‘Taking Metformin but sugar doesn’t go below 200mg/dL. Why?’

If you take Metformin yet your blood sugar stays around or above 200 mg/dL, what does that indicate? Responding to the Quora query: ‘Taking Metformin but sugar doesn’t go below 200mg/dL. Why?’, Dr Pranav Ghody, consultant endocrinologist and diabetologist, Wockhardt Hospitals, Mumbai Central, said that it does not necessarily mean that Metformin has “stopped working”.

“It may mean that your diabetes needs a closer look and possibly a change in treatment,” said Dr Ghody.

Metformin primarily improves the body’s sensitivity to insulin and reduces glucose production by the liver. “However, type 2 diabetes is a progressive condition. Over time, the pancreas may produce less insulin, and one medicine may no longer be sufficient to maintain good glucose control. Current diabetes guidelines also recommend intensifying treatment when individual glucose targets are not being achieved rather than continuing an ineffective regimen indefinitely,” Dr Ghody told indianexpress.com.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Another important question is how and when you are checking your sugar. Dr Ghody said that a reading of 200 mg/dL means something different depending on whether it is fasting, immediately after a meal or two hours after eating. “For many adults with diabetes, typical targets are around 80–130 mg/dL before meals and below 180 mg/dL two hours after starting a meal, although targets should be individualised,” said Dr Ghody.

Diet, lack of physical activity, stress, poor sleep, an infection or certain medicines such as steroids can also push glucose higher. “Missing doses or taking an incorrect dose can obviously have an impact as well,” said Dr Ghody.

Dr Ghody warned against increasing the Metformin dose on your own. “If readings are repeatedly above 200 mg/dL, it is worth checking your HbA1c, kidney function and current treatment plan with your diabetologist. Depending on your HbA1c, symptoms, weight, kidney and heart health, another glucose-lowering medicine or, in some situations, insulin may be appropriate,” said Dr Ghody.

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Do you take Metformin? (Photo: Quora)

A random glucose of 200 mg/dL or higher, “particularly when accompanied by symptoms such as excessive thirst, frequent urination or unexplained weight loss, should not be ignored”. “So the goal should not simply be to bring the number down. The bigger question is why it remains high and whether your overall diabetes treatment needs to be reassessed,” said Dr Ghody.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.