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Metformin isn't affecting my A1C
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Metformin isn't affecting my A1C

3 months ago my Dr. put me on 500 mg Metformin.  These last three months, I have worked very hard to cut carbs and loose weight.  Well, I went back today, and my A1C is the same value, 6.7.  I lost 9 pounds (I am still chubby at 5'4'' and 165 lb), my lipid panels had improved quite a bit (from total Cholesterol of 260 to 217) and I feel so much better than before.  I am discouraged though.  My Dr. says that this is just fine, as long as my A1C is under 7.0.  But, somehow I was hoping that I could recover from this if I worked hard enough.

I know that I can improve my health with more exercise, more weight loss.  My carb intake is low (typical day would be around 350 cal of bread group type carbs, I don't count vegies or milks). I could also lower my saturated fat intake.  But, I don't understand why my A1C remained the same.  Does this mean that if I didn't take Metformin that it would have gotten drastically worse?  
17 Comments Post a Comment
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1711789_tn?1361311607
Hi there!

350 calories is very low for an adult. Lower than adequate calorie intake can cause increased blood sugar levels, increased HbA1clevels and increased weight gain due to the stress hormones kicking in. If you are aiming at correcting blood sugar levels/ HbA1c and losing weight; aside indulging in moderate amounts of physical exercise it is also essential to maintain a healthy diet plan. A healthy diet should consist of adequate amounts of calories with carbohydrates, proteins, fat and plenty of fruits and vegetables to supply vitamins and minerals. Skipping any of the food components is not considered healthy. It may also be beneficial to increase the protein intake slightly and decrease the total carbohydrate intake a bit. The calorie requirement should also be adjusted for one’s physical activities as well. Start with a healthy breakfast, moderate lunch and light dinner. Also keep a track of calorie intake and your work out. With gradual consistent efforts, you should be able to achieve normal blood sugar levels/ HbA1c and weight.
Hope this is helpful.

Take care!
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231441_tn?1333896366
Hi.

I am assuming that the 350 calories is referring to those from bread type foods.  However, 350 calories (assuing that bread etc have 4 calores/g carbohydrate)  is about 90 g of carbs. You will also be getting carbs from fruits, veges, and milk.  So your total carb amount could still be high.   You may get better results if you can reduce the carbs a bit more.   Avoid sweet fruits (maybe applces or berries maybe ok in limited quantity).  Get most of your carbs from non-starchy veges. Aovid potato and strictly limit grains / flours.

6.7 A1C is definitely higher than it should be.  BUT you are making great progress with the weight loss nad reduced carbs and the improvement in lipids.    Keep working on the weight and exercise.  

Don't give up!  Your are getting benefits, it's just not showing on the A1C yet.

500 mg of metformin is a low dose.  Ask your Dr. if you can try a higher dose.  Dose can go up to a maximum of 2000 mg.

Do you have a blood sugar meter?  My advice is to get one.  Start testing 2 hours after every meal so you can see the effect of different foods on your blood sugar.  Also test fasting in the morning.  Then you can start modifying your diet to avoid the foods that make you go high.

Optimal target is to keep fasting < 95 and post eating < 120. No readings over 140.  Your doctor may tell you higher targets are ok, but these targets I am recommending will help you avoid any sort of diabetic complications.

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Avatar_f_tn
Hi.  The 350 cal was with respect to eating things like bread, oatmeal, crackers, corn, etc.  I've been eating plenty of calories.  Thank you though for taking the time to comment.  
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Avatar_f_tn
Thank you very much!  I just called the Dr.'s office to ask for some test strips.  My (deceased) husband was a diabetic, and I have his One Touch Ultra.  I will try taking my blood sugars and try to see if I can get some better results.  Thank you.  Is there a way to do this though without wreaking my fingers with sticks?  My fingers are very sensitive, and are always in use (piano and computer keyboard).

I was thinking of testing to see if the Metformin really had any effect on my blood sugars.  I was going to take them for a week, then go off the meds and take them for a week.  Does that seem like a bad idea?  My A1C was 6.7 before I started taking the Metformin.  I've taken it now for 3 months, and my A1C is still 6.7.  I don't want to have to endure the side effects of this med if it isn't helping me.
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231441_tn?1333896366
Hello,

If you are still having side effects from Metformin you should discuss with your Dr about possibility of a different med.  I don't believe you should just go off it.  Apparently the effects of metformin take a few weeks to build up.  You could try an alternative brand (the original) - glucophage.  Ask your Dr. It works better for some than the generic.

Rotate between fingers and also position on fingers. Some people find that it is less painful to test using the sides of the fingers or the backs of them.

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Avatar_f_tn
Thanks.
The reason I was questioning the Metformin is that I've been taking it for 3 months.  I changed my diet, yet my A1C remained the same as taken before I started the meds (last December when I was eating what I wanted).  

I don't have any side effects with the Metformin, but I still don't want to take meds that don't help me.  There is still a tax on my liver and kidneys from taking this even though I can't feel it.
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Business_woman3
Hello, I agree that 500mg of Metformin is the starting dose, and you may or may not see an effect on your A1c.  However, keep in mind that metformin is helping the insulin that your body produces to work more effectively.  Diabetes takes on average 10 years to develop, and your body had developed insulin resistance in that time period.  It's important to keep taking the metformin, and over time the doctor may increase the dose as your diabetes progresses.  I commend you on your lifestyle changes ...keep up the good work!  What side effects are you concerned with from the metformin?  Remember that the benefits of this medication far outweigh the possible side effects.  
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Avatar_m_tn
the A1c covers 3 months so even if your BG control is relay good for the last month your A1c is going to be slued high due to the first month and have.  I bet your next A1c is going to be rely good
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1711789_tn?1361311607
The average calorie requirement of an adult is around 2000 calories, half of which should be obtained from carbohydrates. Even when doubling the 350 calories, assuming hidden carbohydrates; the total carbohydrates would still be low. It is important to understand that aside the total calorie intake, it is the calorie distribution that is important since different food items tend to have different glycemic indices.
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Avatar_f_tn
The only side effect I have right now is being more thirsty that I've been in the past.  

However, I would like to be able to have 2 glasses of wine in a single afternoon when I go on vacation, and I'm afraid to do that because of the warnings about drinking.  It is a pretty special vacation abroad (the once in a lifetime deal), and there will be wine tasting.
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231441_tn?1333896366
Hello,

if you are more thirsty than before maybe it is because your blood sugar levels.

I think moderate alcohol consumption is ok with metformin - I mean a glass or two (not bottles. LOL! :)).  

Worst case, stop for a few days before the vacation and start again once you get home.  Do check this advice with your Dr.

Enjoy your vacation.
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Avatar_f_tn
Thank you for your comments.  Your answers are really good. I am changing slowly, as this is what I know my personality requires.

Right now I'm struggling with trying to figure out how to take off weight.  This week I've stepped up exercise to 30 minutes a day, and am trying to adjust to this as a lifestyle choice.

Cheers!  Kay.
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Avatar_f_tn
Thank you very much for your help.  You have been encouraging.  It is hard to think that this will take a long time.  I'm going to continue to work at taking weight off (it is so stubborn).

Anyway, thank you again for your help.
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Avatar_f_tn
I was 115 pounds and went on a diet to get my A1C down from 6.9.  So I cut out carbs (drastically) lost 10 pounds and probably ate a lot less.  Well my A1C went up to 7.3 on this diet!  I did not realize that if I do not have a certain # of calories a day my A1C would go up despite my diet.  So sad for me - mostly everything for diabetics is weight loss which I did.  I was at a normal weight at 115 but I had a lot of stomach fat.  I went from a size 6 pants to size 3, so my stomach shrunk, but my A1C went up.  I am not on any meds at this time, and need to have another blood test done. I am wondering if I should start on Metformin.  Can anyone explain this medication to me, side effects etc.  I am learning to juggle my diet so my blood sugar doesn't spike (from starving myself) - my morning blood sugar reading has always been under 125 since I have started testing, but my A1C is high.  My last blood test was the end of December (7.3) - and when it was 6.9 I was eating whatever I wanted (before dieting).  My blood sugar 2 hours after eating is usually under 125 too....I testing my blood the other day: 89 and a minute later -- 95 and then another minute later 111.  This happens everytime I retake my blood sugar reading from the same site, I can't figure out why it varies so much with each test.  Thanks for reading. Hope to hear from some of you. Julie
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1423357_tn?1373023915
This is interesting to hear the doctor's comments, as well as the other forum members.  I went on an ultra low carbohydrate diet after clocking in a 7.1 A1C.  My fasting level at the time was 160 (mg/dL), and I was overweight, and 60 years old.  I reduced my carbohydrate intake to less that 50grams per day.  I lost over 10% of my body weight, two waist sizes, and my A1C six months later was 5.9.  That was exactly two years ago.  Today I continue a low carb, Paleo style diet.  I eat huge quantities of dry roasted nuts, strawberries, eggs, cheese, meats, and low carb vegetables.  I shun carbs as much as possible.  Carbs use to be a treat in a Paleolithic diet; wild honey, and fruit were seasonal "treats".  The rest of the time, diets consisted of proteins, and fats.  Grains and sugars are relatively recent additions to the human diet, and we aren't genetically wire to live on them.  Unfortunately, carbohydrates have become pervasive in our diets today.  We're exposed daily to foods that contain massive quantities of carbs.  Sooner or later, it catches up to us in the form of diabetes.  

Today, I continue to try and hold my carbohydrate intake to 50 to 100 grams daily.  The carbohydrates I do consume are "latent" carbs found in, eggs, or the  few carrots I eat daily.  For me, this diet was worked spectacularly.  My most recent A1C was 5.6 and my total cholesterol reading was around 140, down from 215.  Pre-dinner, (5 hour fasting) blood sugars are usually in the high 70's to low 80's.  I remain unmedicated.

People today, especially young people need to realize that it's OK for feel hungry. Dare I say that it's good to feel hungry?  But when faced with that feeling, people immediately satisfy theor hunger, and that's where we go wrong.

The low carb, Paleo diet works for me.  I've got the A1C together with total cholesterol readings to prove it.  It's easy, and I find the food selection to my liking.  Do I miss a plate of pasta with tomato sauce, or a baked potato, a handfull of M&M's?  I did, but that yearning has faded in the last year.  I now would rather sit down with a fist full of walnuts and almonds and a wedge of cheese, than a cookie.  It works, but it requires the dreaded CHANGE.
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Avatar_f_tn
Maybe it wasn't your weight that was causing your A1C to go up.  Could you be a Type I?  My suggestion would be to eat healthy, exercise and let a endo Dr. figure it out.
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Avatar_f_tn
I have Pcos and was prescribed Metformin to help me ovulate ,now my doctor wants me to have fasting blood test .will there be any changes in the results due to intake of met ,since i do not know if i am diabetes.
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