What’s the best method of dosage of Metformin (Gluocphage)?

I take 2000 mg a day, two 1000mg tablets once in morning and once in evening with meals. I tend to not eat big meals and usually 4 a day instead of 3 so would I be better off taking 500mg 4 x a day instead? My levels have not been that great lately.

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Answer:
Once again, I disagree with the physician (you might want to verify his credentials). Metformin acts in three ways, one of the ways is to reduce the intake of glucose in the intestine. My doctor stated to take it a half hour before meals, which would make sense if you wanted to maximize this effect.

What Tin says is true. Think of Metformin as merely a supplement to assist your body in managing glucose… it's not a cure all. It's vitally important to exercise and keep your intake of refined carbs to a minimum. For us type twos, lowering insulin resistance and managing blood glucose is more about proper diet and adequate daily exercise than it is about taking medication. Trust me. I was on the stuff for years. It wasn't until I learned the proper diet and committed to daily exercise that I was able to quit the Metformin altogether. That was over a year ago. Now I manage my diabetes with diet and exercise only.

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Answer:
Metformin is a long term drug, you have to build it up in your system. It would be just about as effective if you took both at the same time except it would cause some pretty nasty GI side affects. That is also the reason to take it with meals, it lessens the GI issues. It has been nicknamed metfartin due to these issues. I would ask your physician to do some more testing as your A1c is kind of high and that is a lot of metformin for a pre diabetic to be on and you say levels haven’t been that great how high have they been?

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Answer:
If you’ve 1000 mg tablets then you have immediate release as opposed to extended release metformin. The dose of metformin is completely unrelated to meals meaning that you might take the dose whenever is most convenient. I’m a bit confused as to how much metformin you’re taking. You say 2 1000 mg tablets in the morning and 1 1000 mg tablet in the evening. The maximal recommended dose for metformin is about 2500 mg daily. If you are taking 3 1000 mg tablets a day then you’re probably taking too much. If your glucose levels are 'not that great' then you would need a second medication added to the metformin. I strongly encourage pioglitazone (Actos) as the second agent even though there’s no generic. Your goal for glucose (ideally) would be for it to vary between 70 mg/dL (3.9 mmol/L for non-US readers) and 140 mg/dL (7.8 mmol/L). Your glycated (glycosylated is often used but incorrect) hemoglobin A1C should (ideally) be 6% although most would accept 6.5% and to be perfectly honest we lack evidence that an A1C of less than 7% adversely effects micro and macro cardiovascular disease. Nonetheless - I ask my diabetics to get their A1C down as low as possible with few episodes of hypoglycemia. The A1C is a 90 day average of your glucose throughout the day. Even though the A1C isn’t linearly related to mean glucose it is close. You may use the following formula: 6% = 120 mg/dL (6.7 mmol/L) and the mean glucose increases about 30 mg/dL (1.7 mmol/L) for each 1% above an A1C above 120 mg/dL (6.7 mmol/L). Thus an A1C of 7% would approximate a mean glucose of 150 mg/dL (8.3 mmol/L), 8% would approximate a mean glucose of 180 mg/dL (10 mmol/L) and so on. If you need additional information please feel free to email me at johnerussomd@jhu.edu. I wish you the very best of health and may God Bless.

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Answer:
Precious , I understood your question totally. Beings that you’re pre-diabetic 2000MG a day seems fine . But one question for you , Are you exercising? Exercise is as important as meds. Walk at least 30 minutes a day. Nordic Walking prefered.Thats with 2 ski poles or plain sticks or PVC pipe. Ski poles are sometimes a little to long. This type of walking increases your workout by 46%. Try it you’ll enjoy it. And so will your Pre- diabetes.

Take care>

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Answer:
It really doesn't matter how you break it down. It will still be the 200 mg of the medication. Instead, ask you physician about possibly upping the strength. Many people are on 1,000 mg daily.