Glucose response to metforming therapy

I started taking 500mg metforming twice a day this past Wednesday. I'm wondering how long before I start seeing lower glucose levels.  My average so far is 322, highest 375 and lowest 330.  I might add that I am also taking Sutant for renal cell carcinoma, Hyzar and norvesc for high blood pressure.  A side effect of Sutant is a shut down of my thyroid consequently I am also taking synthroid.    

[Zoelula]

I don't have the exact answer to how long before the Metformin takes effect, gus. When I started on meds I started on a combination of Metformin and a couple others and I do remember seeing results fairly quickly (maybe a week)  I do have questions as to whether you are testing your blood sugar on a regular basis and modifying your diet based on the results you see. You sound like you have a lot on your plate; best of luck to you!

[WaveRider]

"I'm wondering how long before I start seeing lower glucose levels."

That's too hard to answer. Metformin helps to lower your glucose by producing some insulin in the gut but it really depends on your lifestyle, your nutrition, your activity. Ignore one and you decrease the chance of Metformin helping you.

I drafted this document the other day and you will be the first.

There are over 21 million American adults and children who suffer from diabetes type 2 and the number is growing rapidly each day. The typical diet high in sugar and processed foods only adds fatigue, creates cardio issues, and raises glucose levels which in turn brings about diabetes.

Here are some tips to help control and lower your glucose:
1. Cut out sugar and processed foods. It’s the most important and hardest thing to do. Eat more fruits and veggies instead. Skip desert, period. Stop munching. Its not too late start eating better.
2. Eat a better breakfast. Your metabolism is faster in the morning than it is later in the day. Skip the man made dry cereals for they are loaded with sugar. Instead of doughnuts, eat foods high in fiber, protein and good fats, like a veggie omelet, or oatmeal with ¼ tsp cinnamon and handful of blueberries for the antioxidant compounds.
3. Learn to love your veggies. Although it’s contrary to many American meals, eat a main course of veggies with a small side of meat to provide the right nutritional balance.

Moderate exercise:
1. Go for a walk after eating to help burn off excess glucose.
2. Do some sort of moderate exercise daily or at least 3-5 times a week.

Weight:
1. You’d be surprised how much lower your glucose will be if you shed those EXTRA pounds.

It’s all up to you to start practicing a better lifestyle control to improve and maintain good health. If you enjoy being sick and miserable, ignore this post completely.

[WaveRider]

Good morning Zoe!

[gus201]

Thanks for your responses.  I went to see my oncologist this morning and discussed the diabetes. It was my kidney specialist that put me on metformin. The oncologist thinks that my high TSH maybe a factor in my having diabetes.  I have started an exercise routine trying slowly to get back to where I use to do, 30-40 minutes on a threadmill or stationary bike.  I have also modified my diet and have taken all sugars off and increase vegetables (cooked and raw).  I started doing this right after I got my diagnosis. Also according to my weight this morning I have lost 2 lbs in one week.  Last night before dinner my glucose level was 526 mg/dl, the morning before breakfast it was 228 mg/dl.  I take two reading a day, before breakfast and before dinner.  I have oatmeal for breakfast and I j recently read that cinnamon helps reduce the glucose level.    

[WaveRider]

Start monitoring what you eat. Don't munch on bad things between meals too. That last before dinner 526 mg/dl reading is dangerous and can and will lead to electrolyte imbalance. Congrats on tackling diabetes head on for you're on the right path. But, again, watch the foods. Even foods that contain little or no sugar may jack up your glucose. That is why its important to monitor what you eat, when you eat, and how much you eat and then eliminate and/or reduce your intake of those foods so it doesn't wreck havoc on your body. Start a log/diary of some sorts. This is what I did until I knew which foods to avoid.

Good luck.

[gus201]

I find myself overwhelmed with trying to decide what to eat and what to avoid.I thing as you suggest a journal of food intake will help. I imagine that it is a matter understanding what is good and what is not good and that will come with time.  Thank you

[WaveRider]

Yes, its a slow process but isn't that with everything new that we learn? Just remember, if you follow those golden rules your life will be happier and healthier. The hardest thing is giving up foods that you once enjoyed. When you start reading and understanding food labels, you will be happy that you gave up poison. The fun is finding new foods that you never knew existed!

[Zoelula]

Yes it can be overwhelming at first, gus, but it will come together in time. You do have to give up certain things but that doesn't mean you can't enjoy your food which means testing to find out what things work for you and what don't.

Hey, waverider...I'm surrounded by "your kin" at the moment..in Costa Rica for the week at a surfer spot!

[gus201]

Five days after starting metforming my dr. added Janumet 50/1000mg in the morning and metforming 500mg in the evening.  My glucose levels started to come down when i started on it 4 days ago.  Last evening my glucose level was 117 and this morning 134. I'm almost up to my previous level of exercise( 45minutes) and starting to feel much better. I'v also lost 2 additional pounds with diet and exercise and I have also posted my values on my tracker.  Hope to bring it.  

[Zoelula]

Way to go, gus!!

[WaveRider]

That's one big ATTABOY Gus! Way to go.

[gus201]

Are you really 103 years old.  Pretty good!  Appreciate yours response to my posting.  I's good to have a support group that is willing to give encouragement and information when need.  Just to let you know that my diabetes is pretty much in control right now.  It didn't take too long to bring my glucose levels down.  Feel much better.

[CoWriter]

"Metformin helps to lower your glucose by producing some insulin in the gut"
-------------------

I'm a Diabetes Educator and I have been reading some of your answers and I'm amazed at the misinformation you are giving people.

Metformin does NOT produce insulin in the gut nor does it stimulate the pancreas to produce more insulin like sulfanylureas (like Glyburide and Glipizide) do.  Furthermore, insulin is produced by the pancreas, not the gut.

Matformin helps to make your cells more sensitive to insulin.  The way it helps "in the gut" is by slowing the absorption of sugar from your stomach and intestines in to your blood.

Co

[CoWriter]

Metformin will not be enough to lower a blood sugar of over 300 down to normal levels.  See your doctor.

Co

[WaveRider]

You need to read the pharmaceutical on Metformin (glucophage) and get your facts straight. Furthermore, no one said anything about Metformin stimulating the pancreas. That is your own statement as a misinformed educator, not mine.

"Matformin helps to make your cells more sensitive to insulin"
And, at least spell Metformin correctly. Explain "your cells". What cells are you talking about or are you making this one up too?

[gus201]

I have a question for all of you.  I'm on metformin and Janumet meds and I have been having a great deal of gastric distress.  Uncontrollable flatulence and gastric reflex especially at night.  Is anybody out there taking the same meds having the same problem.  I think I need to call my doc. and maybe change meds.  By the way my glucose levels have really come down.  Last night it was 9, this morning 107.

[gus201]

meant to post a glucose level of 91 not 9.

[gus201]

Just read this:The most common ( > 5%) established adverse reactions due to initiation of metformin therapy are diarrhea, nausea/vomiting, flatulence, abdominal discomfort, indigestion, asthenia, and headache.

[WaveRider]

To help prevent Metformin side effects from occurring take it with food. If you are, consult with your doctor about your dosage.

And, congratulations on your successful glucose level. I know you won't let get out of control as cow's mother. I'm sure you must feel that after all your efforts, why does your blood glucose still rise during the night when you haven't eaten? Here are some Google pages that may help you understand this. http://tinyurl.com/d2t76s

[gus201]

I take meds with food never on an empty stomach.  Call the doc this morning waiting for a reply. Since i'm loosing weight and exercising i wondering if i can control the glucose level with diet and exercise.  Doc will probably say no.  I started taking some probiotics a few months back because my cancer med was causing havoc with my digestive system.  The probiotics cleared it up but not helping with the glucose meds. I;ll google the pages you suggested.  Thanks

[WaveRider]

Thus is taken from the mfg of Metformin

Q4. How is type 2 diabetes usually controlled?

High blood sugar can be lowered by diet and exercise, by a number of oral medications, and by insulin injections. Before taking glyburide and metformin hydrochloride you should first try to control your diabetes by exercise and weight loss. Even if you are taking glyburide and metformin hydrochloride, you should still exercise and follow the diet recommended for your diabetes.  

[gus201]

Glucose level this evening before dinner is 65, isn't that too low.

[WaveRider]

When did you eat last before this test? Normal 8-10 hour  fasting low is 70 mg/dl.

[Super_sally888]

Hi Gus,

I've just been reading your journey.

Super congrats on getting your blood sugar levels down so well and so quickly.

Possibly you can get off or reduce the meds later, but give youreself time to get your weight down and your diet habits and exercise and all down pat.

With diabetes,it is not justa bout what you eat, but also when you eat.  Particularly when you are on meds.  Yes the 65 is on the low side of normal.  YOu probably don't want to go much lower than that.

You will also need to play with what and when you eat, to give yourself stable blood sugar levels that don't go too low as well.

Congrats again.  What an acheivement and hopefully and inspiration to others too.

[gus201]

In response to Waverider's question, that low glucose level was before dinner at about 5:30 pm.  I had lunch at the school cafeteria at 12:30 pm.  Lunch consisted of small serving of pot roast, salad (lettuce and tomato no dressing) and small serving of canned pineapples.  I'm a substitute teacher, have been since I retired.  Couldn't stay home all day and do nothing.  This past week was my first full week of working since I have been feeling pretty good.  Except for yesterday!  Even yesterday morning I wasn't feeling good.  I jokingly told the first period class to call 911 if I passed out.  This are high school kids. I want to thank  Super_sally 888 for her comments.  I'm not trying to be an inspiration for anybody, I'm just trying to get my health back to where I can enjoy life.  I take one day at a time and I give thanks at the end of the day for a good day and ask for another one tomorrow.

[WaveRider]

My suggestions is to test and test often - before and 2-3 hours after every meal. A can of pineapples is laden with sugar. This can cause a roller coaster effect. Foods that are especially high in sugar -- even natural sugar and honey -- are known to cause a very quick rise in blood-sugar levels. They are rated high on the “glycemic index” (GI) -- a measurement of the effect a food has on one’s blood sugar level. The higher the rating on the index, the more rapid the increase in blood sugar level. The spike doesn’t last very long and is followed by a corresponding fast drop in blood-sugar level. (often it drops even lower than it was before we ate). This is commonly referred to as the “spike and crash syndrome.” Make sense?

So, Gus, the bottom line is to pay attention to what you eat. The unfortunate part of diabetes is we have to give up and avoid many foods we once ate. If you must eat them out of temptation eat them in moderation, but try to break the habit. Continuing to eat them in the long run is unhealthy. Heck, I gave up fresh pineapples shipped to me from family in Hawaii. At first that was a hard apple to swallow but I don't miss them now.

[Zoelula]

How was your breakfast that day? Also, I would stay away from the canned pineapples...LOTS of sugar. Might have jacked up your blood sugar and then a big drop.

Good advice from Sally. I too am in the process of learning about what keeps me stable. In my case I'm waiting for new meds to get to the correct dose to get my numbers in range, then I can fine tune it with food. It's definitely a balancing act. Lows are no fun. Do you know what number your doc wants you to treat lows at? Some people say 70, some 60. Occasional lows (and highs) are unavoidable but if you see a consistent pattern you will want to make changes of some sort, diet or meds. "Tight control" is good, but risks you going too low. Learn to recognize what your symptoms of hypoglycemia are.

I too think you're doing great!
Zoe

[gus201]

I was not aware of the "high and crash" syndrome.  Interesting!. That is probably what happened to me. I didn't think about the high sugar content of the canned pineapple.  I'll stay away from canned fruit from now on and stick to the fresh stuff.  I'll look up the glycemic index and keep that in mind as I muddle my way through all of this important information.  Thank you so much, I am learning a lot from you folks.

[WaveRider]

To lessen the absorption of fructose [fruit sugar] found in honey, tree fruits, berries, melons, tropical fruits and some root vegetables, such as beets, sweet potatoes, parsnips, and onions - eat them with other low carb foods.

If you must eat packaged or canned foods ALWAYS read the ingredients on the label. Sugar is normally  listed in grams. For every seven grams of listed sugar that equals to one heaping Tablespoon of refined sugar. Next time at the grocery store checkout Coca Cola's (Glaceau) Vitaminwater. There are 13 grams of sugar in one serving, but the bottle is 2.5 servings. So an entire bottle contains about 32.5 grams of sugar. For the sake of comparison, a can of Coca-Cola Classic contains about 39 grams of sugar. Because the sugar found in Vitaminwater or Coke is made from a refining (or purifying) process, it contains no nutrients or vitamins beneficial to our health, just sugar, water, and coloring.

[gus201]

Not to gloat but just because I feel good about it, I've gotten my weight down to 197 lbs. When first diagnosis with diabetes I weight 207, down from 211.  I lost the weight by just watching what I eat, small meals and fruits or low cal snacks between meals to kill the appetite. I have not been starving, as a matter of fact sometimes I feel like maybe I have over eaten.  Also I exercise in the afternoon about 3 pm for at least 30 minutes more if I feel good.  One of the best things about controlling my diabetes is not having to go to the bathroom every hour or so which I was having to do before.  It wasn't fun as those who have experience it would know.  Anyway just a post to let you all know that I am feeling 100 percent better, thyroid under control, blood pressure under control, and hopefully cancer under control.

[WaveRider]

Glad you posted back with positive results. Other readers will benefit from your posts. When eating fruit try to eat them with something else to slow the absorption of fruit sugar (fructose) entering your body. Keep up the good work and don't stop the weight loss until you reach your goal.