Asked to decide what meds should I take next...

[Lorraine G]

So saw the nurse today and was given a list of drugs to be added to my metformin to help lower the HbA1c as on diagnosis in Dec 2017 was 81 and now is 63.
Sulfonylurea Medicines
Nateglinide & Repaglinide
DPP-4
Pioglitazone
Acarbose
GLP-1
SGLT2
God I'm confused, I am not sure where to turn and wondered if you lovely people could help?
I have started to loose weight and do not want to take meds that will increase the weight but other than that what should I do?

 

[EllieM]

I'll leave the T2s to advise on the meds but have you tried going low carb as regards diet?

 

[dbr10]

So saw the nurse today and was given a list of drugs to be added to my metformin to help lower the HbA1c as on diagnosis in Dec 2017 was 81 and now is 63.
Sulfonylurea Medicines
Nateglinide & Repaglinide
DPP-4
Pioglitazone
Acarbose
GLP-1
SGLT2
God I'm confused, I am not sure where to turn and wondered if you lovely people could help?
I have started to loose weight and do not want to take meds that will increase the weight but other than that what should I do?

Was this a real nurse? Sounds like she's asking you.

 

[Boo1979]

How much info have you been given re the potential risks and benefits of the different medications? This balance will vary somewhat based on the individuals particular health profile. Your DSN is asking you to make an inappropriate / uninformed choice if she / he has not given you the info
http://www.joslin.org/info/oral_diabetes_medications_summary_chart.html
Edited to add another link
https://www.guidelinesinpractice.co...sks-of-glucose-lowering-agents/453996.article

 

[kokhongw]

on diagnosis in Dec 2017 was 81 and now is 63

You have made good progress...why the rush to add more medication?

Meanwhile have you been tracking your pre/post meal glucose response? That may well help you to re-balance your diet.

 

[Tophat1900]

Asked to decide?... that sounds disturbing to me, like it's a lucky dip.

Based on your a1c reduction, I just can't see why you'd need more drugs? All sounds very unprofessional to me.

 

[Lorraine G]

She has given me a leaflet which tells me about the meds and side affects.

I am keen to try low carb diet but i am feeling it is a huge mountain to climb and I don't know where to start

 

[Hiitsme]

Hi @Lorraine G
You've made good progress so I agree with @kokhongw why not try with diet. Are you testing? Testing before a meal and 2 hours afterwards will help with finding what foods suit you and what is better avoided. It's the carbs that increase blood sugar so any cutting down on them is good.

 

[Mick1959]

She has given me a leaflet which tells me about the meds and side affects.

I am keen to try low carb diet but i am feeling it is a huge mountain to climb and I don't know where to start

Lorraine, start on a LCHF diet slowly, rather than dive in the deep end first time. Cut out or down on one thing, then progress one day at a time before moving onto the next food to cut out, not forgetting to increase the protein.

I have elected to do the LCHF diet, and made the slow change over 3 weeks checking what foods made my BG spike and what proved beneficial, and I am still learning and will be for many months to come, but that is also part of the fun

 

[Rachox]

Well done on your progress so far. I agree with what the others have already said. How about trying low carb. rather than taking more meds yet. Start gently so you avoid ‘carb flu’. I started at less than 100g carbs, then after six weeks I dropped to between 50-70g. I have naturally dropped to between 40-60g these days as it’s really not worth the tiny piece of naan bread with a curry and cauli rice or the tiny portion of spaghetti with a bolognese when I can have a normal portion of butternut squashetti?
Diet Dr is a good place to start for recipe ideas. Here’s a link:
https://www.dietdoctor.com/low-carb

 

[Lorraine G]

Well done on your progress so far. I agree with what the others have already said. How about trying low carb. rather than taking more meds yet. Start gently so you avoid ‘carb flu’. I started at less than 100g carbs, then after six weeks I dropped to between 50-70g. I have naturally dropped to between 40-60g these days as it’s really not worth the tiny piece of naan bread with a curry and cauli rice or the tiny portion of spaghetti with a bolognese when I can have a normal portion of butternut squashetti?
Diet Dr is a good place to start for recipe ideas. Here’s a link:
https://www.dietdoctor.com/low-carb

So I have told the nurse i am trying with diet and Metformin first and will review mid Jul on my next blood results. She was a bit taken aback but happy to let me make the decision. Now I don't know where to start. I have looked at Dr Diet and signed up for the two week challenge but not sure I want to go that low to start with. I have done Atkins in the past and found that OK. Just so unsure and finding it unnerving.

 

[Rachox]

So I have told the nurse i am trying with diet and Metformin first and will review mid Jul on my next blood results. She was a bit taken aback but happy to let me make the decision. Now I don't know where to start. I have looked at Dr Diet and signed up for the two week challenge but not sure I want to go that low to start with. I have done Atkins in the past and found that OK. Just so unsure and finding it unnerving.

I started by carb counting meals I used to cook and adapting each one til I got a collection of meals. So I carb counted my version of spaghetti bog for instance, I always made it from scratch anyway and found a portion without the spaghetti was about 14g carbs, so eating that with butternut squashetti was straight away something I could eat with just one alteration. I make curries with jars of sauce, I check the carb count and find the lowest then serve it with cauli rice and no naan bread now. Simpler things would just be meat, chops, chicken breast or fish for example with above ground veggies. Dessert I keep to berries, Greek yoghurt, Oppo low carb ice cream, dark chocolate 85% or above. Have a look on the ‘what have you eaten today’ thread in the low carb sub Forum. Many of us post what we eat each day and swap recipes. It’ll give you loads of ideas.

 

[Resurgam]

She has given me a leaflet which tells me about the meds and side affects.

I am keen to try low carb diet but i am feeling it is a huge mountain to climb and I don't know where to start

Low carb is such an easy fix that I'm surprised that you would consider anything else before giving it a go - what makes you think it is difficult?

 

[bulkbiker]

So I have told the nurse i am trying with diet and Metformin first and will review mid Jul on my next blood results. She was a bit taken aback but happy to let me make the decision. Now I don't know where to start. I have looked at Dr Diet and signed up for the two week challenge but not sure I want to go that low to start with. I have done Atkins in the past and found that OK. Just so unsure and finding it unnerving.

If you found Atkins ok then go with that. As for your nurse she was probably surprised that firstly you wanted to try something different yourself and second that you didn't blindly follow what she said. Some nurses look on it as a personal insult if you disagree with them others seem more interested if you go against the grain but it is very rare for them to have seen people take control of their own condition in the way you want to. Go for it and good luck!

 

[lindijanice]

Hey @Lorraine G well done on getting your numbers lower!! Just remember that this diabetic journey is just that - a journey and not a sprint - so you have time to ease into lower carb eating as others above have suggested. If you are motivated to not add any other meds, you can do this. Just be patient with yourself and remember what one person with diabetes can't eat, another one can, as we are all so individual. I happily found this week that I can tolerate 1/3 cup of steel cut oats with cream and walnuts and barely went up 1 mmol when I tested before and two hours after. I was tickled to think I could enjoy it once in a while! That is just an example as some people can't eat it at all without spiking like crazy!

You have been given some really good advice about easing into low carb to avoid carb flu - just remember to add a bit more protein and fat to keep you satisfied as your body will scream for those pesky carbs that got you where you are now! Defeat them!! Blessings/L