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Metformin Not Lowering Blood Sugar

Metformin 101: Blood Sugar Levels, Weight, Side Effects

Metformin 101: Blood Sugar Levels, Weight, Side Effects

As a type 2 diabetic, you've probably heard of Metformin, or you might even be taking it yourself. Metformin (brand name “Glucophage” aka “glucose-eater”) is the most commonly prescribed medication for type 2 diabetes worldwide…and for good reason. It is one of the safest, most effective, least costly medication available with minimal, if any, side effects. There are always lots of questions around Metformin – how does metformin lower blood sugar, does metformin promote weight loss or weight gain, will it give me side effects – and lots more. Today we'll hopefully answer some of those questions. How Metformin Works Metformin belongs to a class of medications known as “Biguanides,” which lower blood glucose by decreasing the amount of sugar put out by the liver. The liver normally produces glucose throughout the day in conjunction with the pancreas’ production of insulin to maintain stable blood sugar. In many people with diabetes, both mechanisms are altered in that the pancreas puts out less insulin while the liver is unable to shut down production of excess glucose. This means your body is putting out as much as 3 times as much sugar than that of nondiabetic individuals, resulting in high levels of glucose in the bloodstream. Metformin effectively shuts down this excess production resulting in less insulin required. As a result, less sugar is available for absorption by the muscles and conversion to fat. Additionally, a lower need for insulin slows the progression of insulin resistance and keeps cells sensitive to endogenous insulin (that made by the body). Since metformin doesn’t cause the body to generate more insulin, it does not cause hypoglycemia unless combined with a sulfonylurea or insulin injection. Metformin is one of the few oral diabe Continue reading >>

Metformin No Longer Working?

Metformin No Longer Working?

I've been on and off the diabetes roller-coaster for about five years now. Before I was diagnosed I had no idea my sugars were highbecause I wasn't heavily overweight (I'm 5/9, around 175 lbs) I didn't think *I* could have a problem, but I drank every single day since I was 18 and that became a problem. But I also loved pasta, rice, potatoes and sweets, so that really put the nails in my coffin. I was doing really well with diet and exercise there for a while, and was completely off metformin, but since the end of last year, my sugar habits having crept backalthough I still maintain a very low-carb, non-processed-food dietI restarted the metformin. I walk briskly for about five-eight hours a week and really try to keep my carb and sugar intake down, but it seems that these days the metformin are not helping keep my sugar levels down. Could I be building a tolerance to metformin? These days it seems that even up to 6-8 hours after I eat my main meal of a daywhich is regular-to-small portions of non processed foodsone of my favorite dinners is grilled chicken in a whole wheat pita with onions, peppers, garlic and lettuce/slaw mix (minus the mayonnaise)and I've completely laid off the pasta/rice/potatoes food train in the last few yearsmy sugars are high. By high I mean around 9-11Mmol (meaning up to 198 in US measurements). This seems to make my heart pound and wake me up in the middle of the night, which leads to my chronic insomnia. I know that's a lot of questions but what I mainly want to know is, could my metformin be losing its efficiency? I take 500mg daily and try to take it before I eat dinner, but it seems to make little difference whether I take it before or after dinnermy sugar levels soar and stay around 195 for hours. My doctor is a schmuck who knows very l Continue reading >>

Metastudy Confirms Metformin Appropriate Treatment For Prediabetes

Metastudy Confirms Metformin Appropriate Treatment For Prediabetes

A study that reviewed several previous studies about the impact of using metformin on the progression of prediabetes to diabetes confirms that yes, people with prediabtes who take metformin end up with better blood sugars after 3 years than those who don't and are therefore less likely to be diagnosed with full-blown diabetes. This isn't original research, it's just a look at the major studies that have examined the impact of metformin on prediabetes. But because I hear from so many people with prediabetes whose doctors won't give them any help at all, I though it worth a look. Treating prediabetes with metformin: Systematic review and meta-analysis Muriel Lilly, Can Fam Physician Vol. 55, No. 4, April 2009, pp.363 - 369 The key issue to remember here is that the concept that "prediabetes" progresses to "diabetes" which treats the two conditions as if they were separate diseases is flawed. In fact, the medical definition of "diabetes" is completely arbitrary. A committee years ago chose some blood sugar test results and defined them as "diabetes." They could have--and many argue should have--chosen different test result numbers. But they chose the ones they did mainly, their own documentation showed, to diagnose people with diabetes as late as possible, because of the severe penalties the American medical system imposes on people who have pre-existing conditions. You can read about how the diagnostic standards for diabetes were set HERE. "Prediabetes" was also defined arbitrarily at the same time as "diabetes" was defined and as has been the case with diabetes, the definition has changed over the years. But what you, the person with abnormal blood sugar, need to understand is that there's no sudden change in your health that happens when you get an official diabetes dia Continue reading >>

Proven Tips & Strategies To Bring High Blood Sugar Down (quickly)

Proven Tips & Strategies To Bring High Blood Sugar Down (quickly)

Untreated, high blood sugar can cause many problems and future complications. Recognizing signs of high blood sugar levels and knowing how to lower them can help you prevent these complications and increase the quality and length of your life. Topics covered (click to jump to specific section) High blood sugar level symptoms and signs Symptoms of high blood sugar include: Increased thirst Tired all the time Irritability Increased hunger Urinating a lot Dry mouth Blurred vision Severe high blood sugar can lead to nausea and fruity smelling breath The signs and symptoms for high blood sugar are the same for both type 1 and type 2. Signs usually show up quicker in those who have type 1 because of the nature of their diabetes. Type 1 is an autoimmune disease that causes the body to stop making insulin altogether. Type 2 is caused by lifestyle factors when the body eventually stops responding to insulin, which causes the sugar to increase slowly. People with type 2 can live longer without any symptoms creeping because their body is still making enough insulin to help control it a little bit. What causes the blood sugar levels go to high? Our bodies need sugar to make energy for the cells. Without it, we cannot do basic functions. When we eat foods with glucose, insulin pairs with it to allow it to enter into the cell wall. If the insulin is not there, then the glucose molecule can’t get through the wall and cannot be used. The extra glucose hangs out in the bloodstream which is literally high blood sugar. The lack of insulin can be caused by two different things. First, you can have decreased insulin resistance which means that your insulin doesn’t react the way that it is supposed to. It doesn’t partner with glucose to be used as fuel. Secondly, you can have no insuli Continue reading >>

Metformin And Insulin Resistance

Metformin And Insulin Resistance

About a year ago, my endocrinologist determined that I was exhibiting signs of insulin resistance. In short, my body requires more than the average amount of insulin to cover carbohydrate. She suggested that I start taking metformin, noting that it would do two things for me: It would decrease the amount of insulin I need to take and it would help curb my appetite, thus resulting in weight loss. When I first got on it, I thought it was great. My blood sugar levels improved, my appetite was in fact curbed, and all seemed wonderful — until I stopped taking my metformin. As a high school senior, I had atrocious sleeping habits! That, coupled with the fact that taking metformin was really killing my appetite, was causing me to become exhausted and get some pretty severe headaches. Looking back on it now, it’s very clear that the metformin wasn’t the problem, it was me. However, as a stubborn senior in high school, I was determined to maintain my sleeping habits, as I deemed them completely normal and in accordance with the typical behavior exhibited by my peers (boy, how I’ve changed…). So, I stopped the metformin. The last three weeks or so, I’ve been back on metformin regularly. I decided to start it up again after my last appointment with my CDE. Thus far, it’s really been working wonders and my blood sugars have decreased substantially! Where my 30-day average was hovering around 190 just a few weeks ago, it has now dropped to 137! I was seriously shocked when I saw how much my average fell. For the most part, my blood sugar levels are in range, but I have had my fair share of lows as well. Managing metformin really is a science that can change on a daily basis depending on my activity level. For example, the first two weeks that I was back on metformin, I Continue reading >>

About Metformin

About Metformin

Metformin is a medicine used to treat type 2 diabetes and sometimes polycystic ovary syndrome (PCOS). Type 2 diabetes is an illness where the body doesn't make enough insulin, or the insulin that it makes doesn't work properly. This can cause high blood sugar levels (hyperglycemia). PCOS is a condition that affects how the ovaries work. Metformin lowers your blood sugar levels by improving the way your body handles insulin. It's usually prescribed for diabetes when diet and exercise alone have not been enough to control your blood sugar levels. For women with PCOS, metformin stimulates ovulation even if they don't have diabetes. It does this by lowering insulin and blood sugar levels. Metformin is available on prescription as tablets and as a liquid that you drink. Key facts Metformin works by reducing the amount of sugar your liver releases into your blood. It also makes your body respond better to insulin. Insulin is the hormone that controls the level of sugar in your blood. It's best to take metformin with a meal to reduce the side effects. The most common side effects are feeling sick, vomiting, diarrhoea, stomach ache and going off your food. Metformin does not cause weight gain (unlike some other diabetes medicines). Metformin may also be called by the brand names Bolamyn, Diagemet, Glucient, Glucophage, and Metabet. Who can and can't take metformin Metformin can be taken by adults. It can also be taken by children from 10 years of age on the advice of a doctor. Metformin isn't suitable for some people. Tell your doctor before starting the medicine if you: have had an allergic reaction to metformin or other medicines in the past have uncontrolled diabetes have liver or kidney problems have a severe infection are being treated for heart failure or you have recentl Continue reading >>

Metformin | Diabetesnet.com

Metformin | Diabetesnet.com

Thu, 11/18/2010 - 15:57 -- Richard Morris Two drugs from the biguanide class, metformin and phenformin, were developed in 1957. Unfortunately, phenformin reached the U.S. market first and resulted in several deaths from lactic acidosis. When this risk surfaced, phenformin was pulled from drugstore shelves worldwide. Metformin was eventually found to be 20 times less likely to cause lactic acidosis, but it was tainted by the history of its cousin. Metformin first became available in France in 1979 and has been widely used in Europe since then, but it was not cleared for use in Type 2 diabetes in the U.S. until 1994. Target Organ: Liver, secondary effects on muscle and fat. Action: Lower glucose production by liver, increase number of insulin receptors Side Effects: bloating, fullness, nausea, cramping, diarrhea, vit B12 deficiency, headache, metallic taste, agitation, lactic acidosis Contraindications: DKA, alcoholism, binge drinking, kidney or liver disease, congestive heart failure, pregnancy, use of contrast media, surgery, heart attack, age > 80 Metformin is a chemical kin to the French lilac plant, which was noted in the early 1900’s to lower the blood sugar. However, French lilac, like phenformin, turned out to be too toxic for use in humans. Metformin, with a much shorter action time than phenformin, has a much lower risk for severe side effects and is quite safe for use by anyone who is otherwise healthy. In fact, in the major UKPDS study, it was the only drug that reduced diabetes-related death rates, heart attacks, and strokes. It should not be used by those who use more than two ounces or two drinks of alcohol a day, who have congestive heart failure, or who have significant kidney, liver, or lung disease. Metformin lowers fasting blood glucose levels by an Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>

When Type 2 Diabetes Treatment Fails, What’s Next?

When Type 2 Diabetes Treatment Fails, What’s Next?

For most people, type 2 diabetes changes over time — even for those who follow their treatment plan exactly as directed. As the disease progresses, your diabetes care team can help you adjust your treatment plan and manage your blood sugar levels. If a change is needed, your doctor may add new diabetes medications or suggest starting an insulin regimen. This doesn’t mean you did something wrong — shifting gears is a natural part of managing a changing chronic disease like type 2 diabetes. There are a number of factors that can contribute to a decline in blood sugar control, says Margaret Powers, PhD, RD, CDE, past-president of health care and education for the American Diabetes Association and a research scientist at the International Diabetes Center at Park Nicollet Health Services in Minneapolis, Minnesota. When type 2 diabetes first develops, you may be insulin resistant, which means you make a lot of insulin but your body can’t use it effectively, Dr. Powers says. Then, over time, you make less insulin and become insulin deficient. “This is seen a lot, but it doesn’t happen overnight — it’s a gradual process,” says Powers. Other factors, including a significant change in weight, activity level, or diet, or starting new medications, can also affect blood sugar, she says. Stress is another factor that can impact your treatment. An additional illness or a major change like a divorce, job loss, or a loved one’s death can increase stress, which can raise blood sugar. These life changes may affect how well people take their medication, says Susan Weiner, RDN, a certified diabetes educator in New York and the 2015 Educator of the Year of the American Association of Diabetes Educators. “Before, there may have been someone who helped motivate and suppor Continue reading >>

Diabetes Discussion Boards - Joslin Diabetes Center

Diabetes Discussion Boards - Joslin Diabetes Center

Couple or threethings are contributing to your morning blood sugars. first off, any kind of illness will raise blood sugars. Stomach flu will definitely do that. second, you are on a lower dose of metformin then you may need. The typical dose seems to be 1000mg BID (twice daily). You are taking half of that. Your dr. will probably increase your dose by 500 mg at a time. Trust me, don't try to rush getting to a higher dose with metformin, unless you enjoy living in the bathroom. third, there's something called the dawn effect. We all have it, and it effects some people more then others. In the early morning hours, the body starts producing more of certain hormones as preparation for awakening. These hormones have the effect of raising blood sugars, which for a non-diabetic, there's enough insulin to deal with. Since we are diabetic, this causes our blood sugars to go up in the morning. One way to combat thise, believe it or not, is to have a small snack with about 15gms of carbohydrate just before going to bed. This helps to keep the liver from running out of glucose and going into gluconeogenisis (fancy term for making sugar). Please don't be discouraged. It takes a while to get into a diabetes program that works for you. I've been around the block experimenting with different meds, and insulins. I agree with everything that's been said, in particular, that your Metformin dose is probably half of what it could be. I understand a typical dose to be 1,500-2,000. Plus, if you are a Type 2, you may want to try a combination of Januvia and Metformin. Januvia was designed to work together with Metformin in the body - the extent to which, they are now packaging the two drugs together: "Janumet". You can read more about here: Yes, being sick will throw off blood sugar. Just KE Continue reading >>

I Take Metformin 500 Three Times A Day, Yet My Blood Sugar Is High?

I Take Metformin 500 Three Times A Day, Yet My Blood Sugar Is High?

Q: I take metformin 500 three times a day, and I eat less carbs and I exercise, yet my blood sugar levels remain high—up to 171 this morning. I'm sorry to hear that your blood glucose levels remain elevated despite taking metformin, watching your carbs, and exercising. Are you getting enough high-quality sleep on a regular basis? Inadequate sleep can cause high blood sugar readings in the morning even in people who eat right, exercise, and take medication as directed. Your elevated fasting blood blood sugar may also be due to the Dawn Phenomenon, in which increased production of growth hormone and other hormones overnight cause your liver to release stored sugar. Sometimes having a small protein snack—like a handful of nuts or a hard-boiled egg—before bed can help lower morning blood sugar. In fact, some people find that adding some carbs, like a half cup of berries, to the protein snack actually helps bring down their morning blood sugar even more. However, this is very individual, so it's a good idea to experiment with different snacks and amounts of food to see how your own blood sugar responds. Finally, consistency with diet, exercise, and medication is important, and it may take some time for blood sugar to normalize. If the measures above and keeping carb intake down, speak with your endocrinologist or other diabetes specialist. Answered By dLife Expert: Franziska Spritzler, RD, CDE Certified diabetes educator and registered dietitian living in Southern California. Disclaimer The content of this website, such as text, graphics, images, and other material on the site (collectively, “Content”) are for informational purposes only. The Content is not intended to be a substitute for, and dLife does not provide, professional medical advice, diagnosis or treatm Continue reading >>

Steps To Take If Your Oral Diabetes Medication Stops Working

Steps To Take If Your Oral Diabetes Medication Stops Working

Oral medicines are effective at lowering blood sugar when diet and exercise aren’t enough to manage type 2 diabetes. Yet these drugs aren’t perfect — and they don’t always work in the long term. Even if you’ve been taking your medicine just as your doctor prescribed, you might not feel as well as you should. Diabetes drugs can and often do stop working. About 5 to 10 percent of people with type 2 diabetes stop responding to their medicine each year. If your oral diabetes drug is no longer working, you’ll need to figure out what’s preventing it from controlling your blood sugar. Then you’ll have to explore other options. Look at your daily habits When your oral diabetes medicine stops working, make an appointment with your doctor. They will want to know if anything in your routine has changed. Many factors can affect how well your medicine is working — for instance, weight gain, changes in your diet or activity level, or a recent illness. Making a few changes to your diet or exercising more each day might be enough to get your blood sugar under control again. It’s also possible that your diabetes has progressed. The beta cells in your pancreas that produce insulin can become less efficient over time. This can leave you with less insulin and poorer blood sugar control. Sometimes your doctor may not be able to figure out why your medicine stopped working. If the drug you’ve been taking is no longer effective, you’ll need to look at other medications. Add another drug Metformin (Glucophage) is often the first drug you’ll take to control type 2 diabetes. If it stops working, the next step is to add a second oral drug. You have a few oral diabetes medicines to choose from, and they work in different ways. Sulfonylureas such as glyburide (Glynase Pres Continue reading >>

What Next When Metformin Isn't Enough For Type 2 Diabetes?

What Next When Metformin Isn't Enough For Type 2 Diabetes?

› Turn first to metformin for pharmacologic treatment of type 2 diabetes. A › Add a second oral agent (such as a sulfonylurea, thiazolidinedione, sodium-glucose cotransporter-2 inhibitor, or dipeptidyl peptidase 4 inhibitor), a glucagon-like peptide-1 (GLP-1) receptor agonist, or basal insulin if metformin at a maximum tolerated dose does not achieve the HbA1c target over 3 months. A › Progress to bolus mealtime insulin or a GLP-1 agonist to cover postprandial glycemic excursions if HbA1c remains above goal despite an adequate trial of basal insulin. A Strength of recommendation (SOR) A Good-quality patient-oriented evidence B Inconsistent or limited-quality patient-oriented evidence C Consensus, usual practice, opinion, disease-oriented evidence, case series The "Standards of Medical Care in Diabetes" guidelines published in 2015 by the American Diabetes Association (ADA) state that metformin is the preferred initial pharmacotherapy for managing type 2 diabetes.1 Metformin, a biguanide, enhances insulin sensitivity in muscle and fat tissue and inhibits hepatic glucose production. Advantages of metformin include the longstanding research supporting its efficacy and safety, an expected decrease in the glycated hemoglobin (HbA1c) level of 1% to 1.5%, low cost, minimal hypoglycemic risk, and potential reductions in cardiovascular (CV) events due to decreased low-density lipoprotein (LDL) cholesterol.1,2 To minimize adverse gastrointestinal effects, start metformin at 500 mg once or twice a day and titrate upward every one to 2 weeks to the target dose.3 To help guide dosing decisions, use the estimated glomerular filtration rate (eGFR) instead of the serum creatinine (SCr) level, because the SCr can translate into a variable range of eGFRs (TABLE 1).4,5 What if metfo Continue reading >>

Type 2 Diabetes Faqs

Type 2 Diabetes Faqs

Common questions about type 2 diabetes: How do you treat type 2 diabetes? When you have type 2 diabetes, you first need to eat a healthy diet, stay physically active and lose any extra weight. If these lifestyle changes cannot control your blood sugar, you also may need to take pills and other injected medication, including insulin. Eating a healthy diet, being physically active, and losing any extra weight is the first line of therapy. “Diet and exercise“ is the foundation of all diabetes management because it makes your body’s cells respond better to insulin (in other words, it decreases insulin resistance) and lowers blood sugar levels. If you cannot normalize or control the blood sugars with diet, weight loss and exercise, the next treatment phase is taking medicine either orally or by injection. Diabetes pills work in different ways – some lower insulin resistance, others slow the digestion of food or increase insulin levels in the blood stream. The non-insulin injected medications for type 2 diabetes have a complicated action but basically lower blood glucose after eating. Insulin therapy simply increases insulin in the circulation. Don’t be surprised if you have to use multiple medications to control the blood sugar. Multiple medications, also known as combination therapy is common in the treatment of diabetes! If one medication is not enough, you medical provider may give you two or three or more different types of pills. Insulin or other injected medications also may be prescribed. Or, depending on your medical condition, you may be treated only with insulin or injected medication therapy. Many people with type 2 diabetes have elevated blood fats (high triglycerides and cholesterol) and blood pressure, so you may be given medications for these problem Continue reading >>

Wait Times: How Long Until Your Med Begins Working

Wait Times: How Long Until Your Med Begins Working

Photography by Mike Watson Images/Thinkstock There are many type 2 medications, and each drug class works in the body in a different way. Here’s a quick guide to help you understand how long each drug will generally take to work: These short-acting oral medications, taken with meals, block the breakdown of complex sugars into simple sugars in the gastrointestinal (GI) tract. “Simple sugars are more easily absorbed and cause the blood sugar to ultimately go up,” Sam Ellis, PharmD, BCPS, CDE, associate professor in the Department of Clinical Pharmacy at the University of Colorado says. These drugs are minimally absorbed into the blood, so a certain blood level concentration is not necessary for them to work. You will see the effect immediately with the first dose. “You take it before a meal, and with that meal you see the effect,” says George Grunberger, MD, FACP, FACE, President of the American Association of Clinical Endocrinologists. While researchers aren’t exactly sure how these oral medications work, it’s likely that the meds block some absorption of glucose in the GI tract. “You’ll see most of the effect in the first week with these drugs,” says Ellis. alogliptin, linagliptin, saxagliptin, sitagliptin These drugs work to block the enzyme responsible for the breakdown of a specific gut hormone that helps the body produce more insulin when blood glucose is high and reduces the amount of glucose produced by the liver. Take a DPP-4 inhibitor (they come in pill form) and it’ll work pretty fast—you’ll see the full effect in about a week. “It’s blocking that enzyme after the first dose a little bit, but by the time you get out to dose five, you’re blocking the majority of that enzyme,” Ellis says. albiglutide, dulaglutide, exenatide, exe Continue reading >>

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