Type 2 Am I in remission? And other questions...

[AdamW2]

Hi there, I an newly diagnosed with T2 about 10 weeks ago. My HBA1C was 7.6 on first test and the confirmation test a few days later showed 7.4. It came as a shock to me as I had no symptoms, I went to the GP as I was having heart palpitations for first time in my life which was concerning me.

The diagnosis terrified me and since day 1 of diagnosis I've been cutting back on carbs and getting daily exercise.

I was prescribed 2 x 500mg of Metformin, I asked to manage with diet first but they insisted. I took 1 x 500mg for the first 20 days and then stopped as I felt my blood glucose levels were generally fine from testing with a meter regularly.

I've dropped 41 pounds so far and feeling much better in general. I am determined to get into remission as soon as possible. However, sometimes my readings confuse me and it would be helpful if anyone here could spare a few minutes to read and answer my questions if possible please.

1. Most mornings on waking my BG is between 4.3 and 5.4 (occasionally as high as 5.8 but rarely). After meals I almost never see it go above 7 within 20 mins - 2hrs after eating. Does this mean I am likely in remission?

2. Some days I will eat mostly the same food and get the same exercise and I monitor my hydration carefully with an app but BG readings can vary from an average of mid 4s to mid 5s. Is this normal or should I try to identify some other cause that is effecting BG such as sleep and stress?

3. My next HBA1C will be in just under a month. If I let the nurse/doc know that I have been meds free for 3 months already, will they declare remission or will it be a minimum of several more quarterly HBA1C tests before they will declare this?

4. I recently decided to test the effects of chocolate on my BG after months without any confectionery. I tested my BG before I ate chocolate (carbs 39g - almost all of which sugars) the effect was a rise after 20mins from 5.4 to 5.7 and it dropped back to 5.4 after an hour. Very encouraging. However I repeated the experiment the next day and it rose to 7.4 and took 90 mins to go back into the 5s. My question is, would you expect a person with T2 to jump to BG of around 7.5 or would you expect it to be higher?

5. Finally, in a healthy person with no diabetes does their BG ever spike higher than 7.8 during peak times after meals etc?

Sorry for such a large post. I have researched for so many hours online and realise I am obsessing somewhat over my diagnosis. But these questions keep bothering me and any insight from you good people would be much appreciated.

Thanks in advance

Adam

 

[Bluetit1802]

Hello and welcome,

Very well done for jumping in and doing something positive to help your diabetes. However, I think you are trying to run before you can walk. This is a long game. Your numbers look very good, but they are only good because of your low carb diet (with the odd bit of chocolate), and you are really only just starting. Whether your doctor/nurse says you are in remission is in the lap of the gods, even if your HbA1c is in non-diabetic levels. There are no official guidelines as yet for what remission is. No official definition. Therefore each doctor/nurse will have differing ideas. Some say several consecutive HbA1cs in the non-diabetic range without meds, others are more generous, others don't mark any patient in remission. Some think an HbA1c under 48 (6.5%) is remission, others think it needs to be under 42. (6%).

 

[Rachox]

Hi and welcome to the forum. I think aside from any of the self testing you have done, it is still early days for you. As @Bluetit1802 says there isn’t a consistent definition of ‘remission’. I have it under my avatar here, but didn’t put it there until I had had non diabetic HbA1cs for over a year and with the qualification of the Oxford Dictionary definition of ‘remission’ in my signature, which is a “temporary diminution of the severity of disease or pain”. I would actually prefer the description, very well controlled. My medical records don’t show remission as my GP says I’m very well controlled, and indeed if the coding is changed on your records, unless the GP is careful you will lose the automatic referrals for screening which once diagnosed as diabetic should continue.

 

[Squire Fulwood]

First of all Adam, in what country do you live that still measures Hba1c in percentages? Secondly, your numbers don't seem to add up.

1. These are good readings and don't indicate diabetes. How you got from here to a high Hba1c is a bit of a mystery.

2.Again, 4s and 5s are non diabetic readings.

3. If your Hba1c continues to be high I guess you are in for the duration. They won't declare remission if they only see high Hba1c's.

4. The current official advice is if the blood sugar levels return to below 8.5 after two hours. then you are OK. Your numbers appear to be from another planet.

5. Yes probably but when a healthy person is healthy they don't usually check their blood sugar levels so we may never be certain.

The conflict between your (random) readings and your Hba1c is puzzling. If you have dropped 41 pounds due to low carb then I think you should continue to eat low carb. Obviously high carb was doing you no favours. Carry on as you are going is all I can suggest. The pills issue is between you and your Health Care Professional, there is no-one on here qualified to advise on that.

 

[Rachox]

First of all Adam, in what country do you live that still measures Hba1c in percentages?

I’m in the UK and my GP still quotes percentages! Both the old and new readings are recorded on my on line results page though.

 

[AdamW2]

Thanks for your replies so far.

@Squire Fulwood I agree my daily readings don't seem to tally with my HBA1C but prior to diagnosis I was quite out of control with my eating, I would binge eat fast food most days, plus it was within a couple months of Christmas so even more indulgence. Part of me hoped this was the cause of such high readings in the HBA1C but I guess if my metabolism was normal it would never get to such a high 3 month average.

I am in the UK. Some nurses gave me my results in percentages, others staff in the same GP in the new readings. In new money: my first reading was 60 and my second was 57.

@Rachox and @Bluetit1802 you also answered another question that I forgot to ask which was - if declared in remission will my body handle sugars again like a person who does not have diabetes. The fact that remission seems to be a bit of a grey area answers that somewhat. And I will never go back to eating how I used to so that question I suppose is irrelevant!

 

[Resurgam]

If you get normal Hba1c levels for a couple of years then you can claim to be in remission - my doctor lost all interest some years ago now, as I dropped out of the diabetic range very fast.
I always found that carbs made me put on weight very fast, which is why I started to eat low carb in my early 20s - so even though I can probably eat more carbs now, it would just result in regaining weight at a great rate, so if anything I have reduced my carbs rather than tried to eat 'normally'.

 

[Deleted member 308541]

I’m in the UK and my GP still quotes percentages! Both the old and new readings are recorded on my on line results page though.

It's the same here with my GP, as does the blood test results from the pathology shop.

 

[Deleted member 308541]

My next HBA1C will be in just under a month. If I let the nurse/doc know that I have been meds free for 3 months already, will they declare remission or will it be a minimum of several more quarterly HBA1C tests before they will declare this?

I have had 5 hba1c blood tests that have been in the low 30's in the past two years.

I have another hba1c test in <6 weeks, and if that is around the 34 mmol/mol mark, I will be stopping the last 1 x 500 Metformin dose I take on my GP's advice. I could then say I was in "remission" but I prefer "very good control".

 

[Bluetit1802]

@Rachox and @Bluetit1802 you also answered another question that I forgot to ask which was - if declared in remission will my body handle sugars again like a person who does not have diabetes. The fact that remission seems to be a bit of a grey area answers that somewhat. And I will never go back to eating how I used to so that question I suppose is irrelevant!

If you manage to achieve remission it is highly unlikely your body will handle sugars like a non-diabetic. It is only because you aren't feeding your body with carbs that your numbers are low. Change that and you will be back where you started.