Hi Ann, welcome to the club no one asks to join! There is wonderful support, information, and experience here on this forum. Although I am Type 1, I was originally diagnosed Type 2 and use Metformin. A couple of things I’ve discovered might be of use to you, given the following part of your question:
So, there are three primary ways that the body finds “glucose to burn,” or release into the bloodstream. You can digest carbohydrate and convert to glucose (why we get the postprandial spike); your body can convert ingested (or stored) protein into glucose (“gluconeogenesis,” which is pretty rare at “problematic levels” if you aren’t super-skinny, Type 1, or eating no fats or carbs at all); and your liver can convert stored glycogen and release glucose into the bloodstream. Since you have high fasting BG, and especially if they are higher than your bedtime BGs, that sounds like the last bit (also known as “Dawn Phenomenon”).
The liver often tries to be helpful by dumping glucose into the bloodstream to help us get going in the mornings. For those of us that are diabetic, this isn’t nearly as useful as it might be for someone with a “normal” metabolism. The three ways to deal with Dawn Phenomenon are pretty standard: use basal insulin which can help normalize sugars not the result of digested food; take Metformin ER (which helps to stop the liver from dumping glucose); or starve your liver of glucose (and thus glycogen) by eating very low-carb. If you’re Type 2 without a very high A1c, the latter two options are likely your best bet.
As for timing of Metformin ER: ER is extended release, and it has a fairly long action (12 hours?). You might try taking it at bedtime for starters and see if that helps with the morning BGs. It takes time to build up in the system to effective levels. I take 500mg ER at night and 500mg ER in the morning, and that helps a ton with my Dawn Phenomenon (and some related issues like exercise-induced high blood sugars).
Personal experience here, so take it for what it’s worth (“Your Diabetes May Vary” is the watchword in these parts): I can “starve” my liver of glycogen if I eat less than 50g of digestible carbs a day and exercise a lot (I lift weights 3x per week and cycle and row on off days). If I do that, my fasting BG is almost always below 90mg/dL. If I eat more than 50g of carbs, or I skip a day of exercise, my fasting BG will usually be in the 100-120mg/dL range. Many people who don’t exercise a lot find that “ketogenic” diets work well for them, and that usually means less than 25g of digestible carbohydrate per day. That amount doesn’t work for me, since I experience uncontrollable (and undesirable) weight loss if I eat that way. But it does work for a lot of people! Might be worth trying.
Personally, I suspect autoimmune hepatitis, as I have a history of autoimmune issues.
Other thing is this: with a history of autoimmune disease, you should really insist that your doctor order a full panel for Type 1 autoantibodies. Sudden onset (5.5 to 8.5 A1c and 85 fasting to 140+ in a few months) is something that is characteristic of LADA (adult onset Type 1). It’s worth finding out, since if you are Type 1 Metformin is not likely to do the trick (for long, anyways). Forewarned is forearmed…