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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated A1C Levels While On Metformin?

I have type2 diabetes. My blood work just came back and A1C is 12 has been high for awhile on metformin 1000 mg 2 x a day and trajenta 5mg. My doctor tested c-peptide and it was .87 and he says my body is not producing much insuline. Last A1C was 13. Should I go see and Endorse or just take lantus like my Md of over 10 years suggest?
Tue, 6 Mar 2018
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Dietitian & Nutritionist 's  Response
Hello,

I understand your hesitancy to go on insulin. It is a natural very normal concern to question a major move such as this. Most certainly if there is any question about a plan of care; seek out a second opinion from a specialist. I do not think your personal physician would take offense at this.

I cannot express an opinion on this matter without seeing all of your labs and health history, however, I noted that a c-peptide test was done and that was low indicating to your doctor that you needed the insulin.

One thing I would be concerned with is whether or not you received any type of medical/nutritional advice on controlling blood sugar with diet, exercise and lifestyle. Such interventions can reduce need for medication.

Regardless, the blood sugar needs to be controlled to prevent cardiovascular and neurological complications without delay. If you decide on obtaining a second opinion, I would do so without hesitation as time is of importance.

If indeed your body is not producing insulin, then you will need insulin injections. If it is a matter of insulin resistance, this may be a different situation where perhaps insulin may be used until other lifestyle modifications are made such as losing weight if overweight, et cetera.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Kathy Shattler
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  Anonymous's Response
Anonymous's  Response
Hello! Welcome to HealthcareMagic!

As a naturopathy and yoga physician after studying your brief history have some suggestions from my side. You say type-2 diabetes and insulin is not produced in a surplus amount. Faulty life style and stress is cause are cause for insulin depletion. Good diet plan and diabetic pack will help to overcome the symptoms of diabetic complications.

Thank you for contacting us. Hope this clarifies your concerns.

Take care

Regards,
Dr. Vijaylaxmi S Nayak , Naturopathy & Yoga Specialist

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
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What Causes Elevated A1C Levels While On Metformin?

Hello, I understand your hesitancy to go on insulin. It is a natural very normal concern to question a major move such as this. Most certainly if there is any question about a plan of care; seek out a second opinion from a specialist. I do not think your personal physician would take offense at this. I cannot express an opinion on this matter without seeing all of your labs and health history, however, I noted that a c-peptide test was done and that was low indicating to your doctor that you needed the insulin. One thing I would be concerned with is whether or not you received any type of medical/nutritional advice on controlling blood sugar with diet, exercise and lifestyle. Such interventions can reduce need for medication. Regardless, the blood sugar needs to be controlled to prevent cardiovascular and neurological complications without delay. If you decide on obtaining a second opinion, I would do so without hesitation as time is of importance. If indeed your body is not producing insulin, then you will need insulin injections. If it is a matter of insulin resistance, this may be a different situation where perhaps insulin may be used until other lifestyle modifications are made such as losing weight if overweight, et cetera. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Kathy Shattler