Dr Sam - some information to take into account
From: Anna (anonymous@obgyn.net)
Tue, 29 Apr 2003 01:21:46 -0500 (CDT)
Dr. Sam,
You may recall the following from my previous posts:
- Regular monthly periods (spacing 25 days before but upto 30 days for
last couple of years), got pregnant immediately after TTC
- Had gestational diabetes in pregnancy (fetal demise occured in 5th
month)
- Was on insulin during pregnancy as per my doctor's advice
- Diagnosed with "mild PCOS" and severe IR
- currently overweight not obese
Basic Question: Does having a period regularly (every 25-30 days) mean
that I must have been ovulating? I think I have ovulated regularly
because of cervical mucus changes. Therefore I am not taking Metformin
to ovulate. I am taking it to regulate by blood glucose levels prior to
pregnancy.
Thank you,
Anna.
At Mon, 28 Apr 2003, =?iso-8859-2?q?Zalányi wrote:
>
>Hi Anna,
>
>Your question is very well formulated. Why to take higher doses for IR than for frank diabetes? Unfortunately there is no reasonably simple method to measure the level of IR.
>I have elaborated on this ten days earlier:
>
>This is the $64K question (I have put it several times on this board) and nobody can meaniongfully answer it.
>Here is my opinion: as metformin (sp!) is a diabetes drug, its maximum dose should be considered for frank diabetics only. On the other hand, PCOS with insulin resistance in the background is only the antechamber of diabetes, lower doses should suffice. I consider particularly meaningless to increase the dose within weeks, because to see the effect (on ovulation) of a particular dose level, you should wait a month as a minimum (for a month is needed to see wether you ovulated or not). Taking into account the fact that the effect of metformin on the ovulatory process is indirect, I have kept patients on a certain (low) dose for 3 mo at least, before increasing it.
>Any other opinion is welcome
>
>Sam
>
>> Hi Dr Sam,
>>
>> My doctor put me on metformin (500mg, 3 times per day). I have severe
>> insulin resistance but not diagnosed with diabetes. How is it
>> determined what would be the correct dosage? Should I be regularly
>> checking my blood sugar and if its low then ask to lower the dosage? My
>> mother who is a diabetic takes 500mg glucophage, twice a day. So why am
>> I taking 3 times a day?
>>
>> Another thing I am confused about is some people say it reduces appetite
>> and some say it increases. I have found that on a lower dosage my
>> appetite is reduced and when I take 500mg, 3 times a day I can get
>> hungry.
>>
>I have no experience on this.
>
>> Does Metformin work all through the day?
>>
>> Thanks, Anna.
>>
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