-trained and cannot issue medical advice. However, my experience of several years in this community is that 2000 mg of Metformin is a pretty big dose to start with on someone whose fasting blood glucose numbers are routinely in the low 100s. I wonder if your doctor didn't react/overreact to the 183, particularly if you were not scheduled for another test then or shortly afterward. Of course, we don't know all the details. Lots of things can affect blood glucose, and even those of us who control our BG pretty tightly can see high fasting blood glucose numbers after a carb-laden meal the night before, if we're getting sick or have an infection, etc. That number by itself, in my opinion, should not have started you on 2000 mg Metformin daily.

What you experienced does not seem like a common way to be diagnosed a Type 2 diabetic. I would suggest that it would be worth contacting your care team with the information you gave us -- that that much Metformin is causing issues for you and that the Dexcom (which I'm assuming is properly set up) is reporting the numbers you're getting -- and then see if they're willing to explain why the level of Metformin you were prescribed or whether they need to revisit their testing to get a more accurate picture.

And here is where I will put in a plug for us being our own best advocates. I know doctors go to school for years to gain the education they need to keep us healthy, but sometimes things escape their attention or they work from old information. It is in our best interests to keep up with what our bodies are tellling us and what we learn about the condition and its treatment. Many of us here have avoided the all-too-typical path of "carb up and shoot up" that leads to issues down the road, simply by arming ourselves with information,

Please update us on this. I'm eager to find out what is happening.
 

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Discussion Starter · #3 ·
Thanks
I am changing doctors. It was not only the immediate diagnosis, but also refusing to work with me on the metformin and other things. I set up and calibrated the Dexcom per the instructions.
In the past, I know when my BG is high, as I get MASSIVELY tired when it does as my insulin spikes, This has stopped since I modified my diet.

I will keep you updated....

and thank you
 

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Hi again Rick.

As far as your diagnosis question, based on the 183 FBG and 120 FBGs, if the A1c was above 6.5%, then further testing/retesting was probably needed to verify, maybe even do an oral glucose tolerance test (OGTT). If above 7.0% then probably diabetic. This is just my opinion, but with it and a dollar you can get a small cup of coffee just about anywhere.

Not sure the version of metformin you were put on, regular or extended release, but either one it would be best to start out on a minimal dose and titrate up the dosage slowly over a period of time, the regular especially. It is more prone to cause gastric issues that the ER. The regular may still even cause gastric issues at lower dosages but for many people, that should go away over time. If not try the extended release version. Either version is not know to be the cause of hypos, so not sure what is going on there. Not sure how low your CGM is supposed to read.
 
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Good Afternoon,

On the metformin, my blood sugar drops so low at night, my Dexcom cannot even read it which is kind of scary...


Thanks
If your Dexcom is not providing a reading, you may have compressed it while sleeping.
 
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