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HBA1C increase when on metformin?

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PennyLouise

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Relationship to Diabetes
Type 1.5 LADA
Hi there
Hoping someone can help please.
I was diagnosed in April with an HBA1C level of 93. Started on 500mg metformin x 2 day. June result 76. Doctor increase me to 2x500mg x 2 day. Sept result 70. They weren’t over happy with this but said would wait for next result. Just checked the nhs app for my latest results and it’s gone back up to 77. I’m gutted . I wasn’t overweight but I’ve lost a stone - BMI now 23. I’m 48 - I’ve been much more active since diagnosis and eating balanced diet.
My doctor hasn’t called me yet to discuss but I wondered if anyone else has had this - an increase in HBA1C when taking max metformin and when you feel you are doing everything right? - and what you think next steps might be / what should i ask? Thank you for any advice
 
Welcome to the forum @PennyLouise

Were you reducing calories and aiming for the weight loss you have seen? Or did it happen by itself?

It sounds like you’ve been working hard at your diabetes management, and taking the medications you have been offered, but despite your best efforts your A1c is rising.

Have you been reducing the amount of total carbohydrate (not just ‘of which sugars’) in your diet?

I’m just wondering if there might be something else going on behind the scenes? There’s a slow-onset form of autoimmune diabetes sometimes called LADA or type 1.5 which develops more gradually than classic adolescent T1, and can look a lot like T2 at the beginning.

The fact that you weren’t particularly overweight at diagnosis, and have been losing weight might be clues. Plus the fact that despite trying really hard, your levels are rising rather than stabilising.

It might be worth asking your GP for cPeptide and GAD antibody checks which can provide further clues, and/or a referral to your local hospital diabetes department for more specialist insight.

Hope you get to the bottom of what’s going on. 🙂
 
Thank you so much for the reply. I have definitely lost the weight more easily than when I’ve dieted before - I didn’t know if this was the metformin but I will certainly mention the question of LADA. Reading about it might make a lot of sense. I’ve got no family history of diabetes either.
Thanks again
 
Hi there, it’s horrible when you are trying so hard and not getting the results you deserve. I was diagnosed when I was actually underweight so this made this way more difficult as you will understand. I’m currently diagnosed as LADA diagnosed at 43. However there is talk of yet another re diagnosis of type 2 on the cards. I do have a few type one antibodies so maybe that’s something you should look into. I have heard that slim type 2’s can have a bit of a tougher time reducing hba1c and can often require insulin. There is a different mechanism at play, and not one that is fully understood yet. Do you mind if I ask … do you keep track of your carb intake and how much roughly you eat per day? Mines around 50-70g, I was once only having 30g! That was brutal. I’ve been diagnosed just over 2 years now, I promise it gets easier x
 
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