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Suggest Treatment For Withdrawal Symptoms Of Metformin
Question: I am a Type 2 diabetic. My doctor recently took me off of 500mg of Metformin 3 weeks ago because, after 6 months of being on it, my BG level numbers were consistently low (86 to 98). I lowered it through diet and exercise, dropping 65 lbs. I go for my A1c in 3 months to see how I am doing with being off Metformin.
The problem is that I think I still need to be on it. I check my BG twice a week. Once in the morning right after I wake up and 2 hours after dinner at night. I have seen my levels go up to 122 and 128 two hours after eating, which is a shock. My numbers haven't been that high in 6 months. Across 3 weeks, I'm averaging 111 in the morning and 100 after dinner.
After being off of Metformin for 3 weeks, will my body get used to being Metformin free and my blood glucose eventually lower?
The problem is that I think I still need to be on it. I check my BG twice a week. Once in the morning right after I wake up and 2 hours after dinner at night. I have seen my levels go up to 122 and 128 two hours after eating, which is a shock. My numbers haven't been that high in 6 months. Across 3 weeks, I'm averaging 111 in the morning and 100 after dinner.
After being off of Metformin for 3 weeks, will my body get used to being Metformin free and my blood glucose eventually lower?
Brief Answer:
Diabetes
Detailed Answer:
Your glucose numbers are excellent. Normal glucose readings are less than 140 1-2 hours after meals. You are already there without using metformin. Your doctor has done the right thing by withdrawing metformin. In fact, when I see a patient like you in my practice I advise them to stop checking theirs sugars at home. You may have very likely reversed the diabetes with the lifestyle changes you have made, such as the impressive weight loss. So technically you may be cured of Type 2 diabetes.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid) 12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Diabetes
Detailed Answer:
Your glucose numbers are excellent. Normal glucose readings are less than 140 1-2 hours after meals. You are already there without using metformin. Your doctor has done the right thing by withdrawing metformin. In fact, when I see a patient like you in my practice I advise them to stop checking theirs sugars at home. You may have very likely reversed the diabetes with the lifestyle changes you have made, such as the impressive weight loss. So technically you may be cured of Type 2 diabetes.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid) 12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Correct diagnosis and treatment requires the opportunity to examine the patient so you must see an endocrinologist in-person.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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