Metformin when off Ketogenic Diet

Hello, my first post here. I have had “glucose intolerance” on & off for past 7 years, since the age of 21. We also have a family history of Type-II diabetes. My latest blood works came out with a Hba1c of over 7.5 (This is because I had a lot of events going on and eating a lot of high-carb high-sugar foods) My Doctor put me on metformin which I haven’t started taking yet because I started Keto diet now and that has brought down my blood sugar level to ~100mg/dl 2 hours after food and a fasting of 75-80mg/dl (~4 mmol)

But I’d like to go off keto after 6-8 weeks and do a low-carb diet. I was wondering if it’d be advisable to take metformin while I’m on low-carb and then stop metformin when I get back to Keto?

Also, I workout regularly, doing a fair amount of HIIT & strength training 4-5 times a week.

Hi AsmyS, welcome!
If keto is controlling your BG then perhaps you wouldn’t need to take metformin while you’re eating that way. See what your doctor has to say.

If you decide to move your diet back into a range that can no longer control your BG, then yes, I would try metformin.

My obligatory question: have you had the antibody tests for LADA? You’re very young for T2, even with a family history.

Hba1C is a 3 month average measurement although it is more heavily weighed toward the more recent weeks. At or over 7.5, you are continually running average BG over 170, so these events you are mentioning are not just a recent phenomenon.

“I’d like to go off keto after 6-8 weeks and do a low-carb diet”

What do you consider to be different between Keto and low-carb? Keto is a low carb diet. Many of us basically concentrate on low-carb or very low-carb meals plus a low-carb count for all combined meals in a day. You can do low-carb without doing Keto, but you can’t be doing keto without doing low-carb or else we are using different definitions and/or data points for each.

In order to micro manage the relationship between the amount and type of medication to use, food plan and exercise, you would need to be on a CGM for at least 2+ months to learn exactly how your body reacts to different foods/medication and exercise. You can only go so far with fingersticks as you will not know, for example, how your blood sugar varies during the night and early morning while you are asleep.

With a CGM, you may be able to totally get off of medication or use very little. If you are comfortable with an A1C range around 6-7, you can most likely reach that by fine tuning what you are doing now. If you are shooting for an A1C at 6 or below, you mostly will need a CGM to get those results.

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There are many teens who have type 2 now. It is not just an old person disease anymore. Nancy50

Amy how carbs are you eating to be able to maintain your exercise level? I am bouncing between too few to have a good workout and too many to stay low carb.