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Hello, I started on metformin one month ago and I'm currently taking in 250 carbs a day. I exercise every day by walking and biking. My current fasting BG is around 18.5. What happens if metformin etc and diet and exercise doesn't work? I'm over weight with a BMI of 32. I'm not seeing any real improvement in my sugar levels and I'm not sure what to do at this point. I realize it's only been a month but it seems I should see some difference by now. If anyone has any advice it would be greatly appreciated. Clearly I must be doing something wrong. Help! Thanks

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Hello, It's still early in the game. You've only been on metformin for a month so you need to wait a bit longer to see any results. However, I am a little perplexed as to why you are taking in 250 carbs a day. That is really a lot of carbs for a diabetic. If you were not diabetic and a body builder you might be okay. In all honesty, your carb intake should be between 30g to maybe 80g at most to help you stabilize sugar levels. Your BMI of 32 is high indicating you are considerably over weight which brings about insulin resistance which metformin is not going to be able to deal with. Your fasting measurement of 18.5 is over the top. I don't know whether you have been misadvised or you don't understand what you should be doing. My guess is that you won't see any improvement with metformin even in higher doses. You need to get with your diabetic nurse to determine a proper diet and exercise regime. You need a low carb diet to manage your diabetes. You need to be on a weight loss program as well to increase insulin sensitivity. I stay between 30 and 50 grams of carbs a day and do very well. I'm normal weight and metformin works well for me. In fact, I hope to be able to stop taking metformin because I think I can manage my type 2 with diet and exercise alone.

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