I'm taking two tablets of metformin sustained-release twice daily (morning and evening), but my fasting blood glucose is still over 8 mmol/L. What should I do?

Apr 29, 2023 Source: Cainiu Health

Dr. Pan Yongyuan

Introduction

Under normal circumstances, if fasting blood glucose remains above 8 mmol/L despite taking two extended-release metformin tablets twice daily, the condition can be managed by adjusting dietary habits, increasing the medication dosage, or combining with other antidiabetic drugs. In addition, patients may use insulin injections as prescribed by their doctor to control blood glucose levels. Diabetic patients are advised to maintain a proper diet, monitor blood glucose regularly, and take medications on time and as directed.

Under normal circumstances, if fasting blood glucose remains above 8 mmol/L despite taking two tablets of metformin sustained-release in the morning and two in the evening, this can be addressed through dietary adjustments, increasing medication dosage, or combining with other medications. Specific measures are as follows:

1. Dietary management

Patients with diabetes should pay attention to their diet, adhering to the principles of regular meal times and controlled portion sizes. They should also avoid excessive calorie intake and limit foods with a high glycemic index, which helps improve blood glucose control.

2. Increasing medication dosage

The optimal clinical dose of metformin sustained-release tablets is 2000 mg per day. Therefore, patients are advised to consult their doctor about increasing the dosage to achieve better glycemic control.

3. Combining with other medications

If blood glucose remains inadequately controlled even after increasing the dose of metformin sustained-release under medical guidance, additional medications may be used as prescribed, such as gliclazide tablets or liraglutide injection.

In addition, patients may use insulin injections as directed by their physician to manage blood glucose levels. It is recommended that diabetic patients maintain a healthy diet, monitor blood glucose regularly, take medication on time and as prescribed, and seek prompt medical attention if any discomfort occurs, to avoid adverse effects on health.

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In general, measuring fasting blood glucose and blood glucose two hours after a meal may be required to reflect the baseline glucose metabolism status, assess postprandial glucose regulation capacity, detect impaired glucose tolerance at an early stage, monitor the treatment effectiveness for diabetes, and predict the risk of diabetic nephropathy. If abnormal blood glucose levels are detected, it is recommended to seek timely diagnosis and treatment at a正规 hospital.

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Is a pre-meal blood glucose level exceeding 15 mmol/L serious?

A pre-meal blood glucose level exceeding 15 mmol/L significantly exceeds the normal fasting blood glucose range for healthy individuals. If not treated promptly, it may lead to acute complications such as diabetic ketoacidosis and hyperglycemic hyperosmolar state, which can be life-threatening. Please visit the endocrinology department or emergency department at a hospital as soon as possible for detailed examination and evaluation.

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Under normal circumstances, a fasting blood glucose level between 7-8 mmol/L is certainly not acceptable. The normal fasting blood glucose range for a healthy individual is 3.9-6.1 mmol/L, and a fasting blood glucose level of 7-8 mmol/L has already exceeded this normal range. When the fasting blood glucose level is greater than or equal to 7.0 mmol/L, diabetes mellitus should generally be considered.

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