Consider changing to the Metformin XR formulation with once daily dosing for patients who find it difficult to remember to take the Metformin SR formulation twice daily. I have had several patients who experienced improved A1c and better glycemic control by taking Metformin XR 2 g once daily at a time they can remember every day, rather than taking Metformin SR 1 g twice daily, often only remembering one dose.—JEN GRENELL, APRN, CNP, Rochester, Minn. (205-4)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.

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