Doctor says I have to stay on metformin

[Guzzler]

Ask to come off the Metformin after you have stabilized your blood sugars and achieved an Hba1c (3-month average) below 5.7%. Your GP will have experienced very few diabetics who can achieve this unless they are prepared to switch to a very low carbohydrate (keto) diet with fasting and exercise every day.

Some of us can reach non Diabetic HbA1c without any regimented exercise. Diet is key.

 

[Sparrow456]

Which is precisely the reason why testing is recommended then you can have hard evidence rather than guessing.



Do you believe they are godlike? Some doctors give that impression whereas others seem quite willing to work with their patient. I know for sure which I prefer.

Bulkbiker - I have never had to stick myself with a needle! Have excellent CONTROL, am HEALTHY and ALIVE - enough said.

 

[ert]

Some of us can reach non Diabetic HbA1c without any regimented exercise. Diet is key.

Then you must have a lot more insulin on diagnosis than I have. Sigh.

 

[Guzzler]

Then you must have a lot more insulin on diagnosis than I have. Sigh.

Perhaps you'd like to fill in your details as this would make clear to all where you are coming from.

 

[HSSS]

Ian - I unlike many on this forum am a NON Tester. My GP and Nurse also say it is not necessary to test and not to buy a tester. I had my bloods tested by the nurse every 6 months. After just over a year I was taken off my Metformin and am now diet controlled. My blood is only checked annually with my last HbA1c 41. Please remember that everyone is different and everyone's body behaves differently. What food you eat and how you eat it may be completely to how someone else eats similar food, those having a completely different reaction on your body.
Some Diabetic feel the need to be in constant control and test regardless of what their GP's say, whilst others Don't. Have you been offered the chance to go on a diabetic information course - if not ask to go. You will be able to ask all sorts of questions there without getting silly comments like "Doctors are not Gods".

Quite frankly you sound lucky. Lucky if you got good quality advice about what to eat and not eat on your course. Lucky that your choices worked out (you had no way of knowing that til 6 months or a year down the line- what if they hadn’t been so good? It’s happened to many on here) lucky that you achieved control and health without complications full stop. Some of us have to work a bit harder to get the same results. That’s necessary for some not a rebellious need for control as you imply. Some of us have personal experience of misdiagnosis, poor advice and indifferent medics. To us it is not “silly” to understand what is happening to our own bodies. I’m sure I matter more to me than I do a random locum gp. We don’t give the advice to test for fun or to inflict needle stick injuries. We do it because it works and isn’t down to good luck.

 

[Guzzler]

Bulkbiker - I have never had to stick myself with a needle! Have excellent CONTROL, am HEALTHY and ALIVE - enough said.

You have excellent control unless something happens (like aging). Testing at home gives you a heads up should trends rise, something an annual A1c cannot do.

 

[ringi]

Personally I consider Metformin be a useful aid for advoiding complications of type2, hence as I don't get any side effects I am happy to keep taking it however low my BG gets. However it is low carb that has given me the most benefits.

 

[wiflib]

Bulkbiker - I have never had to stick myself with a needle! Have excellent CONTROL, am HEALTHY and ALIVE - enough said.

Hi there. It states in your bio that you take insulin. Could you clarify your situation?

 

[Brunneria]

Hi Everyone,

I have just deleted a post for rudeness and attacking members - both of which are against the forum rules.

Please be aware that if there are more such posts, where members are unable to stay polite, then those posts will also be deleted, and further sanctions may be applied.

So please, keep it civil.
We can all hold different views, and express them, without stooping to insults.

 

[bulkbiker]

Bulkbiker - I have never had to stick myself with a needle! Have excellent CONTROL, am HEALTHY and ALIVE - enough said.

Me neither I use a lancet.. if you are happy with your bi-annual snapshot (which almost undoubtedly will become an annual snapshot) then great.
I don't like nasty surprises so am far happier checking my levels daily. Once I had discovered that the Diabetes Nurses at my practise thought that T2 was a chronic, progressive disease and that I'd undoubtedly end up on insulin I decided to prove them wrong and fast. Self testing brought that change about pretty quickly so I would always advocate for it. I would also advocate forcefully for taking control of your own health as you are the one it is most important to ...not your doctor. But as I said each to their own.
I too have excellent control am extremely healthy far lighter than I was and very much alive and kicking though I'm not sure exactly what that is supposed to prove...

 

[Type2inUS]

Hello all. I am new to the forum and am excited to read what is here. This is actually the first forum I've been on.

When I'd heard that T2 was lifelong and progressive I pretty much gave up. I fight depression as well, so my sense of 'why bother' is understandable. But then I learned that I could slow it down, at least, which gave me a bit of hope. When I suffered from ANOTHER ruptured disk and needed surgery they wouldn't do it until I got my a1c below 7. I hopped on the bandwagon and finally decided I could obviously make a difference. I got an Abbott Freestyle Libre, which is a flash glucose monitor, which completely beats hands-down multiple finger sticks every day! And it is so enlightening to see what my bc does throughout the day - and night! It's not covered by our insurance, but it does require a Rx from the MD for pharmacies to fill it (at least here in the U.S.). That is one of the best tools I've come across, and strongly recommend it!

 

[EllieM]

Then you must have a lot more insulin on diagnosis than I have. Sigh.

That, unfortunately is one of the differences between T1 and T2. T2s have a problem with processing carbs, and tend to produce large quantities of insulin while they attempt and fail to do this (until their insulin producing cells wear out). So if they avoid the carbs they can often maintain perfect sugar levels. T1s just produce ever decreasing amounts of insulin..... Though the symptoms (high blood sugar) are the same, they are really two different diseases.

 

[Type2inUS]

Bulkbiker, I took a peek at your profile page and saw that the other man in your picture is Dr. Fung. I just read his book The Diabetes Code on recommendation by my sister. I thought it was awesome, and fills me with so much hope! I'm excited to begin some intermittent fasting but am taking it slow as I am on insulin and am recovering from a year of four surgeries (ugh!). I'm thinking of trying to contact him to see if he has some guidance for me - or if he would be willing to do some long distance IDM program.

Regardless, I strongly recommend this book, especially to Ian2477, as a strong learning tool about Type 2 diabetes, where it came from, and how it really works! I'm going to be talking to my endocrinologist at my next appointment.

 

[kitedoc]

My doctor says she advises against type 2 diabetics purchasing blood glucose monitors,as they aren't an accurate reading of blood sugar over a 3 monthly period.

All blood glucose meters are now supposed to meet an industry standard of +\- 5 % error rate. That is better than most continous monitoring devices.
The blood test for over the 3 months only gives an average - it does not indicate whether you might be higher in BSL say, after a particular meal and then too low after another over those 3 months as the average looks OK.
The beauty of the blood glucose meter testing is that you can see the excursions of bsl and do something to reduce the highs and lows to obtain even beter control.

 

[Type2inUS]

I believe the more informed we are, and the more tools we have under our belts (e.g., glucose meters), the better we become at doing what we need to do and making ourselves better. Reviewing the great insights of people such as are on this forum, who share what we've all struggled with and learned, and sharing where you yourself are at, is a great way of growing, too.

 

[Tophat1900]

My doctor says she advises against type 2 diabetics purchasing blood glucose monitors,as they aren't an accurate reading of blood sugar over a 3 monthly period.

As has already been stated, many good reasons to test. It is imo better to test then to ignore. What's the worst that happen from testing, you actually know what your reactions to food are, which is quite important. And you can take measures to do something about a spike if you know you have one as opposed to not knowing you have one and let it stay high causing damage. Another important thing is you can see your trends as they progress over time and this provides a lot more info imo then a HBa1c or a one off FBG level.

Or you can not test and ignore levels and spikes that happen and just rely on a once a year test that could be just fine, but it's far more probable that it won't be fine if you have no idea what is going on and waiting a year to find out doesn't seem to make much sense to me.

A lot of experienced people here have advised to get your own meter and I'm all for that too. It is of course up to you what you do.

 

[aealexandrou]

Your doctor has also told you to increase the Metformin. Do you agree with this? Doctors are not gods. They do not know it all.
At the end of the day, all doctors are supposed to do is advise, with reasons. They cannot tell you to do anything. The choice is yours, and yours alone.

In my opinion, and I am not alone in this, the finger prick readings from blood glucose meters are far more an accurate indication of how your blood sugars are than the HbA1c. They tell you instantly what each meal has done to your levels if you test before you eat and 2 hours after first bite. If the rise is too high you can change that meal to something less carby, right there and then, without waiting months for your next HbA1c test. Most GPs tell us not to test, and give a variety of excuses, but this is for financial reasons. If they told us to test they would be obliged to provide the mean to do it - and they can't do this because of the costs involved. Bite the bullet, ignore the GP, and buy your own meter. That is the only sensible thing to do.

Knowing your BSL and the effect of the food you eat is paramount. A three months test is worthless if you do not know what raises, lowers or keeps you insulin where it should be.

 

[aealexandrou]

Ian - I unlike many on this forum am a NON Tester. My GP and Nurse also say it is not necessary to test and not to buy a tester. I had my bloods tested by the nurse every 6 months. After just over a year I was taken off my Metformin and am now diet controlled. My blood is only checked annually with my last HbA1c 41. Please remember that everyone is different and everyone's body behaves differently. What food you eat and how you eat it may be completely to how someone else eats similar food, those having a completely different reaction on your body.
Some Diabetic feel the need to be in constant control and test regardless of what their GP's say, whilst others Don't. Have you been offered the chance to go on a diabetic information course - if not ask to go. You will be able to ask all sorts of questions there without getting silly comments like "Doctors are not Gods".

You clearly have a good constant diet that does not need checking. Nevertheless, within that three month period you do not have a clue what foods effect your BSL the most. The averaging out over the last three months before your test may also hide any unusually high spikes you may have. Large, albeit short term, fluctuations may have a detrimental effect on your long term health, including neuropathy and retinopathy. You also appear content with being a T2D. As with any chronic disease, insulin resistance can be controlled for long periods of time, but eventually and gradually it will get worse. It is no longer acceptable for a T2D to simply live and maintain his/her condition because we know it can be partially or fully reversed. It took me 5 years to learn that my GP didn't know anywhere near as much as I did and whats worse, the original advice given at the Diabetes clinic was plainly wrong and geared to keeping me in long term chronic sickness. I have never received any updated advice or recommendation, even after major studies by Newcastle University and the Diabetes Association have proved what a small minority of doctors have been saying for years, namely, T2D is an easily treatable condition.

 

[ert]

Perhaps you'd like to fill in your details as this would make clear to all where you are coming from.

That, unfortunately is one of the differences between T1 and T2. T2s have a problem with processing carbs, and tend to produce large quantities of insulin while they attempt and fail to do this (until their insulin producing cells wear out). So if they avoid the carbs they can often maintain perfect sugar levels. T1s just produce ever decreasing amounts of insulin..... Though the symptoms (high blood sugar) are the same, they are really two different diseases.

Unfortunately, it's not as simple as T1 producing ever decreasing amounts of insulin for no apparent reason. The main reason is T1 run their average blood sugars high to avoid hypos on insulin, which kills off one's islet pancreas cells after a honeymoon of six months. Dr Berinstein says you can stay in honeymoon indefinitely if you can keep your blood sugars low. Some type 1's do have ongoing immune system responses, presenting with continuous GAD and IA2 antibodies, so this doesn't apply to them.

 

[Brunneria]

All blood glucose meters are now supposed to meet an industry standard of +\- 5 % error rate. That is better than most continous monitoring devices.
The blood test for over the 3 months only gives an average - it does not indicate whether you might be higher in BSL say, after a particular meal and then too low after another over those 3 months as the average looks OK.
The beauty of the blood glucose meter testing is that you can see the excursions of bsl and do something to reduce the highs and lows to obtain even beter control.

Hi Kitedoc,

I’m wondering if maybe you made a typo there?

The current ISO standards are a +/- 15 % error rate.
https://www.diabetes.co.uk/blood-glucose-meters/iso-accuracy-standards.html
And
https://www.diabetes.co.uk/blood-glucose-meters/blood-glucose-meter-accuracy.html

@Ian2477
I know that it seems like a huge error rate, especially when we first encounter the idea that blood glucose readings are important to our health, and we want an ideal accuracy of 100%
But the reality is that unless someone is type 1 and needs highly accurate readings to fine tune their insulin doses, then for most type 2s, the +/- 15% error zone still allows us excellent information to track tends and identify foods with good and bad effects on our blood glucose.