Question from Sunnyside, Washington, USA:

Could you please tell me if Glucophage (metformin) lowers postprandial glucose levels or only targets fasting levels? I was diagnosed with type 2 diabetes almost six years ago based on an Oral Glucose Tolerance Test (I was not pregnant). I’ve had normal fasting levels since, usually in the 90s mg/dl [5.0 to 5.5 mmol/L] with a few 100 to 110s mg/dl [5.6 to 6.0 mmol/L]. Sometimes, my postprandial levels go high, occasionally slightly over 200 mg/dl [11.1 mmol/L], like 205 mg/dl [11.4 mmol/L], with a few around 221 mg/dl [12.3 mmol/L]. I’ve sometimes tested one hour after supper found my glucose over 200 mg/dl [11.1 mmol/L], but at two hours, it can be under 140 mg/dl [7.8 mmol/L]. The highest I’ve seen my glucose was 255 mg/dl [14.2 mmol/L] one hour after lunch when I had a touch of the flu in February of this year; it was down to 123 an hour later.

My A1cs have been slowly increasing, especially over the past year. In December 2005, it was 5.6%, but in December 2006, it was at 6.08%, the highest it’s been. I will have another one done in June.

At my last appointment with her, my doctor suggested thinking about putting me on Glucophage. I know some diabetics with lower A1cs and still not on medication, even though their fasting levels may be in the 120s mg/dl [6.7 to 7.1 mmol/L]. I also know that pre-diabetics are put on medication at diagnosis. What about someone diagnosed as I was?

What do you suggest for me? I am an almost 48 year old female. I’ve lost around 25 pounds since diagnosis and probably could lose another 15 to 20 pounds. I am also on blood pressure and cholesterol medications.