Am I cured

[yorkshiredigger]

My GP rang out of the blue and said beacuse my HBA1C is 40 ( Been on Atkins diet prior to blood test)
That I am cured and can come off metformin. I wouldn't agree to it without consideration, so then he said drop to one 500 a day, but again I said I would have to cosider it.
I do go above 8 after meals not too much though.
forgive me but my logic is, 1 I work very hard on a low carb diet I cut out bread potatoes alcohol except special occassions. Also doesnt it mean the tablets are working? If I am doing well on this format levels are low risks are low then I should be well for many years.
If I come off them and start having spikes and levels are high then I can be risking good health.
I feel mre stressed about it now than I did when first diagnosed 5 years ago.
My exemption cert expired in Nov...
I cannot see a specialist with his consent.

 

[2131tom]

I'm in a similar position in that my HbA1c is quite low - and generally always has been - but like you I work at keeping it that way. If I slip, various symptoms come back and my BG levels rise again.

My GP takes the other view to yours and says once you're diabetic, you're always going to be a diabetic and has never suggested taking me off metformin.

My take on it is that I'll always be predisposed to diabetes. If my body lets me control it then I'll do my best to take advantage of that, but (unless they come up with a miracle cure) I don't ever suppose I'll be like those out there who've never had it.

Keep well.

 

[SunnyExpat]

My GP rang out of the blue and said beacuse my HBA1C is 40 ( Been on Atkins diet prior to blood test)
That I am cured and can come off metformin. I wouldn't agree to it without consideration, so then he said drop to one 500 a day, but again I said I would have to cosider it.
I do go above 8 after meals not too much though.
forgive me but my logic is, 1 I work very hard on a low carb diet I cut out bread potatoes alcohol except special occassions. Also doesnt it mean the tablets are working? If I am doing well on this format levels are low risks are low then I should be well for many years.
If I come off them and start having spikes and levels are high then I can be risking good health.
I feel mre stressed about it now than I did when first diagnosed 5 years ago.
My exemption cert expired in Nov...
I cannot see a specialist with his consent.

If you are still on metformin,apply for a renewal of your cert.
Personally, I intend to stay on it, as I understand there may be other benefits to it.

My diabetes, and Hba1c are well controlled as well.

 

[yorkshiredigger]

thanks folks
I know I will have a battle though as he can be very intimidating. He is basing this on the New Castle diet. CAn he force me off them?

 

[Bluetit1802]

How long have you had a non-diabetic HbA1c level? Is this your first one? I understand from my DN that they like to see continued control at non-diabetic levels for a year or more before declaring you are no longer diabetic and suggesting you come off the diabetic register (at least at my surgery). Metformin is a different matter. Your doctor probably feels you don't need it any more, but if you feel you do need it then keep pressing the matter.

 

[pleinster]

Cured sounds great....I would not be convinced...I came off my meds by choice as they were a making no difference and went onto a low carb diet with great results, and I suspect my next HbA1c will be closer to 40 BUT..I still get a wee spike of up to about 7.5 8.2 or so (due to steroids I am on) and can sometimes hit 8.0 or so after a meal (despite very low carb content)...I am putting myself back on meds to see if now that I am on the diet it might make an impact it didn't before. Once I get to HbA1c results of about 30..I'll maybe think I'm reversing something, but not till then...and I don't believe that that means I can then eat rubbish again! I think you tell you doctor you'd feel safer staying on it for now...maybe try agree a target...35 whatever. I hope it's all good fro you though...I'd suggest not letting up too much on you diet at least. good luck.

 

[4ratbags]

I also came off my meds by choice and I was only technically a diabetic for 11 months but I will always consider myself a diabetic. He shouldnt be able to force you off them, stand your ground if you are adament about continueing with Metformin as it is YOUR health.

 

[martsnow]

I don't think your G. P. has, much ground to to stand on, to stop your medication, because you are in "remission".

It would be the same, as saying, to a kidney transplant patient, that they, could come off, all their anti rejection medication, because they, had not shown, any signs of rejection.

To me it's a bit of a no brainer, and the G.P should allow you, to continue with your medication, if that's what you desire

 

[pleinster]

I don't think your G. P. has, much ground to to stand on, to stop your medication, because you are in "remission".

It would be the same, as saying, to a kidney transplant patient, that they, could come off, all their anti rejection medication, because they, had not shown, any signs of rejection.

To me it's a bit of a no brainer, and the G.P should allow you, to continue with your medication, if that's what you desire

Interesting analogy, as a kidney transplant patient who got diabetes as a result of anti-rejection drugs (mainly one steroid), I am being told that if my diabetes remains problematic - I will probably have said steroid reduced and then stopped (as I have no signs of rejection)...isn't life bizarre...isn't health a riot.

 

[andcol]

I was diagnosed with an HbA1c in the 90s and 3 months later I was at 40 - I had already stopped the metformin (reacted to it) and I saw no difference in my levels in my meter readings after stopping them. My GP Practice say they like to wait 3 years before declaring "cured", Prof Taylor recommends 4, some GPs say immediately.

So coming off the metformin - try it and see what happens you can always go back on them and then you have the evidence for your GP.

As for going to 8 that is quite normal as my non-diabetic wife and daughter do as well.

 

[AndBreathe]

I think to state the GP doesn't have grounds to recommend cessation of a treatment they feel is no longer required is a bit bullish. Surely, the aim is to be on as little medication as possible?

The current NICE Guidelines do rather point to supporting your Doc, although your description of is assessment of a cure could be a smidge premature. Wouldn't you want to try at least reduced Metformin, or are you more concerned about losing your excemption certificate?

The new NICE Guidelines, published yesterday, so bang up to date, can be found here: http://www.nice.org.uk/guidance/ng28

 

[SunnyExpat]

I think you have to be careful in how you view diabetes as a condition.


It's very easy to get into an arms race, where you lose sight of treating the condition, but instead strive to be medicine free, strive to be the lowest BG level, strive to be labeled as 'normal' rather than 'diabetic' etc.
I take a more relaxed, balanced view of the condition as part of my lifestyle.
Metformin seems to have other benefits, so personally, even though my BG is normal, it's normal whilst taking Metformin. (I haven't noticed it makes a lot of difference now, to be fair), and I think the other benefits it claims to have seem to convince me to still take a minimal dose.
My GP is happy with this, we've worked together to get to this point, so it's probably worth talking it over, but as others have said, it should be a period of several years before you are reclassed as not diabetic.
If you do decide to agree to be taken off, it should be done under supervision, and with tests every three months, to ensure your hba1c is stable.

(Actually, there isn't much in the Nice guidelines that applies if you do lower your HbA1c, so I guess we're leading the way here.

'If adults with type 2 diabetes achieve an HbA1c level that is lower than their target and they are not experiencing hypoglycaemia, encourage them to maintain it. Be aware that there are other possible reasons for a low HbA1c level, for example, deteriorating renal function or sudden weight loss. [new 2015]' )

 

[yorkshiredigger]

Thanks everyone for your input, I think ringing me at home at 5pm during ur supper was half the problem. I felt intimidated by his pressure to come off with n discussion.
I also feel "Feel" that its all abut saving money, even an aspirin I feel comes from his own pocket. Probably unfair but its my opinion.

Could some be so kind as to send me a link to the benefits of Metformin so I am well prepared.
if I come down to one per day then may I insist on a HBA1C in three months time.
Also last Q what is the non diabetic HBA1C level as alot our you folk are lower than me 35+
Many thanks for your support
TTFN

 

[andcol]

an HbA1c below 42 is the normal range
42 - 48 is prediabetic
48+ is diabetic.

You should aim to be below 48

 

[catherinecherub]

Could some be so kind as to send me a link to the benefits of Metformin so I am well prepared.

The many benefits of Metformin.

http://www.empoweryourhealth.org/magazine/vol7_issue3/the-many-benefits-of-metformin

 

[britishpub]

When my 2nd HbA1c came in at 32, I asked about still needing to take the Metformin, and my GP responded, "my advice would be continue with what you are doing beecause it is certainly working"................so I did.

And I know for certain I am not "cured" as after eating 2 slices (as opposed to the usual 1) of German Rye bread the other day, I had an 8.8 after 2 hours and a 9.2 after 3, the highest readings I had seen since a week after diagnosis.

 

[Bluetit1802]

When my 2nd HbA1c came in at 32, I asked about still needing to take the Metformin, and my GP responded, "my advice would be continue with what you are doing beecause it is certainly working"................so I did.

And I know for certain I am not "cured" as after eating 2 slices (as opposed to the usual 1) of German Rye bread the other day, I had an 8.8 after 2 hours and a 9.2 after 3, the highest readings I had seen since a week after diagnosis.

Just a sharp reminder to us all that we are still diabetic even when we are well controlled and have HbA1cs that say otherwise. Only a very lucky few are cured. The rest of us are only in remission and an extra slice of bread can send us back again.

 

[Chook]

Just a sharp reminder to us all that we are still diabetic even when we are well controlled and have HbA1cs that say otherwise. Only a very lucky few are cured. The rest of us are only in remission and an extra slice of bread can send us back again.

My thoughts exactly.