[temperance]

I was on metformin extended release 500 mg, which didn't work to control my blood sugars so my doctor changed me to 500 mg immediate release twice a day which seems to be working, however I can't really gauge it that well because now I'm experiencing a loss of appetite. It started about 24 hours after I started the new rx so I'm sure that's the problem but my question is as a diabetic, how do you handle decreased appetite? I feel hungry and my stomach is growling but I don't really wanna eat...

[dano]

The decreased appetite is a blessing in disguise for most T2's. Several people have mentioned that they get a decrease in appetite when they take Byetta, it appears that loss of appetite is a side effect. I have never really had the decreased appetite, that I know of, but this comment comes from a person that has to set an alarm to know when to eat lunch. I always try to drink lots of water and maybe snack on some low carb vegetables during the day. I would think that may help you as well. I am glad that the metformin 500 mg immediate release twice a day is working for you.

[temperance]

I am not one who needs to lose an extreme amount of weight and obviously when you don't eat, you run the risk of having high blood sugars because of glycogen being released from the liver. My fasting sugars have been in the 1-teens and 120's.

[dano]

It is great that you don't need to lose weight. You are well versed in the glycogen muscle and liver "dump". It sounds like you pretty much have the Diabetes Beast by the tail. If you can figure out the minor problem with the decreased appetite and get the fasting blood sugar in the range of 70 to 90 you will be perfect. Good luck with your management.

[janzar]

so, if i don't eat..skip meals...this could be a cause of high blood sugars?! is this correct?

[dano]

Yes it could be the cause, but it also depends on when it happens. However, there are several other things that can cause this as well, for instance the medicine that you may take may not work for you or if you experience the high blood sugars during your fasting (early morning) blood test then you may want to google pre dawn phenomenon. Diabetes can be different for all of us, since we are all different and our bodies react differently as well and in short, what works for one may not work for another. We just have to keep testing and find out what works for us. I hope this helps in some way.

[temperance]

Yes, in a nutshell there are two reasons not to skip meals. First of all, diabetic or not, when you skip meals, your body goes into starvation mode and the next time you eat, instead of using your food for fuel, your body stores it as fat. This is why starvation diets don't work.

Second, if you are diabetic, when you don't eat your liver will still produce glycogen until the glycogen stores are used up. If it gets bad enough your body will start breaking down fats for energy leaving behind acidic remnants called ketones. This will land you in the hospital with something called DKA-diabetic ketoacidosis. Trust me, you don't want it.