First, thanks for the forum!! I was recently diagnosed Type 2 last December with an A1C of 10.1. I immediately began taking 10U of Levemir at night along with low carb and exercise. Dropped 20 pounds and have felt great. Most mornings my FBS was 85-95 and two hour PP under 140. Well, Friday was my first three month check and doc was extremely pleased with an A1C of 6.0, Tot Chol of 178 (33 pt. drop), and the weight loss. He has taken me off of the Levemir and now has me on Metformin twice a day (500MG). My FBS has been around 115 each morning and today was 133. No change in exercise and diet. Feels like starting over. A part of my brain says, if it aint broke, why fix it. I expressed this to my doc but I will follow his guidance for now. Hopefully there will be improvment using the metformin.
Often, when you are diagnosed with diabetes your blood sugar has been very high. And this can totally exhaust your poor pooped out pancreas. It is just overwhelmed. The insulin can give your pancreas a reprieve while you get your diet, exercise and medication in order. And some of us are lucky, your pancreas can regenerate and as long as you are careful about things, you can actually stop using the insulin and do fine.
It used to be that doctors were very hesitant to start patients on insulin and many struggled for many months trying to get their blood sugars down. Your doctor was actually forward thinking. I know that you are worried about maintaining your blood sugar control. But if you can keep and A1c of 6% and stay healthy and not need insulin for years, why not? If you really do need that insulin, it is always there.
ps. I take 2500 mg of metformin, you could actually take more medication before needing to explore whether you need insulin.
nope. liver stops excess glucose release on up to strength in blood stream at sufficient dose. unclear what residuals do much of.
years on metformin.
Metformin may take 4-6 weeks to build up to maximum effectiveness. It has three primary means of action, it increases your insulin sensitivity, it reduces the amount of blood sugar produced by your liver and it reduces the absorption of carbs in your digestion. My experience is that the insulin sensitivity effect takes time to achieve, but the effect on your liver and your digestion is pretty quick. Some people time their metformin to be taken in the evening and reduce their morning blood sugar levels (reduces Darn Phemnomenon).
Yes, that is the current explained theory but does not encompass the work of the Salk Institue or John Hopkins CHildrens hospital work on Metformin.
Most statement seem to suggest they really do not know how metformin really works in fact.
But thank you for filling in the rest of the data.
Metformin works differently than insulin. It works in the liver not the pancreas. It may also take awhile to work. I found over a year to 18 months I had to raise my metformin dose to the max 2550 mg. Normally I have great bgs but every once in awhile I get a higher one 115-125 and it freaks me out. Also higher morning bgs are due to something called Dawn Phenomenom which plays havoc with our bgs.
If it were me, if things didn't improve within 6 months of starting metformin, I'd ask for an increase in the dose. If that didn't work, I'd ask to go back on the Levemir.
I'm going to take a different approach to the others who answered.
I reckon if you're able to get really good numbers on that (small) dose of Levimir I would be wanting to stay on it (and preserve the pancreas long-term) than going off it and getting higher numbers, with risk of longer term complications / burning out your pancreas.
Congrats on the weight loss and low carb and exercise. Lifestyle makes a huge difference.
What are your 2 hr PP off the levimir. A1C of 6 is considered "good" for a typical person with diabetes, but far from non-diabetic and 'optimal'. Truely normal A1C is in the mid 4s to low 5s and that would be the ideal long term goal.
I beleive you should be targeting normal blood sugar levels rather than "good for a diabetic person" levels.
That said, metformin is a first line medication and works great for many. So give the metformin a good chance, but do push aggressively to be back on insulin if that is what it takes to get back to optimal numbers.