### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Many symptoms.... 57 year old male, recently diagnosed with diabetes...now normal A1c with metformin and diet. Gallbladder removed 2 weeks. Symptoms onset over the past 6-8 months. Rapid weight loss 110 lbs. Exhaustion, pain in back Need to rest after small trips to the store. Loss of voice with too much use. Recent loss of appetite (2 weeks)

### output:

Hello, You mention that your symptoms appear 6-8 months ago and in my opinion that is not related to your recently diagnosed Diabetes.  Metformin can cause a decrease of appetite, food consumption and induce weight loss, but I don't think that Metformin is the cause of your 110lbs weight loss. Metformin can lower the A1c by an average of 1.5% for 3-6 months therapy if it is well-combined with proper diet and physical activities. About your symptoms, if you were my patient, I will suggest doing some blood work like total blood count to check for anemia, basic metabolic panel to check the status of kidneys, electrolyte and acid/base balance, a thyroid panel to check for hypothyroidism and a spinal X-ray of your lumbosacral zone to see if there is any reason that causes your back pain. These test will give a lot of information and will be helpful to find an explanation for your actual symptoms. My advice is to consult physically your doctor because it is necessary to do the tests to deduct the right diagnosis, only then you can have the right treatment (these things cannot be done online). Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. 