Metformin ER

[Duggold]

I was recently diagnosed with Type 2 due to a 7.5 A1C test. First question: during the last 2.5 months, I have been in pain and stressing from a herniated disc. It was actually the pre-surgery screening that caused the A1C test to occur. On top of that, for 10 days about 6 weeks ago I was on Prednisone. The docs seem to be discounting all that and believe the A1C still to be accurate.

At the office, my first reading 2 hours after breakfast was 132. I've been testing upon waking, before dinner, 2 hours after dinner and getting: 105 or so waking, 95-100 before dinner, 130-135 2 hours after dinner. These all seem normal to me.

With all of this, they still want me to take 500mg of Metformin ER (at breakfast and dinner, so 1000mg per day). First, think another A1C may be in order a couple months after surgery to act as a validator with these normal BG numbers? Second, is it usual to have the ER version of Merformin initially perscribed? Isn't there a non-ER version that is more common?

[WaveRider]

The FDA requires meter mfg to be within ±20% tolerance. Just be aware of what hypoglycemic symptoms are and what to do in case your levels drop sub-par. Do not hesitate to call your doctor if they do. Good luck

[Duggold]

I was only on the prednisone for 10 days. It was a front loaded dose that tapered off to avoid cold turkey. The machine I am using is the one the Doc gave me in her office. I used it twice in her office to test and the numbers I came up with matched pretty closely the numbers she had gotten from me on her meter so I am guessing it is not a meter issue. I also just got this a few days ago so I don't think a recalibration would be needed so soon.

I also understand a meter can be off 10% or more and not be considered "out of whack" Thus, the +100 readings on waking could just as easily really be 90s right?

[WaveRider]

Interesting post. Let's start with Prednisone a somewhat nasty corticosteroid that does jack up ones glucose levels. Taking Prednisone over an extended period of time [weeks] can and has made ppl diabetic. The other nasty about Prednisone is you cannot cold turkey [stop suddenly] or risk renal and/or severe cardio issues - one has to wean off it gradually.

That aside, your morning levels are tad high where normal max is 99 mg/dl. The others are well into normal. Stress and a herniated disk can elevate glucose levels by themselves. However, the A1c does not lie and is quite accurate. At 7.5% this equates to daily glucose average of 169 mg/dl. One has to ask if you're still on Prednisone and whether your dose has increased or decreased. And, the accuracy of your home test meter and whether it requires calibration. Some do some don't.

The Metformin ER stands for "extended release" sometimes labeled as XR. It is long acting vs the standard which is immediate acting. Long acting is usually Rx'd as it stays in your system longer. There is an SR [slow release] but am unsure of the difference between ER/XR and SR. That's a question for your pharmacist.