When to up my metformin dose?

As the others say, this is a question for the doctor who prescribed your metformin.

He or she may want an A1C lab blood test before making the decision. You could probably get the requisition for that test emailed to you or the lab by phoning their office. A week after the test is done the results should be back to them.

Then, depending on individual circumstances and what you prefer, it could be a telephone appointment to discuss: (1) how you're doing, (2) any side effects, (3) the lab A1C blood test result, and (4) your home capillary blood glucose test results, and (5) concluding with your doctor's decision on what to do next.

If you want to save money on appointments, you could ask for approval in advance for the next jump in dose after that.

So say your doc puts you up to 500 mg 2x daily now.

You could ask your doctor something like, "If my before meals capillary blood glucose (the pin prick blood test) is still almost always above my target in 14 days, am I okay to go to 500 mg at breakfast and 1000 mg at supper?"

Your doctor can access your situation and your knowledge and might give the go ahead to do that.

If your doctor is good with that, you could try going one step further, "If my fasting capillary blood glucose (the pin prick blood test in the morning before food) is still above my target in 28 days from now, am I okay to go to 1000 mg at breakfast and 1000 mg at supper?"

You can ask. It is your doctor's call if, based on your medical condition and your medical knowledge, how likely they think you are to phone if you get into difficulties, if they'll let you do that.

Usually people don't go above 2,000 mg/day, even though 2,500 mg/day is the maximum. If 2,000 is not enough, your doctor might want to consider other options. It is not an automatic increase. And if you're really light weight, even the jump to 2,000 might not be automatic.

The two week gaps between dose increases are to allow your body to adjust. Your doc might prefer four week gaps for some people.

That A1C test I mentioned gives a "average" of your blood glucose levels over the previous 3 months. So there is seldom not much point in doing them more often than ever 3 months, but once you're stable and down to one or two checkup appointments per year, you'll probably want to get one done ahead of those checkups.

Also, once you've been stable for a few months, you'll be probably able to reduce how often you do the pin prick tests. Your doctor will advise you.

I'm a fellow patient, a type II diabetic diagnosed 2 years ago. So all this is still fresh in my mind.

Remember to take the metformin with food. Otherwise you'll probably get the diarrhea. Having food in your stomach when you swallow the pill is more important than swallowing at the exact same minute every day.

I hope this helps.

Metformin is a prescription medication only which is prescribed usually by a Diabetologist.

More than what you may read online and find useful, the only one to make dose increases or decreases is you DR..

I suggest you speak with your Dr. before self medicating.

Take care, masso