A1C Increasing on metformin despite losing weight...SGLT2 or GLP1 next?
Hi all,
I just got some labs done and my A1C is 5.6, so right on the border of being prediabetic (again). It wasn't until I charted my A1C levels and weight that I realized my A1C has gone up despite losing 10lbs and being on a higher dose of metformin, so I think it's time for a change.
Important context:
- I am 5'7, so weight is not a concern as long as I'm below 160lbs. I feel my "best" around 146-150.
- I've lifted weights 4-5x per week for the past ~10 years, so I have a significant amount of muscle. However, pretty much all of my fat is visceral fat.
- I track my food and aim to hit 120g+ of protein. Carbs are usually around 200-220g. I know this may be high for having IR, but I've done okay with this many carbs in the past.
- I also have Hashimoto's, but that's been controlled and levels have stayed consistent for 15+ years.
- My periods have been pretty wonky, but for the most part I do get some type of bleeding each month. I had to induce once with provera in the beginning of 2025, but my cycles are anywhere from 20 to 38 days otherwise.
- I am currently on 1500mg of met, 50mg of spironolactone, and not on birth control. This met/spiro combo definitely worked well for a bit (see April 2025 in the photo), but clearly doesn't seem to be as effective in recent months.
I'm hoping someone can provide some feedback on switching to an SGLT2 (such as Jardiance) or GLP1 when Metformin is no longer effective. Which medication worked for you? I have an appointment with my endocrinologist and gynecologist next week. Ultimately I will listen to my endo's advice, but I am curious if anyone has had a similar experience.
I am specifically interested in those for whom weight loss was not needed, but I am open to any feedback!