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I'm A 67 Year Old Male. I Just Got Diagnosed

Posted on Tue, 9 Apr 2019

Question: I'm a 67 year old male. I just got diagnosed w type 2 diabetes, also have non-alcoholic cirrhosis.I have been on the Fuhrman nutritarian diet for several months (with some slip ups) and have lost 19 pounds in 2 months--from 242 to 223. My sugar level hit 327, and yet I felt great. Also, just got back readings of ldl 100 and 'slightly elevated' liver enzymes. I started metformin and the sugar levels (183), my weight, have been coming down. I'm exercising, but not as frequently as I should, but I'm getting back into it. I'm also a squamous non small cell lung cancer survivor (PDT clinical trial at Roswell). If I'm doing everything right (my diet is generally phenomenal--almost entirely vegetarian), any idea what I have to look forward to? Any warnings about negative side effects of metformin? IOn the starter dose, I've been okay.

Answered by Dr. Mirjeta Guni (37 minutes later)

Brief Answer:
About Diabetes treatment;

Detailed Answer:
Hello and thank you for asking!
i have gone carefully through your concern.
Diet and physical activity are very important in treating type 2 Diabetes, so you are in the right way.
Regarding to adding oral anti diabetic agents, it depends on Hba1c level. It shows the mean glucose level of the last three months and depending on it we decide if metformine is enough or you should add another tablet.
Your fasting glucose level should be under 120 mg/ dl and post prandial up to 180 mg/ dl.
So, there is still do i suppose.
Check the Hba1c and give some more information regarding the dose of metformine.
Will be a pleasure to help you further.
Best wishes,
Dr.mirjeta

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Mirjeta Guni (10 hours later)

After nearly two weeks of metformin, my fasting blood sugar levels have averaged 220, down from 324. After a brunch and a metformin pill, it drops to about 180. Tomorrow I will, as directed, double my dosage. My question is: is metformin generally safe for someone who has fatty liver disease and elevated enzyme levels--in other words, could metformin affect the liver enzymes and damage my liver?

Answered by Dr. Mirjeta Guni (3 hours later)

Brief Answer:
About metformin treatment;

Detailed Answer:
Hi again,

It is considered dangerous when the liver enzymes are over twice the normal ranges, so in your case you may increase the dose, but keep monitoring the liver enzymes 2 weeks after you have reached the XXXXXXX dose of metformin.
It should be stopped if the liver enzymes are increased over twice the normal ranges.

Best wishes ,
Dr.mirjeta

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mirjeta Guni (4 days later)

Dr. G;uni--
Not sure. I was doing fine on a single dose of Metformin. Last night, I took a second dose, as prescribed. This morning, woke up with tingling and numbness in fingers, both sides, numbness moving up to my shoulders. Also, loss of balance (no dizziness) and muscle weakness. Blood sugar level roughly half of what it was two weeks ago, when it was 327. It's now 174, but the avg. on one dise was 152. N ther meds involved. My doctor is a little baffled, suggested possible lactic acidosis. Need second opinion. Your reply is urgently requested.
Thanks,G

Answered by Dr. Mirjeta Guni (7 minutes later)

Brief Answer:
About your symptoms;

Detailed Answer:
Hi again,
Lactic acidosis is a rare complication and happens in patients taking metformin when they have renal impairment. Your tingling sensation should be due to electrolyte disturbances ( low calcium, potassium or magnesium levels) that should be checked.
So before deciding to stop metformin i would suggest to check;
Lactates (lactic acid)
Potassium
Calcium
Magnesium
Do not hesitate to attach the results for further suggestions.
Best wishes,
Dr.mirjeta

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mirjeta Guni (32 minutes later)

What a bout vitamin b-12. My pharmacist said sometime it block absorption.

Answered by Dr. Mirjeta Guni (13 minutes later)

Brief Answer:
Yes, check VitB12 too;

Detailed Answer:
Yes, low vit B12 may be a cause of numbness too.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mirjeta Guni (11 hours later)

since yesterday, i can barely type this. went to er, had mri brain scan ekg bloodwork...nothing. couldn't rule out b 12 but i wonder if it isn't calcification around c-vertebrae. everything south of nek gone numb. breathing fine, little coordination. Goinmg to go to neurologist asap. Any other ideas?

Answered by Dr. Mirjeta Guni (25 hours later)

Brief Answer:
About numbness;

Detailed Answer:
Hi again,
Spine disc herniation would be more probable! Your neurologist will confirm/rule it out.
Best wishes,
Dr.Mirjeta

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng