... But I hv heard that the recommended dose is 500mg. bd. Which is the correct one?
Diabetes, Type 2 - I was diagnosed with diabetes type 2 and placed on metformin 500mg/day?
Question posted by kcfp on 4 Jan 2013
Last updated on 5 January 2013
5 Answers
Inactive
5 Jan 2013
Number 1. Everyone is different. Number 2. your doctor should be treating you not advice on a forum. Number 3. See an endoctrinologist not a PCP or GP for diabetes. If the correct tests are not done, you could have other problems then just glucose inbalance. A full panel testing your thyroid, adrenals (cortisol), testosterone & so forth. Your kidneys need checked also, & vit. D levels. These are just a few an endoctrinologist will check that can be affected by diabetes type 2...
Inactive
5 Jan 2013
Oh, & my PCP had my huy on just one pill a day, & glyberide also, but the endoctrinologist has him on two a day & two other meds for his diabetes because he can't get his glucose under 240... Mary
cupcake7667
5 Jan 2013
I have written this answer four times now as I was up right when it was posted but my posts weren't posting for awhile, so everything I said has been covered but since my hand went numb typing my answer, I have to responds:) I also was wondering what your A1c was? I'm suspecting not extremely elevated because of your dosing for Metformin. I'm a dietitian and have done a million diabetes educations. I hope you have the chance to meet with a dietitian as they spend time covering the basics to control DM, lifestyle and exercise, which of course includes a heart healthy diet, loaded with whole grains, fresh fruit and veggies, lean protein and heart healthy fats. If you have an endocrinologist, many have their own dietitians on site or who they refer too ( that's all new as I had to add something different than what my original answer was. Ok, I have seen metformin be prescribed at 250 mg, 250 bid, etc.
It depends on your weight, your A1c and how proactive your MD is regarding nutrition. Hopefully you weren't told what so many of my pt's are which is to avoid all carbs, including fruit, you can't ever have a potato again or to try the South Beach diet. All of that is false. It's about portion control and learning how to count carbohydrates. Are you testing your blood sugars. Most often, newly diagnosed diabetics aren't provided with a glucometer and encouraged to test as doctors would like you to try to lose weight, and manage your blood glucose via diet and exercise, however I believe all should be encouraged to test so you can see what your liver is doing (fasting glucose numbers, aiming for <110) and how your body is responding to food ( 2 hrs post-meal aiming for <140). You can buy a glucometer at any pharmacy but will need an Rx for strips.
The last thing I wanted to share with you is how Metformin works. It does two things; 1) Increases muscle glucose uptake (helping the glucose get into your cells where it's used for energy as with diabetes this process is hindered by insulin resistance), if there's too much glucose int blood stream it's stored as body fat and causes those high readings, 2) it decreases the livers production of glucose ( your liver stores glucose and releases it in times of need which most often occurs overnight and the liver can't monitor how much it's releasing) which accounts for high fasting glucose readings.
I hope I added something that has not been addressed. I added you as a friend so you can send me a pq if you have any questions regarding the novel I wrote ;). Welcome to the site. I wish you luck and success!!!
cupcake7667
5 Jan 2013
Oh! One more thing. Metformin can cause gastrointestinal side effects for the first couple weeks. Take it with food if this happens to you and many experience about a 5 lb wt loss :)
kcfp
5 Jan 2013
Yes, I hv been waiting for the gastrointestinal issue to be brought up because my stomach feels bloated and I suffer from diarrhea. Many thanks again.
Inactive
5 Jan 2013
Meters are free for most patients that have insurance or not. Our doctor has them sitting in their wating room for the lab. anyone you want. They give them away for free. Just check out prices on the strips first so you can get the cheapest ones. that's what expensive for diabetics. Our insurance covers all of it for free... Mary
cupcake7667
5 Jan 2013
Again, try to take the medicine with a meal. It will pass, I promise but if its unbearable contact your doc. Glad I included that :))))
cupcake7667
5 Jan 2013
We give out meters for free too. All I was saying that's its my experience that most docs don't even recommend testing at first (at least the majority that refer to us for diabetes mgmt) which I disagree with as how do you know how you're doing if you don't test rather than waiting three months for your next A1c. But in CO, you do need an Rx for strips as they can be pricy little guys pending insurance.
kaismama
5 Jan 2013
Doctors tell diabetics lots of goofy things, like "just stay away from sweets" "as long as you stay under 200"
cupcake7667
5 Jan 2013
KM: yes they do. You know they are only required one hour of nutrition therapy so they unfortunately can provide as you put it, goofy advice :-)
kaismama
5 Jan 2013
I think diabetic did alot better when the nurses and dieticians had them in the hospital and taught them, rather then this hit or miss stuff now, thanks to insurance companies.
cupcake7667
5 Jan 2013
Agreed! I won't even tell you what my hospital charges for out patient education but if the person is uninsured, they can't afford it or would be willing to pay that price, I certainly wouldn't. It's astronomical. The best is when we catch the newly diagnosed when they're still in the hospital and we can educate them for free.
kaismama
5 Jan 2013
I'm willing to bet not a whole lot of people are even willing to give up the time to go. What kills me is the hospital charges are huge amount for things like this yet the person doing the teaching isn't getting paid more to do it. Where is the hospitals need for so much money?
cupcake7667
5 Jan 2013
Funny you ask this, re beer hospitals are like any other financial institution and unfortunately patient care is not the top priority. All the dietitians had a meeting with a CE something and he wanted to know why are diabetes classes aren't filling up and why OPnumbers are dropping. My boss just looked at him and said its because of the cost!
butterflylynn
4 Jan 2013
Kcfb,
it sounds like you were just recent diagnosed is that correct ?
Depending on what your A1C number is & just starting out on Metformin 500 mg is fairly normal to start out as.
They will more than likely increase your dosage once they see how & if the Metformin helped or not.
I started at 500 mg once a day & increased now to 500 mg 3x day now.
You will more than likely find that the Metformin will make you nauseous to begin with. Just make sure you test you blood sugars often. Best of luck, Kathy
kvsundarrajan
4 Jan 2013
Much depends on your blood glucose levels, which you have not mentioned. If you are just about getting into diabetes with fasting glucose of less than 110 and post-prandial levels of 150 and you have no other pathological conditions like heart ailments, continued infections, slow-healing of wounds, liver problems, etc. , then Metformin 500 mg OD should be enough provide you take regular exercises / brisk walking. But if these levels are exceeded, you need to take a BD regimen. However, most doctors agree that diabetes patients are entitled to vary their dosages from OD to a max. of BD of Metformin 500 mg per day according to their tested blood glucose figures and also according to what they have been eating through the day and how much exercise they have put in.
More importantly, I would suggest taking a blood glucose check once a week - both fasting and 2 hrs after meals - for two weeks and then once every month and regulating your Metformin dosages accordingly. (Do consult an Endocrinologist. Also, there is no better treatment than regular exercises and brisk to fast walking in the open air- this promotes Pancreatic release of Insulin. )
kaismama
4 Jan 2013
You would do the blood sugar that infrequently? Or do you mean at the lab? Most people are told once a day at least for the home checks.
kcfp
5 Jan 2013
Thanks so much kvsundarrajan
Inactive
4 Jan 2013
Usual Adult Dose for Diabetes Mellitus Type II
500 mg orally twice a day (with the morning and evening meal)
Extended Release:
500 to 2000 mg orally once a day (with the evening meal). Maximum daily dose is 2500 mg.
Click on the link:
https://www.drugs.com/dosage/metformin.html
I suggest you talk to your DR. about it, if you are not taking the Extended Release version.
Take care,
kcfp
4 Jan 2013
Thanks
Inactive
4 Jan 2013
You are welcome.
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Further information
- Metformin uses and safety info
- Metformin prescribing info & package insert (for Health Professionals)
- Side effects of Metformin (detailed)
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