Prescribed Metformin but wondering I can do this on diet alone

[copilost]

The sleep issue is largely down to renewing my mortgage and realising I have 17 years left still to pay on it. I will be nearly 70 by the time I'm done. With a diabetes diagnosis 2 months ago, and my dad dying recently, leaving me the oldest survivor in my parents' family line, the mortgage thing has just forced me to project 20 years into the future and contemplate my own mortality. Precisely the sort of thing that kicks in at 3am

ah yes LIFE! It's a thing isn't it? Can relate to a lot of this and the 3am think-storm.
These middle age years are challenging for sure. I suspect old age isn't a walk in the park either but I never would be a teenager again
I cried when I got the T2 diagnosis because it was yet another thing in the car pile up of things in my life. Honestly it looked like the Blues Brothers around here. Might be still does but I'm wearing shades (at night).
Hugs to you in what sounds a difficult time.

 

[Nicole T]

I didn't sleep brilliantly last night, either. No particular reason for it, this time (I seem to have stopped worrying about the financial stuff for now) just, in spite of heavy eyes, I wasn't ready to go to sleep until 2am, and then woke up around 6:30. Yet I've tested as 6.1, and I'm perfectly happy about that.

Now that I think of it, when I first got my meter and read a 9 in the morning, I'd been drinking that same Morrisions 'no added sugar' drink before I tested. It's the prime suspect at the moment. I think I'll cut it out because they have a berry one that's just as nice, that's properly zero carb.

Perhaps another factor the other day was that I tested after driving. I'd been out to meet a friend, and while driving sensibly and fairly chilled, was quite aware that I was cutting it fine for the 9am I wanted to be home to clock on for work. I got back at 8:58. So maybe I (or at least my body) was stressing a little over that, without even realising it.

 

[Nicole T]

So I'm broadly happy with how things are going. The very beginning of the chart is the couple of days before I went low carb. Since then, the only readings that have been outside of the 4 to 8.5 range have subsequently tested within that range immediately after, so I've put them down to test errors. Unfortunately, you can't adjust or remove them in the GlucoRx software.

But since mornings seem to be sticking around the low to mid 6's, AC readings rarely dip into the 5's, and PC readings often hit low to mid 7's, I'm wondering whether I should go on a low dose of Metformin after all. My big scare was morning after hypos, but since I'm not pulling below 5.5 any mornings, that seems unlikely on a low dose of Metformin. If it'd bring my levels down say 0.5 to 1 mmol/L, it might still be beneficial.

Thoughts, anyone? Obviously no binding medical advice, but more of a "What would you do, in my situation?" Just be conent with the fact that figures are consistently below 8.5? (And almost always below 7.5) Or accept medication to try to get the figures even lower?

 

[Andydragon]

So I'm broadly happy with how things are going. The very beginning of the chart is the couple of days before I went low carb. Since then, the only readings that have been outside of the 4 to 8.5 range have subsequently tested within that range immediately after, so I've put them down to test errors. Unfortunately, you can't adjust or remove them in the GlucoRx software.

But since mornings seem to be sticking around the low to mid 6's, AC readings rarely dip into the 5's, and PC readings often hit low to mid 7's, I'm wondering whether I should go on a low dose of Metformin after all. My big scare was morning after hypos, but since I'm not pulling below 5.5 any mornings, that seems unlikely on a low dose of Metformin. If it'd bring my levels down say 0.5 to 1 mmol/L, it might still be beneficial.

Thoughts, anyone? Obviously no binding medical advice, but more of a "What would you do, in my situation?" Just be conent with the fact that figures are consistently below 8.5? (And almost always below 7.5) Or accept medication to try to get the figures even lower?

you can’t remove them from the GlouoRX on purpose as I think it allows type 1s who are monitoring to hide hypos which is not good when Dvla are watching

Did your nurse/doctor not give you a target level? There are NICE guidelines and you are higher potentially (depending when you are testing) so if you want to follow those lower would be better than you are now

https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

Personally speaking, I’m still on all my drugs and I want to be in normal non-diabetic range so for me, I want to average about what I seem to be now, 4.5 to 5.5 pre meals but ideally lower so I can come off drugs (would be happy with only a lower dose of metformin)

So, depends on your aim, metformin may help you in this and has other effects such as slight appetite suppression so can help with weight loss too if it’s tolerated

 

[Nicole T]

you can’t remove them from the GlouoRX on purpose as I think it allows type 1s who are monitoring to hide hypos which is not good when Dvla are watching

Did your nurse/doctor not give you a target level? There are NICE guidelines and you are higher potentially (depending when you are testing) so if you want to follow those lower would be better than you are now

https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

Personally speaking, I’m still on all my drugs and I want to be in normal non-diabetic range so for me, I want to average about what I seem to be now, 4.5 to 5.5 pre meals but ideally lower so I can come off drugs (would be happy with only a lower dose of metformin)

So, depends on your aim, metformin may help you in this and has other effects such as slight appetite suppression so can help with weight loss too if it’s tolerated

The only advice I've had from the nurse is to try to keep it below 9. Reading elsewhere, that's for Type 1's, and the recommended upper limit for Type 2's is 8.5. The chart you linked confirms that.

Over the last 7 days, my general reading (mostly waking level) and AC figures have both averaged 6.4. PC has averaged 6.8. So that currently puts me within the Type 2 target range for AC and the non-diabetic range for PC, as long as I limit my carb intake. With respect to the diagnosis table further down the page, I periodically get fasting (particularly morning) readings over 7, but I haven't seen a 2 hour post-prandial even close to 11 since going low carb, even when I've been experimenting with carbs to see what spikes me.

When I first went low-carb, I was getting pre-diabetic or non-diabetic figures the whole time. Now I'm occasionally getting diabetic levels for morning fasting and AC, though consistently non-diabetic for PC. It's a move in the wrong direction, and that's what's got me thinking maybe I should accept Metformin at a low dose.

 

[bulkbiker]

It's a move in the wrong direction, and that's what's got me thinking maybe I should accept Metformin at a low dose.

Or maybe cut the carbs a bit more.. like ditch bread entirely?

 

[Nicole T]

Or maybe cut the carbs a bit more.. like ditch bread entirely?

The home made stuff is supposed to be around 2g per slice. I haven't tried the Nimble yet. I did try some regular wholemeal the other day, and I still don't tolerate it well. But I won't be doing that again.

That's one of the questions, too: whether to compromise over diet vs drugs. I see friends basically eating what they want, and just taking whatever medication their GP throws at them to regulate their BS. That's not a route I'm looking to go down, but maybe there's a sensible compromise to be found.

 

[bulkbiker]

I see friends basically eating what they want, and just taking whatever medication their GP throws at them to regulate their BS.

Longer term not a great idea.. the medication will cease to work after a while and they will be on stronger meds and higher doses.. Id rather save that for somewhere far in the future (if I need it ever).

Sensible compromise is for after you have normalised your blood glucose levels. At the moment you are having trouble doing that.

Trying to replicate addictive foods like bread in a lower carb form didn't help me at all. I had to cut them out and stop eating for entertainment. I now enjoy every meal but realise it is for fuel.

 

[MrsA2]

I too seemed to have crept back into mostly 6 and rarely a 5.
I cut back wine to just once a week and upped activity
This week I have only seen 5s

This diabetes lark is a proving a pretty strict master to me

 

[Andydragon]

The home made stuff is supposed to be around 2g per slice. I haven't tried the Nimble yet. I did try some regular wholemeal the other day, and I still don't tolerate it well. But I won't be doing that again.

That's one of the questions, too: whether to compromise over diet vs drugs. I see friends basically eating what they want, and just taking whatever medication their GP throws at them to regulate their BS. That's not a route I'm looking to go down, but maybe there's a sensible compromise to be found.

I was like that, starting on 500mg metformin and bydureon then the metformin kept creeping up to eventually 2000mg and then the Dapagliflozin added in. I was on the path to insulin basically

your friends may be able to manage it for now, but at some point it will likely tick over to insulin and/or some very very nasty impact from blood sugars

I don’t know how many carbs you have. Potentially you could have some metformin and be able to handle more carbs. You won’t know unless you try it

I am not perfect, I still have fish and chips and pizza and sometimes cake. But it’s now the exception, not the rule. I’m once a week rather than every day. If my body cannot improve I may have to give that up. I hope not and that the odd treat will be okay but I really don’t know

ultimately we have a long term and very dangerous condition that is in our power to improve. But it means compromise, or it means giving up stuff we don’t want to.

 

[Daphne917]

I too seemed to have crept back into mostly 6 and rarely a 5.
I cut back wine to just once a week and upped activity
This week I have only seen 5s

This diabetes lark is a proving a pretty strict master to me

I tend to hover around the low 5s with an occasional 4.5 or 5.9.

 

[Nicole T]

I was like that, starting on 500mg metformin and bydureon then the metformin kept creeping up to eventually 2000mg and then the Dapagliflozin added in. I was on the path to insulin basically

your friends may be able to manage it for now, but at some point it will likely tick over to insulin and/or some very very nasty impact from blood sugars

I don’t know how many carbs you have. Potentially you could have some metformin and be able to handle more carbs. You won’t know unless you try it

I am not perfect, I still have fish and chips and pizza and sometimes cake. But it’s now the exception, not the rule. I’m once a week rather than every day. If my body cannot improve I may have to give that up. I hope not and that the odd treat will be okay but I really don’t know

ultimately we have a long term and very dangerous condition that is in our power to improve. But it means compromise, or it means giving up stuff we don’t want to.

I've mostly been trying to stay practically carb free apart from evening meal, which I'm always keeping below 50g, and aiming for 30g or less. I'm having the Moser Roth 85% dark chocolate (Aldi) chocolate bars as a treat, sometimes having 3 or 4 bars a day, if I'm honest. 4.6g of carbs each bar. But generally, snacking on pork crunch when I feel the urge.

I'm currently experimenting with a few carbs in the morning (maybe 20g or so) to try to 'kick start' my metabolism, in the hope of getting lower figures later in the day. So 2 slices of Nimble toast this morning. In about 45 minutes, I get to see how badly that's spiked me the from 7.1 I got immediately before eating it. (Edit: it took me to 8.0, which isn't horrendous.)

I'm not planning to be an angel all of the time, either. I've a meal with a friend coming up next weekend. She always does a curry, and I'm wondering what to do about the rice. Take my own Konjac? Ask her to prepare it by rinsing part way through? Or just take the hit and see how badly it spikes me? Though there will be alcohol involved (plenty of it) so it'll be hard to get meaningful figures from it.

 

[DCUKMod]

I've mostly been trying to stay practically carb free apart from evening meal, which I'm always keeping below 50g, and aiming for 30g or less. I'm having the Moser Roth 85% dark chocolate (Aldi) chocolate bars as a treat, sometimes having 3 or 4 bars a day, if I'm honest. 4.6g of carbs each bar. But generally, snacking on pork crunch when I feel the urge.

I'm currently experimenting with a few carbs in the morning (maybe 20g or so) to try to 'kick start' my metabolism, in the hope of getting lower figures later in the day. So 2 slices of Nimble toast this morning. In about 45 minutes, I get to see how badly that's spiked me the from 7.1 I got immediately before eating it. (Edit: it took me to 8.0, which isn't horrendous.)

I'm not planning to be an angel all of the time, either. I've a meal with a friend coming up next weekend. She always does a curry, and I'm wondering what to do about the rice. Take my own Konjac? Ask her to prepare it by rinsing part way through? Or just take the hit and see how badly it spikes me? Though there will be alcohol involved (plenty of it) so it'll be hard to get meaningful figures from it.

There's a third option, Nicole. You could have the curry, and just ignore the rice.

To me, that is focusing on the deliciousness, and ignoring the carrier element.

 

[Alexandra100]

Take my own Konjac? Ask her to prepare it by rinsing part way through?

Good idea, why not rinse it at home and bring it with you in a container? Then all you have to do is tip it on your plate. The less bother it is to your host, the more acceptable, IMO. I find cold konjac rice perfectly enjoyable, and anyway the curry should warm it up somewhat. I am envying you already!

 

[Nicole T]

Just applied my first Libre. I really wish I'd done it in a mirror, because I've stuck it much closer to my elbow than I thought I had, though still within the area they show to apply it. Anyhow, I'm stuck with it there for the next couple of weeks, assuming that it goes the distance. I've bought a band to keep it on. An obviously 3D printed affair, on close inspection. Not what I was expecting for a tenner.

They're not wrong about the early readings. 5.4 on my GlucoRx-Q (which is realistic, since the only thing I've had since breakfast is salad.) 8.0 on the Libre. I do hope I haven't invested £50 in another random number generator, and that the figures settle down over the next 24 hours or so. Though it turns out I'm not out on the town tomorrow night after all. Saturday night is going to be the eye opener.

 

[Brunneria]

Just applied my first Libre. I really wish I'd done it in a mirror, because I've stuck it much closer to my elbow than I thought I had, though still within the area they show to apply it. Anyhow, I'm stuck with it there for the next couple of weeks, assuming that it goes the distance. I've bought a band to keep it on. An obviously 3D printed affair, on close inspection. Not what I was expecting for a tenner.

They're not wrong about the early readings. 5.4 on my GlucoRx-Q (which is realistic, since the only thing I've had since breakfast is salad.) 8.0 on the Libre. I do hope I haven't invested £50 in another random number generator, and that the figures settle down over the next 24 hours or so. Though it turns out I'm not out on the town tomorrow night after all. Saturday night is going to be the eye opener.

After using quite a few Libre sensors myself, and knowing that you are not an insulin user, the best advice I can give is to not focus on the numbers. Instead, look at the direction of the arrow, and the steepness of the curve on the graph. Certainly for the first few days.
My sensors are always wangy (technical term) for the first 48 hours, unless I apply them and leave them for 48 hours to 'bed in'. So while that first 48 can be interesting, and sometimes useful, I don't view the numbers as accurate, until things have settled. It is supposed to be due to inflammation and the body rejecting the filament, which eases off in time. Not everyone gets it, so don't assume it will happen, but don't be surprised if it does.

Enjoy. It is a revelation to see what is going on when you are asleep!

And if the line flatlines at night, it is unlikely that you have died. You probably just slept on the sensor.

 

[Antje77]

Just applied my first Libre. I really wish I'd done it in a mirror, because I've stuck it much closer to my elbow than I thought

I like it close to my elbow, easier to scan

 

[Nicole T]

5.8 GlucoRx-Q or 9.6 Libre at 7:45am. New sensor still settling in, I hope. Otherwise I've just invested £54 in a random number generator. (Meant to post this to a different thread, but I suppose it's relevant here, too.)

 

[Brunneria]

5.8 GlucoRx-Q or 9.6 Libre at 7:45am. New sensor still settling in, I hope. Otherwise I've just invested £54 in a random number generator. (Meant to post this to a different thread, but I suppose it's relevant here, too.)

Remember that your sensor reads your interstitial fluid, not your blood. So it is 10-15 mins behind your blood glucose. I also find that the Libre often shows a marked rise if I get to my feet and move about. A blip, as it were. For instance, getting up to the loo in the middle of the night, or getting up after a couple of hours on the sofa. Also first thing in the morning. If I check again 5 mins later, the Libre has itself realised that the sudden spike was a blip and has ironed out that little rise and given a steady line.

These are all teensy idiosyncrasies to the Libre that you get so used to that you don't notice them after a while.

However, if your sensor stays way out of wack for long, then you can just ring up Abbott and talk to customer services about it.
They usually send out a replacement for the faulty sensor, but will ask a series of questions first, to establish that you are using it correctly and that it was correctly applied.

 

[Nicole T]

Remember that your sensor reads your interstitial fluid, not your blood. So it is 10-15 mins behind your blood glucose. I also find that the Libre often shows a marked rise if I get to my feet and move about. A blip, as it were. For instance, getting up to the loo in the middle of the night, or getting up after a couple of hours on the sofa. Also first thing in the morning. If I check again 5 mins later, the Libre has itself realised that the sudden spike was a blip and has ironed out that little rise and given a steady line.

These are all teensy idiosyncrasies to the Libre that you get so used to that you don't notice them after a while.

However, if your sensor stays way out of wack for long, then you can just ring up Abbott and talk to customer services about it.
They usually send out a replacement for the faulty sensor, but will ask a series of questions first, to establish that you are using it correctly and that it was correctly applied.

I noticed a 1 mmol/L rise between testing just after waking up, and testing after actually getting up. 90 minutes between the two (I woke rather early) though, so the activity isn't necessarily responsible. Though finger prick testing, I've noticed a similar, roughly 1 mmol/L rise from very basic activity, such as going for a short drive (school run.)

I've just bought my son an e-bike, so I shouldn't have to do the school run from now on. Though we'll see how keen he is to use it through the winter or when it's raining.