Brief Answer:
Metfornin is weight neutral. Aids lifestyle.

Detailed Answer:
Hello. I am Dr Praveen and I will be answering your query. Read your query and noted the content. Metformin is a weight neutral drug which means it does not increase or decrease your weight on its own merit. However, the benefits of metformin is in its ability to aid a person in his or her lifestyle. It helps one adhere to a healthy lifestyle. Metformin being an insulin sensitizer decreases resistance. Studies have shown favorable effects of metformin over lipids, the heart and decreases cancer in diabetics. Diet and exercise are fundamental to the management of diabetes as you are aware. Metformin is indicated for all type 2 patients for the above mentioned significance. Regarding exercise let me reassure you by saying the benefits if exercise is beyond weight loss. So please continue doing it. However if the bmi is very high and resistant to loss you may try medications from the glp1 class which are injectable. Wishing you good health. Plz feel free to clarify any more doubts if you have any. I will be happy to help. Take care. Warm regards, Dr Praveen.

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Brief Answer:
It won't harm your eyes or heart

Detailed Answer:
Hello again,

I understand your concern.

Metformin is safe. It has no adverse effects on the eye or the heart. It isn't directly responsible for diabetes. You can be double sure about that.

I understand your a1c is normal, but serum insulin levels are high.

In the setting of one being overweight its due to insulin resistance requiring the body to increase insulin secretion for compensating the need. This is a feedback mechanism. This resistance is organ specific. We have resistance at the muscle, fat and liver. Fat accumulation is the prime reason behind it. We all have fat at a subcutaneous level and also around our organs. So when one looses weight the fat loss may not be uniform. But loss of weight will decrease the insulin resistance regardless of insulin levels which is subject to change based on a lot if factors. Change in insulin levels will happen but it takes time. Metformin helps a great deal. Exercise is equally important. A diet that is less challenging to the pancreas goes a long way too. You are on the right track. You have started early and it will be definitely useful in the long run. Wishing you good health. Take care. Regards, dr XXXXXXX

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Brief Answer:
It will take years to normalise or near normalise

Detailed Answer:
Hi. It will take years before it normalises. Depends on your baselines characteristics but up to two years is common. It normalises or decreases and stays constant. Insulin levels vary with a lot of other factors like your diet content, fasting state etc as well. Studies have shown insulin resistance begins at birth and its a long process that we are trying to reverse. Research shows that the molecular change takes a while to reverse which is why serum insulin levels are more resistant to change. How much metformin are you on? What is your bmi presently? What was the last value of serum insulin and was it checked before or after food?

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Brief Answer:
Read your reports

Detailed Answer:
Hello.

The incremental high after food is quite substantial but it will decrease now that you are on metformin. Just avoid a diet with a high glycemic index. Your bmi is around 28. You can bring it down within a few months. Just remember that any change you do be it in terms of diet or exercise should be gradual and for life. The insulin levels etc will normalise.

In my opinion you should try to come away from the focus of insulin levels and just move to one where your blood glucose is in the normal range, you are maintaining an ideal weight, you are eating healthy and exercising well. That's the best we can do and that is all there is to it. Don't worry. Its so commendable that you have decided to get things under control. You will do it. You can. Just be persistent in your efforts. Metformin can induce gastric side effects and hence you increase on the dose gradually. Keep monitoring your blood glucose levels. Eat small and frequent meals.

Take care.

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Brief Answer:
very ideal

Detailed Answer:
Hi. You are welcome. Keep it in the same range. Please let me know how your values transform with time. Wishing you good health. Take care.

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Brief Answer:
It does in most people

Detailed Answer:
Hi. The gastric side effects will improve in 90 percent of patients. It will take a week or so. I would suggest you retain the dose at 500 mg and not escalate it. There is no reason to increase it actually. You should try the extended release preparation. The tummy tolerates it better. The giddiness is most likely related to your gastritis itself. If it doesn't improve you may use a PPI class of medication like lansoprozole. The cramps etc is seen less commonly seen with metformin and will improve. May I ask you to have a look at your vitamin d levels too if possible?

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