I take one 500 mg metformin daily and one 2 mg Avandia every other day. When I get up in the morning, my blood sugar runs between 100 mg/dl [5.6 mmol/L] and 110 mg/dl [6.1 mmol/L]. I take my pills when I get up, while eating breakfast at 7 a.m. Around 10 a.m., my sugar starts dropping even though I eat a snack. By 11, it is already in the high 60s mg/dl [3.7 mmol/L] to low 70s mg/dl [4.1 mmol/L]. I eat lunch at noon but don’t like to eat again before that time. Is this something I should worry about I told my doctor about it, but he just wants to keep giving me more pills to take. Should I seek another doctor?

When you ask about seeing another doctor, I tend to think about how can you communicate more effectively with your present one. It is true that both metformin and Avandia are insulin sensitizers. That means they do not induce insulin secretion where hypoglycemia is more likely. Their use may cause sugars to go to low normal. If you are symptomatic, you have to ask yourself whether you are sensitive because you haven’t been at that level of glucose for a while, or whether you truly are having intolerable bouts of low glucose. One of the ways to get around the lows is to eat on a routine schedule and avoid missing meals. I agree that you do not want to force feed yourself just for the goal of avoiding lows. This leads to a lot of weight gain. However, the combination of these two medications have been shown to be helpful in the treatment of diabetes.

JTL