Hi I'm TJ, I live with two T2 diabetics. I was wondering if anyone has the same problem my dad has encountered. He was originally prescribes Metformin HCL but the PA wasn't happy with his morning levels and changed him to Metformin HCL ER. His levels rose significantly through out the day on the ER. He went back to the Metformin HCL and informed his PA of this. This last visit the PA once again switched him to the ER and after about a week his levels rose even more drastically. We are looking for a practice where he will see an actual Dr. and not just a PA but is there any reason that they would be switching him back to the ER knowing that it increases his levels? He is also on insulin if that makes a difference. If anyone knows or has an idea about this I appreciate it.
Metformin HCL vs Metformin HCL ER and high BG levels
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Do you know if he was having stomach trouble with the regular metformin? Some people experience unpleasant gastric effects. Switching to the metformin ER oftentimes alleviates the gastric effects. However, switching from metformin to metformin ER shouldn't really cause an increase in blood sugar.
Is he on insulin or any other blood sugar meds? If his carbs are high in his diet, I'd look to that as a possible cause. Unstable (high) carb levels eaten each day can cause extreme blood sugar fluctuations. How long was he taking the metformin? Metformin generally takes a few weeks to build up before it reaches its maximum effectiveness.
Is he on insulin or any other blood sugar meds? If his carbs are high in his diet, I'd look to that as a possible cause. Unstable (high) carb levels eaten each day can cause extreme blood sugar fluctuations. How long was he taking the metformin? Metformin generally takes a few weeks to build up before it reaches its maximum effectiveness.
There's no difference in the two apart from the extended release tablets being coated to - ummm - extend its release.
Without more information on the other management methods employed by your dad - things such as his food plan - there's no way we can make a determination. Keep in mind that even using injected insulin, metformin does not give license to eat more carbs.
Without more information on the other management methods employed by your dad - things such as his food plan - there's no way we can make a determination. Keep in mind that even using injected insulin, metformin does not give license to eat more carbs.
I don't now what he does at work now but I do know that the first time this happened that neither his eating habits nor his insulin had changed when he took both metformin types. At that time he was home after having surgery and we fixed everything he ate and we did most of his injections. His carb intake was a little less than the dietician recommended at the time.
Now I'm pretty sure he eats about the same every day with a cookie once in a while. While he could eat less carbs he is eating what the dietician recommended but he is back at work and more physically active.
I was just curious that with no change in diet or insulin that the ER would raise his BG both times. The one thing that is different this time is that he is back to work and spends more time in the sun and drinks more water. But with the increased activity that should lower his BG, right?
His dosage for both the regular and the ER is the same twice a day. Since metformin has to build up in a persons system it shouldn't matter the time of day he takes it in relation to meal times should it?
Thanks for the input Mary & Shanny. Oh, and the regular metformin doesn't bother him.
Now I'm pretty sure he eats about the same every day with a cookie once in a while. While he could eat less carbs he is eating what the dietician recommended but he is back at work and more physically active.
I was just curious that with no change in diet or insulin that the ER would raise his BG both times. The one thing that is different this time is that he is back to work and spends more time in the sun and drinks more water. But with the increased activity that should lower his BG, right?
His dosage for both the regular and the ER is the same twice a day. Since metformin has to build up in a persons system it shouldn't matter the time of day he takes it in relation to meal times should it?
Thanks for the input Mary & Shanny. Oh, and the regular metformin doesn't bother him.
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Like Shanny said ER refers to "Extended Release".
Metformin takes a while to build up in the system & work at optimum levels. So if there is some change in the BG levels, it should also settle down in 2/3 weeks.
I would recommend a thorough reading of bloodsugar101 to get a good understanding of diabetes.
Activity can increase or decrease your blood sugar levels. It would depend on the body's internal stock of glucose. If the stores are high, some of the glucose will be released & sugar levels will tend to go up - and vice versa.
Metformin takes a while to build up in the system & work at optimum levels. So if there is some change in the BG levels, it should also settle down in 2/3 weeks.
I would recommend a thorough reading of bloodsugar101 to get a good understanding of diabetes.
Activity can increase or decrease your blood sugar levels. It would depend on the body's internal stock of glucose. If the stores are high, some of the glucose will be released & sugar levels will tend to go up - and vice versa.
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Metformin doesn't take effect for weeks, so it's unlikely that the change would happen that quickly.
Also, many nutritionists recommend eating FAR more carbs than is actually healthy.
As a start, be sure to check out these sites:
Blood Sugar 101
LCHF for Beginners | DietDoctor.com
They contain a lot of great info about diabetes and the way to stay healthy.
Many of us here follow a low carb, high fat diet. It keeps your BG low and is heart healthy! Yes, you have been deceived all these years.
The Fat Question: Why fat doesn’t make you fat | Eat Naked Now
Also, many nutritionists recommend eating FAR more carbs than is actually healthy.
As a start, be sure to check out these sites:
Blood Sugar 101
LCHF for Beginners | DietDoctor.com
They contain a lot of great info about diabetes and the way to stay healthy.
Many of us here follow a low carb, high fat diet. It keeps your BG low and is heart healthy! Yes, you have been deceived all these years.
The Fat Question: Why fat doesn’t make you fat | Eat Naked Now
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If the regular metformin doesn't bother him (cause intestinal upsets) then there's probably no reason for using the ER version.
Take a good look at diet because it's the carbs we eat that raise blood sugar, apart from outside factors such as stress, exercise (for some it lowers BG but if too strenuous it can raise it). And some meds will raise BG.
What was your dad's last A1C? If it was 6.5 or higher, then he really should be curbing those carbs because he is opening himself up for diabetic complications. What the folks on this forum have in common is a determination to keep our BG below 140mg/dl at all times. We accomplish this by testing our meals so that we can identify the food that spiked our BG.
The testing that will give the best information is
before the meal - to see where it is before eating
1 hr after first bite - to see how high the spike from the meal
2 hr after first bite - to see if BG is going down to where it was before the meal
If any of these pp (post prandial) readings are over 140 - then the diabetic would do well to avoid the foods in the future.
I know you say he takes insulin, but if he's eating a lot of carbs, all the insulin in the world isn't going to stabilize his BG.
This is a serious matter. I hope your dad can see that and be open to changing his diet and getting his BG in control.
Take a good look at diet because it's the carbs we eat that raise blood sugar, apart from outside factors such as stress, exercise (for some it lowers BG but if too strenuous it can raise it). And some meds will raise BG.
What was your dad's last A1C? If it was 6.5 or higher, then he really should be curbing those carbs because he is opening himself up for diabetic complications. What the folks on this forum have in common is a determination to keep our BG below 140mg/dl at all times. We accomplish this by testing our meals so that we can identify the food that spiked our BG.
The testing that will give the best information is
before the meal - to see where it is before eating
1 hr after first bite - to see how high the spike from the meal
2 hr after first bite - to see if BG is going down to where it was before the meal
If any of these pp (post prandial) readings are over 140 - then the diabetic would do well to avoid the foods in the future.
I know you say he takes insulin, but if he's eating a lot of carbs, all the insulin in the world isn't going to stabilize his BG.
This is a serious matter. I hope your dad can see that and be open to changing his diet and getting his BG in control.
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Like others say, it takes a while for the metformin to begin working, not sure time frame he was on each based on your posts. Also what were the dosages of each. One of them has max dose of 2000 mg and the other 2550 mg, regular is 2k mg I think. Also slightly less carbs than dietitian recommends is way more than most of us eat per day. I look at around 30 grams per day. Despite what they say, carbs are not necessary, so why put the very thing that raises BG the most into your body if you don't have to have it?
Yes, metformin needs to be taken with food at approximately the same times each day. Taking it at meal time really is the best thing to do. Try counting how many grams of carbs he is eating per day. If it is over 100, it isn't the metformin. (Not that I think it is anyway.) He needs to approach 50grams or below per day if he plans to control with diet and metformin.
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