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Discussion Starter · #1 ·
I have been a diabetic T2 since 2005, I take Metformin 500mg once a day and live a low carb diet anywhere between 20-50 carbs a day.
I have gone up to 450 numerous times and go to my doctor regulary
I have used byetta for a year and have used actos too. ATM I have been fighting to keep my BG level lower been around 350 and hovering at 170-240 for about a month. I have a doctors appointment on Tuesday. I have upped my Metformin to twice a day and still showing bad numbers. I am going to ask my doctor for the second time now for insulin. Does anyone have any suggestions for me. and is this a good thing to ask for?

Thanks very much
 

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I am type 2, controlled by diet only right now. I have used medications in the past, but they've always worked. I would think that if your numbers are still that high, that the medication is not working and your doctor would want to try something else, especially if increased the medication hasn't helped.

What kind of carbs are you eating? Is your fasting still high as well? How long have you been on the higher dose?

As I understand it, Metformin can take a while to build up in the system and lower your numbers.

Does goes for a walk after you eat help lower your numbers?

Not sure I'm much help, but I'm sure the others will chime in :)
 

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If I was eating that low carb (which I mostly am), and still having high numbers with medication, I'd also be demanding insulin.

What was the reason your doc refused the first time you asked? Do you and your doc agree on a goal for your blood sugar?

Oh - and welcome to the forum! :)
 

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Discussion Starter · #4 ·
I am type 2, controlled by diet only right now. I have used medications in the past, but they've always worked. I would think that if your numbers are still that high, that the medication is not working and your doctor would want to try something else, especially if increased the medication hasn't helped.

What kind of carbs are you eating? Is your fasting still high as well? How long have you been on the higher dose?

As I understand it, Metformin can take a while to build up in the system and lower your numbers.

Does goes for a walk after you eat help lower your numbers?

Not sure I'm much help, but I'm sure the others will chime in :)
I have been on metformin consistantly for over 6 years. As for diet I am on Atkins, diet is all meat protein eggs and vegetable. average is 20 -45 carbs a day give or take.

I am actually at a lost with as little carbs as i take per day and rising blood sugar levels.

When BG is high I add Metformin twice daily per my doctors orders.
but feel its failing me right now
 

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Discussion Starter · #5 ·
If I was eating that low carb (which I mostly am), and still having high numbers with medication, I'd also be demanding insulin.

What was the reason your doc refused the first time you asked? Do you and your doc agree on a goal for your blood sugar?

Oh - and welcome to the forum! :)
Thank you for the welcome :)

I never did get a reason why he said no, could have been at that time I had no insurance, but have it now. Isnt it better to be on insulin in the first place? Better control, more natural right?
 

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I've heard a lot of criticism of docs being slow or downright resistant to prescribing insulin for Type 2s.

In your shoes, I would be demanding insulin. The stuff has made a world of difference for me.

Please keep us posted!
 

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Even at twice daily, your metformin isn't even half the maximum dosage. You have a very conservative doc, I'd say! What is your A1c? What other tests have you had to document the progress of your diabetes?

When you say 450, would that be a postprandial reading? As for the hovering around 170-240, are those fasting readings or an average of all your readings?

If your doc isn't willing to get moving on controlling your BG, my opinion is that you'd be wise to shop around for a doc who actually knows something about diabetes.

Welcome to DF - thank you for joining us! :wave:
 

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Hi and welcome to the forum. I have been D for almost 5 years. I started out of 500mg of metformin and it did nothing. I doulbed it and it did nothing. Even at 1700 mg I had a hard time controlling bgs. I finally pleaded with my doc to raise it. He kept telling me it wouldn't work, but finally he caved and wrote me an Rx for 2550. I fiddled with the timing of the 3 daily doses and found what worked for me and it has. I find I spike highest in the morning so I take a dose when I wake up and another mid morning. The last dose I take right before bed. My bgs now are consistently in the low 100's. I am surprised your doctor hasn't taken more agressive action with your higher bgs. Metformin works in the liver not the pancreas. So even though it makes us more sensitive to our own insulin, if you are insulin insufficient it won't work by itself. I would definitely push for insulin.

Another thing, even if you are doing Low Carb, if you eat too much protein it can be converted to glucose but at a much slower rate. I do my own version of low carb/high fat. But my protein is usually limited to 2-3 oz of meat at a meal. Many of my meals are meatless. But I do include a significant fat source in each meal. My fat of choice is Coconut Oil.
 
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Even at twice daily, your metformin isn't even half the maximum dosage. You have a very conservative doc, I'd say! What is your A1c? What other tests have you had to document the progress of your diabetes?

When you say 450, would that be a postprandial reading? As for the hovering around 170-240, are those fasting readings or an average of all your readings?

If your doc isn't willing to get moving on controlling your BG, my opinion is that you'd be wise to shop around for a doc who actually knows something about diabetes.

Welcome to DF - thank you for joining us! :wave:

What is the maximum Metformin dose? My doc said 1000mg, but I see others taking more.

Thanks,
Jere
 

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Discussion Starter · #10 ·
What is the maximum Metformin dose? My doc said 1000mg, but I see others taking more.

Thanks,
Jere
I have been on 500mg per day but if it takes off, my nurses tell me to up it to twice a day one in the morning and another at night so 1000mg per day.

Recent news I have a friend who is a nurse and told not to up my dose and to plead with my doctor to get on insulin. Mean while till my doctor appointment this Tuesday, I have picked up a A1c home test kit, now I will have ammo when I go see my doctor.. I havent tested myself yet, I want a fasting reading, the kit however says it doesnt matter though
 

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Maximum Met does is 2550

metformin needs to be taken EVERY day. It is not a drug that works as needed. it has to build up in your system and can take up to 6 weeks to come up to full speed.
 

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Discussion Starter · #12 ·
I just did my home A1c kit after a 12hr fast even knowing the kit says it doesn't have to be. My number is 9.1% and my waking BG was 241.
 

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I just did my home A1c kit after a 12hr fast even knowing the kit says it doesn't have to be. My number is 9.1% and my waking BG was 241.
I have been on 2000 mg of Metformin for a few years now. I take 1000 mg in AM and 1000 mg in PM. I thought 2000 mg a day was max dose, but I do see many here that take 2550 mg. I may have to talk to the doctor about upping my Metformin dose. I used to take Amaryl ( a sulfylonurea), but have recently started basal/bolus insulin so discontinued the Amaryl. The insulin combination has certainly helped me, along with careful control of diet and exercise. I still have difficulty with morning number, but it is slowly coming down. I used to have bg's that, no matter what I did, hovered in the low-mid 300's. I do not understand why a doctor would be so hesitant to put you on insulin with numbers as high as you have. I had been on basal insulin years back and I was the one hesitant to use it. The doctors were actually pushing it on me (turns out back then it did not really make a difference over oral meds so I quit using it. Of course I did not know about the diabetes forum or low carbing at that time). I knew it was time for me to try it again, but in a different fashion this time. I spoke with my Endo and came to the agreement of using the Metformin, Levemir (long acting) and Humulog (fast-acting). It is working so far. I have seen my numbers around meal times being much, much better and I am learning what foods I definitely cannot eat and those that I can without affecting my bg's too much. I say continue to fight, or find another doctor. Be sure to find a specialist in diabetes treatment, not just a general endocrinologist. I have finally found a group of doctors that I feel confident with and who will work with me to get me healthy and fit. You are worth it! Also, I just want to add my short (HA! I never leave a short message) soap-box vent at this point. Why do these doctors think that a patient has no clue about what is going on with their body? Just because they went to school doesn't give them the right to tell me how I feel inside and when I know something just isn't right. The relationship between a doctor and patient should be one that compliments one another and a team effort. A patient should ALWAYS be proactive in their health and treatment of such. Thank you. I'm done now. ;)
 
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Max dose for Metformin is 2550, but for Metformin ER/XR it's 2000.
 

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Discussion Starter · #15 ·
update

I have been doing fairly good, but now my medicine is failing once more
Finally my doctor put me on Lantus. Only problem I am having is my sugars in the morning and at night are at 300, mid day
during peak 200-275. I am taking 5mg glipizide once a day
1000mg Metfromin once a day and 5mg Onglyza once a day
20units of Lantus once a day All Meds in the morning.
If I eat Breakfast that is carb rich versus protein i jump to 400

Is there a break in point for Lantus? I have been on it for only 4 days.
 

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Why are you eating "carb rich" meals? If you stop eating carbs, a lot of the problem will resolve automatically. Carbs raise blood sugar, so don't eat carbs and your blood sugar doesn't rise so much.
 

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Discussion Starter · #17 ·
Why are you eating "carb rich" meals? If you stop eating carbs, a lot of the problem will resolve automatically. Carbs raise blood sugar, so don't eat carbs and your blood sugar doesn't rise so much.[/QUOTE

I had a small bowl of whole grain bran cereal with almond milk for breakfast, I usually eat eggs for break fast which usually only brings it up 25-30 points the rest of my day is low carb.
 

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Lantus isn't meant to offset the meals you eat - for that you need a bolus insulin which is administered at mealtime and dosed on the amount of carbs your meal contains. Lantus is your basal insulin - working in the background to maintain more stable levels and possibly offset dawn phenomenon.

And grains of any kind are going to shoot your blood sugar through the roof. I think if you would restrict your carbs some more, you might be able to do with fewer of all these drugs you're taking.
 
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