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Tuesday, September 16, 2014
Yesterday I was told I had diabetes because my hemoglobin C1A test was 6.7. My dr. prescribed metformin, 2 tablets of 500 mg each. This seems high to me; is it too high a dosage?
No. I in fact put people on a higher dosage but I usually start it slower and then gradually advance so that people get used to the medication and minimize stomach side effects (my usual routine is 1 500 mg pill daily for 2 weeks, then 1 pill twice daily x 2 weeks, then for most people advance to 3 pills daily (2 at one time, one at another) x 2 weeks, then 2 pills twice daily. Generally take it with meals to minimize side effects. Back the dose down to lower dose if persistent GI side effects at a given dose. Goal is both to improve blood sugar and also to reduce the demand on insulin-producing beta cells which there is evidence to suggest preserves beta cell function longer.
Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati