Hi,
After going through your case details, I want to know-
1) Your Age.
2) Your Height and weight (It very encouraging that you have lost significant weight with diet and exercise) to evaluate degree of overweight.
3) Family history of obesity, diabetes.
4) Current medicines other than metformin if any.
5) Any associated
high blood pressure or
cholesterol problem.
I would like to advise you -
1) Continue Low calorie diet and regular exercise.
2) Better to avoid discontinuation or taking medicine on the basis of your own interpretation or symptoms.
3) Quarterly check your HbA1c level that give much better idea regarding your diabetes control. Also check Blood sugar level Fasting and postprandial once in a month or two months.
4) If it is feasible for you to do Self monitoring of blood sugar level (BSL done by glucometer at different times of the day (Fasting, 2 hours after breakfast, before lunch, 2 hours after lunch, before dinner, 2 hours after dinner, early morning sugar 3am) all sugar not daily but whole profile in a week at least once in a month.
If there are symptoms of low BSL or High BSL you should confirm it.
5) Regular BP check, clinical examination to rule out microvascular complications of diabetes (retinopathy - fundiscopy, foot examination for neuropathy)
6) Check your
Lipid profile, it is advisable to take statin (lipid lowering drugs) in diabetes patients above 35yrs though normal lipid level.
7) It better for you to take metformin in maximal tolerated dose, as it will help in reducing
insulin resistance which is a basic pathology of diabetes. Metformin is weight neutral (may help in decreasing weight) and rarely causes
hypoglycemia.
8) Depending upon your BSL control and HbA1c level other
antidiabetic medicines that are either weight neutral or help in reducing weight can be added.
Hypoglycemic blood sugar level in diabetic patient is depend on duration of diabetes, control of diabetes, associated complications.
At blood sugar level of 86 you have symptoms of
low blood sugar level, so it can be hypoglycemia for you.
Also there is rare chances of developing hypoglycemia after taking metformin alone.