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Pre-Diabetes. Just got diagnosed. (2 Viewers)

My wife is a life long Type 1 diabetic.  I'm extremely familiar with the treatment paths of both Type 1 and Type 2 as it also hit my maternal side of the family quite hard.  I keep up with every bit of research on the topic which is more than I can say for your average endo, whom as a general rule seem to be the bottom feeders of the medical profession.  
Sweet.  Mr R also has diabetes.  Metformin works like a champ for him.  Just because your wife has one set of results and crappy doctors doesn't mean everyone does.

Your very obvious hostility about doctors makes everything you say questionable.  Allowing the poster to wait for the initial test results and his doctor's recommendations before going Godzilla on him would be a good idea.

 
Sweet.  Mr R also has diabetes.  Metformin works like a champ for him.  Just because your wife has one set of results and crappy doctors doesn't mean everyone does.

Your very obvious hostility about doctors makes everything you say questionable.  Allowing the poster to wait for the initial test results and his doctor's recommendations before going Godzilla on him would be a good idea.
Not sure why you are singling me out here.  I gave sound advice.  I flagged the A1C as nearly off scale high and worthy of a second opinion for treatment path, which could have been more intensive.  The fact that he treated this at least partially with diet is great and doesn't invalidate the points I was making.

The OP here didn't seem to realize just how out of normal a 12 A1C was for an individual that was his weight.  That alone is alarming. I don't even think a 13 will register on a lab draw, you can get a 13+ pulled at a hospital for sure but 13 is basically RIP.  Note for those watching at home 12 is 3-4x worse than a 6 depending on who you ask, it slides upwards in a non-linear manner.

Metformin is more a maintenance drug.  For an in-control diabetic it is good to smooth things out.  It can't take you from a 12 A1C to a 6.  For all intents it isn't really even a drug, it's just a herbal supplement really.  Been around for 2000 years.  There's not a well defined reason why you need an rx for it versus something like a NO booster like arginine.  

There's a saying in the diabetes community, bad doctors become primary caregivers, worse doctors become endocrinologists.  It's not some secret that the worst  performing medical school students go onto be endos.  You basically just have to read back lab work to people and order more tests.  It's not rocket surgery.  

 
Sweet.  Mr R also has diabetes.  Metformin works like a champ for him.  Just because your wife has one set of results and crappy doctors doesn't mean everyone does.

Your very obvious hostility about doctors makes everything you say questionable.  Allowing the poster to wait for the initial test results and his doctor's recommendations before going Godzilla on him would be a good idea.
Stop. Go away. 

He is good people and knows stuff.

 
You think you need a M.D. to know a 12 A1c is really high?  Thats for all intents 3x the diagnosable level and represents a average glucose level up to 350.  
No ####! One should be freaking out at 7+. I got as high as 6.5 once.

 
Sweet.  Mr R also has diabetes.  Metformin works like a champ for him.  Just because your wife has one set of results and crappy doctors doesn't mean everyone does.

Your very obvious hostility about doctors makes everything you say questionable.  Allowing the poster to wait for the initial test results and his doctor's recommendations before going Godzilla on him would be a good idea.
Metformin could be a wonder drug for those who do not have side effects. Tests have been underway to see if it slows the aging process. Quite a benefit if true.

 
Type 2 diabetes runs in my family and I was diagnosed about a year ago.  Metformin has been effective for me and I no longer have any side effects.  Initially it was rough since it made me have mood swings, extreme dizziness, and nausea at times, but after a few weeks it settled down and now it works well for me and I feel normal.  I also take vitamins and cinnamon pills.  I do expect to eventually have to use a more powerful drug as the disease progresses, but I am hoping to hold off on that for as long as possible.  I am very disciplined when it comes to staying away from sugar, but it's really tough to stay away from carbs.  My father uses insulin and my grandfather died before I was born.

 
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My doc says 5.7 is considered pre-diabetes. 6.0 and you have a foot in. I don't have it myself but am being monitored for it by having my A1C tested every 3 mo as the meds I take can cause such issues. Can't imagine seeing a 12. Wow.

 
My A1C went back up to 10 after being down to 9. Im on Metformin and was on Januvia at the same time. Both give me stomach issues, and lately its pretty bad. I stopped taking the Januvia awhile ago and things got better. It wasn't really helping me.

Today, due to my stomach issues I didn't take anything. Just checked my Glucose and i'm at 300. Shaking like a leaf..... Realized I didn't drink any water today so I am drining some now, and decided to take a Januvia to see what happens. I'm ure I'm in for a world of hurt in a little while, but I plan on checing my glucose agan in a couple gours.

 
Geezus I want to get off ...even metformin.  Trying the keto route to get me going to eat right and then start exercising.  Listened to a health guy on Pete Holmes podcast - Good stuff but pretty scary.  

 
Metformin seems like a good herbal supplement that perhaps everyone should take. I agree that it shouldn't require a prescription. If you want a non-prescription version that does pretty much the same thing with pretty much the same efficacy, try berberine.

 
My A1C went back up to 10 after being down to 9. Im on Metformin and was on Januvia at the same time. Both give me stomach issues, and lately its pretty bad. I stopped taking the Januvia awhile ago and things got better. It wasn't really helping me.

Today, due to my stomach issues I didn't take anything. Just checked my Glucose and i'm at 300. Shaking like a leaf..... Realized I didn't drink any water today so I am drining some now, and decided to take a Januvia to see what happens. I'm ure I'm in for a world of hurt in a little while, but I plan on checing my glucose agan in a couple gours.
Take care of yourself Pack - I'm no expert but I'd check out the Keto thread.  

 
These are important questions.

It sounds like your doctor called for a blood test and you weren't expecting one so it's possible you hadn't fasted for 12 hours which can skew the results.

Also if a Thyroid work up wasn't part of the test that can be one possible root cause for elevated blood sugar levels.
You don't need to fast for an A1C, which is the best indicator of where you are as far as diabetes goes. 

edit.  lord, didnt realize this thread was so old. 

 
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Metformin seems like a good herbal supplement that perhaps everyone should take. I agree that it shouldn't require a prescription. If you want a non-prescription version that does pretty much the same thing with pretty much the same efficacy, try berberine.
I've read that it has anti-aging properties.  

:tinfoilhat:

 
My A1C went back up to 10 after being down to 9. Im on Metformin and was on Januvia at the same time. Both give me stomach issues, and lately its pretty bad. I stopped taking the Januvia awhile ago and things got better. It wasn't really helping me.

Today, due to my stomach issues I didn't take anything. Just checked my Glucose and i'm at 300. Shaking like a leaf..... Realized I didn't drink any water today so I am drining some now, and decided to take a Januvia to see what happens. I'm ure I'm in for a world of hurt in a little while, but I plan on checing my glucose agan in a couple gours.
Drinking at lunch, GB?

 
When I was diagnosed my A1C was 10.4. In 3 months I brought it down to 5.6. It got lower for about a year, then stabilized at normal. I went to a new doctor and he did blood tests and didn't even believe I had ever had it until I showed him old bloodwork. It's all about diet. Avoid carbs. Keto is best, but Atkins, paleo or primal can work too. 

 
When I was diagnosed my A1C was 10.4. In 3 months I brought it down to 5.6. It got lower for about a year, then stabilized at normal. I went to a new doctor and he did blood tests and didn't even believe I had ever had it until I showed him old bloodwork. It's all about diet. Avoid carbs. Keto is best, but Atkins, paleo or primal can work too. 
Absolutely.  Similar story for me ...about 7-8 years ago when I was first diagnosed.  Got overconfident and went back to my old habits.  

 
Really?  So the fact that he is trying to change the treatment plan for someone he has never met and has no credentials to treat doesn't bother you?  Weird.

Suggestions = good.  

Ridiculous pronouncements = bad.
"trying to change the treatment plan" seems like a massive leap

maybe it's me

when someone says "my A1C is 13+" the time for being nice, hemming and hawing, trying not to hurt feelings, using passive language is over.

you may not want to hear it but that's the facts

 
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I am good with all the feedback. I like to read different ideas, think about them, and then do whatever the #### I want. 

Dropping weight, cutting back carbs, walking a lot all seem to help me. The metformin helps. The glipizide helped initially until I got my exercise up. 

Best of luck to everyone dealing with this. 

 
Need to put this all some place- my diabetes related story...

Have been away from the boards for a while (although checking in here and there) because I've been suffering from a spiraling anxiety/depression.  The anxiety came about when I noticed that, irrespective of my diet (which was bad), I was losing weight without working out or dieting at all.  In fact, I was eating ####tier than I ever have.  I initially dropped 20 lbs over the course of a month.

This type of symptom is one of the top symptoms of cancer so I became convinced I was a dead man for 4-5 months now living in a hell with no sleep, drinking heavily, being interested in nothing in life (I quit watching sports, tv, gambling, etc.)  It's been rough...

I was just convinced I was dying and didn't want to know, I just wanted it to happen.  The lack of sleep, effects on my work built up to the point where 2 Fridays ago I had a full on severe anxiety attack and ended up hospitalized for it (it felt like a complete heart attack or stroke, my legs gave out, I couldn't breath, I had an impending sense of doom that I could not shake).  A trip to the psychiatrist and some Xanax has helped level me off and it also prompted me to finally call my Doctor and schedule an appointment.

To note, in the back of my head, I thought, as opposed to cancer it could have been diabetes due to some other symptoms (wounds on my feet never heal all the way - they leave a purplish hue), I was pissing like a racehorse and I've always had a big bladder, and I had constant thirst.  Then again, I kept reading that the weight loss part of things was more of an issue with Type 1, not Type 2. 18 months ago I was "pre-diabetic", so I ruled out Type 1 at the time altogether.

I got 4 vials of blood taken today and a urine-analysis.  Doctor called me back within hours thankfully and assured me there were no signs in my bloodwork to indicate cancer but he definitely has concluded I am now diabetic.  I don't know any details other than that at this point but he called in an Rx for metformin immediately and we have a follow up appointment on Monday as well as with a dietician.  

I'm not sure what questions I should be asking him Monday, I have this shaking feeling maybe it's still cancer as well as diabetes but he assured me twice that the rest of my bloodwork is completely normal - I'm assuming I did the right thing and now need to do the right thing and trust the doctor (I don't have any other cancer symptoms, and I can be a hypochondriac).  I just keep reading on message boards that the weight loss is NOT that common of a symptom for a Type 2 diabetic (although I guess we haven't determined yet if I'm Type 1 or 2), so I'm still nervous.  

have any type 2s here experienced weight loss before diagnosis?  Especially in lockstep with constant urinating?  I just want to make sure I'm asking the right questions when I go back to the doctor and make sure his diagnosis is rock solid.

Any advice, here or on Private Message, or wherever would be most appreciated.  But really I just wanted to vent all of this out as it's been a long 5 months of issues.  This entire post contains a lot more than diabetes issues, I know but it would be nice to talk to someone who maybe, at some point, has experienced similar.

Thx

 
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Need to put this all some place- my diabetes related story...

Have been away from the boards for a while (although checking in here and there) because I've been suffering from a spiraling anxiety/depression.  The anxiety came about when I noticed that, irrespective of my diet (which was bad), I was losing weight without working out or dieting at all.  In fact, I was eating ####tier than I ever have.  I initially dropped 20 lbs over the course of a month.

This type of symptom is one of the top symptoms of cancer so I became convinced I was a dead man for 4-5 months now living in a hell with no sleep, drinking heavily, being interested in nothing in life (I quit watching sports, tv, gambling, etc.)  It's been rough...

I was just convinced I was dying and didn't want to know, I just wanted it to happen.  The lack of sleep, effects on my work built up to the point where 2 Fridays ago I had a full on severe anxiety attack and ended up hospitalized for it (it felt like a complete heart attack or stroke, my legs gave out, I couldn't breath, I had an impending sense of doom that I could not shake).  A trip to the psychiatrist and some Xanax has helped level me off and it also prompted me to finally call my Doctor and schedule an appointment.

To note, in the back of my head, I thought, as opposed to cancer it could have been diabetes due to some other symptoms (wounds on my feet never heal all the way - they leave a purplish hue), I was pissing like a racehorse and I've always had a big bladder, and I had constant thirst.  Then again, I kept reading that the weight loss part of things was more of an issue with Type 1, not Type 2. 18 months ago I was "pre-diabetic", so I ruled out Type 1 at the time altogether.

I got 4 vials of blood taken today and a urine-analysis.  Doctor called me back within hours thankfully and assured me there were no signs in my bloodwork to indicate cancer but he definitely has concluded I am now diabetic.  I don't know any details other than that at this point but he called in an Rx for metformin immediately and we have a follow up appointment on Monday as well as with a dietician.  

I'm not sure what questions I should be asking him Monday, I have this shaking feeling maybe it's still cancer as well as diabetes but he assured me twice that the rest of my bloodwork is completely normal - I'm assuming I did the right thing and now need to do the right thing and trust the doctor (I don't have any other cancer symptoms, and I can be a hypochondriac).  I just keep reading on message boards that the weight loss is NOT that common of a symptom for a Type 2 diabetic (although I guess we haven't determined yet if I'm Type 1 or 2), so I'm still nervous.  

have any type 2s here experienced weight loss before diagnosis?  Especially in lockstep with constant urinating?  I just want to make sure I'm asking the right questions when I go back to the doctor and make sure his diagnosis is rock solid.

Any advice, here or on Private Message, or wherever would be most appreciated.  But really I just wanted to vent all of this out as it's been a long 5 months of issues.  This entire post contains a lot more than diabetes issues, I know but it would be nice to talk to someone who maybe, at some point, has experienced similar.

Thx
My story is similar but different:  I had the weight loss (maybe not over a month but several months to a year), got up 2-3 times  a night to urinate(and countless times during the day) numbness and yet nerve pain in feet, very dry heels, etc.   I was diagnosed type 2 in Feb '16.

I had to suffer 8 weeks after diagnosis before I could see my dietician.  During that time I was living on a 1800 calorie / day diet that was more complicated that calculus.  That sucked - I can eat 1800 in a meal.   There was never a time in 8 weeks when I was not not hungry.   When I finally saw the dietician she was mortified I was instructed to follow what was "obsolete technology" of a diet. 

1) Lesson here:  Definitely go to the dietician ASAP - he/she will explain how a healthy diet does not mean you are hungry all of the time and you can eat a lot more types of food than you may currently think allowable.

I was put on a carb restriction coupled w/ protien.  Calories, sodium, and fat content should be monitored as a general rule of good health but they are not my primary focus per meal.  Each meal 45-60 grams of carb's plus protien.  NOT carb free as you do need some good carbs in your system.  Stay away from Twinkies and fast food, eat colorful plates that include protien and veggies.  I try and limit my bread intake as much as possible, but some is okay, especially whole wheat versus white.

2) Exercise is also very important.   Even something as simple as evening walks or treadmill - burn calories and fat. ?

I am also on metphormin as well as gabepentin (sp?) for the nerve pain.   That is something you should ask about - managing nerve pain is a general quality of life aspect.   And keep your feet well protected - injuries to feet can sometimes go undetected due to numbness and before you know it - BANG! - you have an infection.

Sorry for the long reply - hope this helps innsome small way.  Truthfully, this put me on a path to better health and if you manage it correctly, you will really notice a difference.   

FYI - the VERY first question I looked up the morning of my diagnosis was could I still drink beer?  Guess what - YES! ???? . Just stay away from carb heavy micro brews and such.  

Good luck on your journey...

 
have any type 2s here experienced weight loss before diagnosis?  Especially in lockstep with constant urinating?  I just want to make sure I'm asking the right questions when I go back to the doctor and make sure his diagnosis is rock solid.
This is more a symptom of type 1, typically.  I would maybe ask what makes your doctor think you are making any insulin at all, or is there a chance you have pancreatitis.  (very rare and unlikely)

There is a chance that you are a combination of insulin resistant and also not making much insulin.  That can be tricky to diagnose and is often called (Type 1.5) and few doctors even want to make this distinction as the treatment path is typically slanted towards Type 2 anyways if they decide to call it that.

What made them declare you diabetic?  A1C?  

Without putting too fine a point on it, the first thing to do is clean up the diet.  Visit the keto thread here if you want to nuke it from orbit.  If keto doesn't work, or you still feel bad you need to revisit the idea that you might need actual insulin, but you are a long way from there and this is entirely based on your type 1-ish type symptoms above.

If you don't mind me asking how is your #### working?  If you suddenly lost function there it might actually be that a lot of these symptoms are blood pressure related and with a diet change you could clear it all up, rather quickly really.

 
have any type 2s here experienced weight loss before diagnosis?  Especially in lockstep with constant urinating?  I just want to make sure I'm asking the right questions when I go back to the doctor and make sure his diagnosis is rock solid.
Yes.  Mr R had those exact symptoms.  We knew he had diabetes before he made his appoinment.  He is non-insulin dependant.  Metformin works for him (it doesn't for everyone).

The above advice on paying close attention to wounds, etc, is spot on.

And that depression you feel may be related to the diabetes.

Good luck.

 
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This is more a symptom of type 1, typically.  I would maybe ask what makes your doctor think you are making any insulin at all, or is there a chance you have pancreatitis.  (very rare and unlikely)

There is a chance that you are a combination of insulin resistant and also not making much insulin.  That can be tricky to diagnose and is often called (Type 1.5) and few doctors even want to make this distinction as the treatment path is typically slanted towards Type 2 anyways if they decide to call it that.

What made them declare you diabetic?  A1C?  

Without putting too fine a point on it, the first thing to do is clean up the diet.  Visit the keto thread here if you want to nuke it from orbit.  If keto doesn't work, or you still feel bad you need to revisit the idea that you might need actual insulin, but you are a long way from there and this is entirely based on your type 1-ish type symptoms above.

If you don't mind me asking how is your #### working?  If you suddenly lost function there it might actually be that a lot of these symptoms are blood pressure related and with a diet change you could clear it all up, rather quickly really.
Thanks all. Right now I won't know all of the details until we discuss Monday. That's why I was just checking here first to make sure I was prepared with the proper questions.  Appreciate it culd.

 
My wife is type 2 diabetic, and frequent urination is a sign of that. The doc said your body is trying to rid itself of sugar and will do anything it can. Urniation is one thing. It also comes out in saliva and makes gum disease a common symptom too. 

 
I don't want to get too deep into the details right now re: the mental health issues and all of the results from my testing (mainly because I don't have time right now) but...

Metformin has been a wonder drug for me so far just 14 days in.  I am taking insulin as well but only for the past 5 days and have been going low carb/no sugar for 5 days as well.  

Fasting blood sugar has already gone way down, I finally have the energy again to exercise again, my appetite isn't out of control.  I have had virtually no side effects other than needing to be close to a toilet for the first 4 days or so.  I actually feel great, no panic attacks and the depression and moodiness seems to have cleared up too.  Obviously the drug isn't responsible for all of these quick "fixes" but I believe it's helped me with a chain reaction that has led to the aforementioned good news.  I'm sorry to hear others haven't had as good an experience on it but I feel like my old self again for the first time in many many months which is nice.

 
Started seeing a new doctor, she specializes in Diabetes. She wasn't happy at all with my last doctor, said he's let me diabetes go unchecked for way too long. Said I already have kidney damage and put me on insulin. 10 Units, but it doesn't really seem to be working, BS is averaging 220ish. Tried doubling my Metformin but stomach can't handle it.

Sucks

 
How long have you been seeing your new doc?  It often takes about 6 to 8 weeks for medicine to reach a theraputic level.

 
My wife is type 2 diabetic, and frequent urination is a sign of that. The doc said your body is trying to rid itself of sugar and will do anything it can. Urniation is one thing. It also comes out in saliva and makes gum disease a common symptom too. 
There are drugs that will increase the excretion of sugar by the kidneys, which is an overall good thing for type 2 diabetics. Have her ask her doctor about it. 

 
Started seeing a new doctor, she specializes in Diabetes. She wasn't happy at all with my last doctor, said he's let me diabetes go unchecked for way too long. Said I already have kidney damage and put me on insulin. 10 Units, but it doesn't really seem to be working, BS is averaging 220ish. Tried doubling my Metformin but stomach can't handle it.

Sucks
Do atkins. Or primal or paleo. Be rigorous. Try it for a week. Within 4-6 days your blood sugar should be normal. Basically stop eating carbs. Eat all the protein, fat, etc you want. Your body converts carbs to glucose, which is what spikes your blood sugar. Go to the keto thread. 

 
Fasting Blood Sugar has gone from 243, down to consistently 120-130 in just a week's time.  I have been taking the insulin, metformin, and dieting my ### off.  Is this normal in a Type II ?  I like my doctor but I didn't get a lot of answers on what to look for, just the formulas for basically how much insulin to take so I'm curious what to expect from here if I keep things up on a short term and long term basis?

Also - I take back what I said re: the Metformin, I've had the runs for about 24 straight hours now.  Hoping it will pass (taking 1500 mg a day with dinner meal)

thanks all

 
Fasting Blood Sugar has gone from 243, down to consistently 120-130 in just a week's time.  I have been taking the insulin, metformin, and dieting my ### off.  Is this normal in a Type II ?  I like my doctor but I didn't get a lot of answers on what to look for, just the formulas for basically how much insulin to take so I'm curious what to expect from here if I keep things up on a short term and long term basis?

Also - I take back what I said re: the Metformin, I've had the runs for about 24 straight hours now.  Hoping it will pass (taking 1500 mg a day with dinner meal)

thanks all
You might want to ask your doctor about an extended release formula for the Metformin.  That might clear everything up.

And I'd find a doctor who specializes in treating diabetes who will be more active in your treatment if you aren't satisfied with your current guy.

 
Fasting Blood Sugar has gone from 243, down to consistently 120-130 in just a week's time.  I have been taking the insulin, metformin, and dieting my ### off.  Is this normal in a Type II ?  I like my doctor but I didn't get a lot of answers on what to look for, just the formulas for basically how much insulin to take so I'm curious what to expect from here if I keep things up on a short term and long term basis?

Also - I take back what I said re: the Metformin, I've had the runs for about 24 straight hours now.  Hoping it will pass (taking 1500 mg a day with dinner meal)

thanks all
I am not a doctor, but I am diabetic. I take metformin 1000 Mg 2/day.  I have had the most success with blood sugar control by eating less processed foods and avoiding white foods. The other key was walking. Start with 20-30 minutes and work up to 45. Take a granola bar with you in case you get light headed. I would try to move away from insulin if you are type 2, I don't think you would need it at sub 150 readings. 

 
I was diagnosed several years ago with type II.  My recent physician appt was great.  I have lost 25 pounds mainly by not eating so much bread.  I was a toast guy in the morning, a sandwich or two for lunch, and usually bread with dinner.  I dont even buy loaves of bread anymore.  I buy the wraps and just use those.  They seem to better for you. 

My doc wanted to take me off metformin but I told her I would like to continue taking at least a small dose.  She was ok with that. 

It can be done :)

 
Have mentioned in the diet thread, I got diagnosed as pre-diabetic. I've cut out most carbs that are not fruit or vegetable. If it helps anyone else get away from bread... for sandwiches, I really like Flatout flatbreads. The Light Original wrap is 8g fiber and only 6g of other carbs. The Foldit is perfect for a burger or a grilled sandwich, I like the 5-grain Flax one, and it has less carbs than the Ancient Grains one.  They have only a fraction of the carbs of even a whole wheat bread or bun.

Tonight I had a homemade pizza which is like 90g of carbs. Probably more starch/sugar than I've eaten in the 4 previous days combined. Waited 30 minutes after finishing eating and then did my evening ride on the exercise bike to use up glucose.

Good luck, you guys can do it.

 
How long have you been seeing your new doc?  It often takes about 6 to 8 weeks for medicine to reach a theraputic level.
Saw her once. She is sending me to a nutritionist.

Interesting about the insulin. Everything I'm reading says it works within 24-48 hours

 
Fasting Blood Sugar has gone from 243, down to consistently 120-130 in just a week's time.  I have been taking the insulin, metformin, and dieting my ### off.  Is this normal in a Type II ?  I like my doctor but I didn't get a lot of answers on what to look for, just the formulas for basically how much insulin to take so I'm curious what to expect from here if I keep things up on a short term and long term basis?

Also - I take back what I said re: the Metformin, I've had the runs for about 24 straight hours now.  Hoping it will pass (taking 1500 mg a day with dinner meal)

thanks all
1500mg? I can't handle 1000. And why do you take it at night? I was instructed to take it in the morning.

The runs won;t stop unfortunately. 

 
Saw her once. She is sending me to a nutritionist.

Interesting about the insulin. Everything I'm reading says it works within 24-48 hours
I was referring to the Metformin.  Insulin isn't truly a medicine.  It's a hormone naturally produced by the body.  The shots are to replace what should be there naturally, not to change what your body is doing.

 
I was referring to the Metformin.  Insulin isn't truly a medicine.  It's a hormone naturally produced by the body.  The shots are to replace what should be there naturally, not to change what your body is doing.
I've been on Metformin for a year or so

 

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