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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I have Type 2 diabetes and take 500 mg. Metaformin

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Dr. Yogesh D

General & Family Physician

Practicing since :2009

Answered : 887 Questions

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Posted on Tue, 1 Jan 2019 in Internal Doctor Category
Question: I have Type 2 diabetes and take 500 mg. Metaformin 2x a day. I meter my glucose daily. My fasting(pre-breakfast) readings rangefrom 120-135. This morning my morning glucose reading is 160, the highest reading I ever had. What should I do?
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Answered by Dr. Yogesh D 17 minutes later
Brief Answer:
Your sugar control is not sufficient, need another drug, visit your doctor.

Detailed Answer:
Hello XXXXXXX

Welcome to Ask a Doctor Service.

I have read your query and understand your concern.

Fasting sugar levels of 120-135 consistently and this higher reading of 160 indicate the need for adding an additional drug to manage the blood sugar levels.

An ideal choice would be to add Dipeptidyl peptidase-4 inhibitor like sitagliptin.

This needs to be closely monitored to avoid hypoglycemic episodes so it is a must to consult your endocrinologist or diabetologist and discuss the available options.

Your sugar level is bot extremely high so it is not an emergency, you can consult your doctor tomorrow.

I hope I have been able to help you.

Best wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Yogesh D 0 minute later
I performed a 2nd glucose test about 10 minutes after taking Metaformin.The 2nd reading is 145.

I am visiting family in California. My doctor is in NewYork. I haven't called him yet.
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Follow up: Dr. Yogesh D 3 minutes later
Thank you for your prompt reply -your advice is helpful. I will follow-up with my doctor about adding
sitagliptin to my treatment regimen.
doctor
Answered by Dr. Yogesh D 2 minutes later
Brief Answer:
There is no need to panic, you can test again after 1 hour, and tomorrow.

Detailed Answer:
Hello again,

Thank you for writing back with more details.

Please relax, it is not high enough to cause worry.

Usually, the complete effect of metformin would be appreciable by 1 to 2 hours after taking the medicine.

You can check your blood sugar again after 1 hour to see how it is (it will reduce a little further and it is expected).

You must continue your medicine as before without any change for now.

And you should check your blood sugar level tomorrow morning before breakfast to know if it remains high like today.

You can visit your doctor once you are back in NewYork.

I wish you all the best.

Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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