Managing Postprandial Blood Sugar: Can Metformin Restore Normal Levels?

Medications for treating postprandial hyperglycemia?

Hello, doctor.
I heard that Metformin can be used to treat abnormal postprandial blood sugar levels.
Can this medication really help the body return to normal? Once normal levels are achieved, can I stop taking it, or will I need to rely on this medication long-term? Is abnormal postprandial blood sugar considered diabetes, or is it prediabetes? Thank you, doctor.

Xiao P, 30~39 year old female. Ask Date: 2016/01/11

Dr. Xiao Yongxun reply Internal Medicine

1.
According to the diagnostic criteria for diabetes set by the American Diabetes Association, a.
Fasting plasma glucose level ≥126 mg/dL after fasting for more than 8 hours, b.
2-hour plasma glucose level ≥200 mg/dL during an Oral Glucose Tolerance Test (OGTT), c.
HbA1c ≥6.5% (must be confirmed with a method that is certified by the National Glycohemoglobin Standardization Program (NGSP) and meets the Diabetes Control and Complications Trial (DCCT) standards).
Any of the above a, b, or c must be confirmed on two separate occasions.
d.
If there are clinical symptoms of diabetes (such as polydipsia, polyuria, polyphagia, weight loss, etc.), and any random plasma glucose level ≥200 mg/dL (this condition only needs to be confirmed once).

2.
If the postprandial plasma glucose level is between 140 mg/dL and 199 mg/dL, it may indicate impaired glucose tolerance, currently referred to as [increased risk of diabetes], which is what was termed prediabetes in 2010.
To make this diagnosis, a standard Oral Glucose Tolerance Test must be conducted, rather than a routine postprandial glucose check.
3.
Generally, when postprandial glucose levels are elevated, it is important to monitor the risk of developing diabetes, as this is often more sensitive than measuring fasting glucose levels.
This is why many physicians recommend conducting an Oral Glucose Tolerance Test for patients with elevated fasting glucose levels.
4.
Metformin, a biguanide class antihyperglycemic medication, can improve insulin resistance, inhibit hepatic gluconeogenesis, reduce hepatic glucose release, and promote glucose utilization by muscle and adipose tissue, thereby lowering blood glucose and glycosylated hemoglobin levels, and it may also aid in weight loss.
Since it does not stimulate insulin secretion, it does not cause hypoglycemia.
Due to its numerous benefits, it is recommended as a first-line medication for diabetes treatment.
However, long-term use may lead to side effects such as nausea, diarrhea, lactic acidosis, and vitamin B12 deficiency.
5.
In summary, blood glucose control in diabetes primarily relies on dietary management, regular exercise, and lifestyle adjustments, with medication as an adjunct.
This means that without non-pharmacological treatment, relying solely on Metformin will only lead to a limited reduction in blood glucose or glycosylated hemoglobin levels; however, once the medication is stopped, the high blood glucose state will return.
This is not dependency on medication or addiction, but rather a return to uncontrolled dietary habits, lack of exercise, and poor lifestyle choices.
The same applies to antihypertensive medications; expecting to treat a disease with medication while neglecting to address poor dietary and lifestyle habits is, of course, meaningless.
6.
It is advisable to have a thorough discussion with your physician regarding the medications you are using.

Reply Date: 2016/01/11

More Info

Managing postprandial blood sugar levels is a crucial aspect of diabetes management, and Metformin is a commonly prescribed medication for this purpose. Metformin primarily works by decreasing hepatic glucose production, improving insulin sensitivity, and enhancing peripheral glucose uptake. It is particularly effective for individuals with type 2 diabetes, but it can also be beneficial for those with prediabetes or elevated postprandial blood sugar levels.

To address your questions:
1. Can Metformin Restore Normal Levels?
Metformin can indeed help restore more normal blood sugar levels, particularly postprandial (after meals). Many patients experience a significant reduction in their blood sugar levels after starting Metformin, often within a few weeks. However, the extent to which Metformin can normalize blood sugar levels varies from person to person. Factors such as diet, exercise, and overall lifestyle also play a significant role in managing blood sugar levels.

2. Will I Need to Continue Taking Metformin?
While some individuals may achieve good blood sugar control and feel they can stop taking Metformin, it is essential to approach this decision cautiously. Diabetes is a chronic condition, and many people find that they need to continue medication to maintain their blood sugar levels within a healthy range. If you achieve normal blood sugar levels, it is crucial to maintain a healthy lifestyle, including a balanced diet and regular physical activity. Your healthcare provider will guide you on whether you can reduce or stop Metformin based on your individual circumstances.

3. Is Postprandial Blood Sugar Abnormality Diabetes or Prediabetes?
Elevated postprandial blood sugar levels can indicate prediabetes or diabetes, depending on the specific values and other clinical factors. According to the American Diabetes Association, a postprandial blood sugar level of 140 mg/dL or higher two hours after eating can suggest prediabetes, while levels of 200 mg/dL or higher indicate diabetes. It is essential to have a comprehensive evaluation, including fasting blood sugar levels and HbA1c tests, to determine your overall glucose metabolism status.

4. What Should I Do Next?
If you have been diagnosed with elevated postprandial blood sugar levels, it is essential to work closely with your healthcare provider to develop a comprehensive management plan. This plan may include dietary modifications, increased physical activity, and possibly medication like Metformin. Regular monitoring of your blood sugar levels will help you and your healthcare provider assess the effectiveness of your treatment plan and make necessary adjustments.

5. Lifestyle Modifications:
In addition to medication, lifestyle changes are crucial for managing blood sugar levels. Focus on a balanced diet rich in whole grains, lean proteins, healthy fats, and plenty of fruits and vegetables. Regular physical activity, such as walking, swimming, or cycling, can significantly improve insulin sensitivity and help control blood sugar levels. Aim for at least 150 minutes of moderate-intensity exercise each week.

In summary, Metformin can be an effective tool in managing postprandial blood sugar levels, but it is typically part of a broader strategy that includes lifestyle changes. Continuous monitoring and collaboration with your healthcare provider are essential for optimal management of your blood sugar levels and overall health.

Similar Q&A

Can Switching to Insulin Help Manage Post-Meal Blood Sugar Levels?

Hello, Doctor. Thank you very much for your response. I have had diabetes for 2 years, with an initial HbA1c of 6.6 and a fasting blood glucose of 142. I have been using Metformin for two years. Additionally, my bilirubin has increased from 1.5 to 2.2, and I have been using the N...

Dr. Lin Jianliang reply Internal Medicine
Hello: 1. There are many factors that contribute to postprandial hyperglycemia, and there are various ways to manage it. Insulin is one of the methods. I am not aware of the specific regulations regarding insulin under the health insurance system. 2. Your physician will likely co...

Understanding Blood Sugar Fluctuations and Diabetes Management

Hello Dr. Lin, I would like to ask you a few questions: 1. In non-diabetic patients, is it possible for acute gastroenteritis causing inflammation and persistent vomiting to lead to a temporary increase in blood glucose levels? 2. For patients with prediabetes (elevated blood...

Dr. Lin Jianliang reply Internal Medicine
1. The body may experience abnormal blood sugar levels when feeling unwell or under significant stress. 2. The current trend seems to suggest that the use of metformin for diabetes prevention is not recommended. 3. In the early stages of diabetes, when the condition is not severe...

Managing High Nighttime Blood Sugar Levels in Diabetes Patients

Hello Doctor, my father is about 58 years old and had a stroke two years ago. Hospital examinations indicated that diabetes led to hypertension. After rehabilitation, he was able to live independently and has been monitoring his blood sugar levels regularly. Due to his good condi...

Dr. Xiao Yongxun reply Internal Medicine
Dear Mr. A-Hsiang, Before bed, the blood glucose level was 200 mg/dL, and the fasting blood glucose level in the morning was 105 mg/dL. Clinically, for diabetic patients who manage their condition solely through diet and exercise, these levels are acceptable. Normal postprandial...

Managing Diabetes: Food Control vs. Medication for Blood Sugar Levels

I went to the hospital for a blood sugar test and was diagnosed with diabetes. I bought a blood glucose meter and have stopped taking my blood sugar medication, opting to control it with food instead. My postprandial blood sugar levels are maintained between 120-150 mg/dL, but my...

Dr. Yang Hongzhi reply Internal Medicine
Since the blood sugar levels are not very high, dietary control combined with exercise can be tried for a period of time. Monitoring the glycated hemoglobin (HbA1c) will help assess long-term blood sugar control. If the results are not satisfactory, then oral hypoglycemic agents ...