Good but disappointing HbA1c result

[Sirmione]

Trying to control carbs to X grams per day is trying to over-control your body. There is no way to accurately estimate the carbohydrate contained in any meal and even less accuate information on what type of carbs are in each food as nutritional information on the packaging and the internet is mostly very unreliable and nearly always conflicting. What works for me is without going to some extreme or weird diet to try and reduce my total carb intake to near zero which is of course impossible and then find out what works for me by testing before and after meals.

 

[KevinPotts]

Trying to control carbs to X grams per day is trying to over-control your body. There is no way to accurately estimate the carbohydrate contained in any meal and even less accuate information on what type of carbs are in each food as nutritional information on the packaging and the internet is mostly very unreliable and nearly always conflicting. What works for me is without going to some extreme or weird diet to try and reduce my total carb intake to near zero which is of course impossible and then find out what works for me by testing before and after meals.

I agree, I keep it simple: cut the carbs, normal protein, up the fats, never count calories and my body shape and BG levels tell me the rest


Diagnosed 13/4/16: T2, no meds, HbA1c 53, FBG 12.6, Trigs 3.6, HDL .75, LDL 4.0, BP 169/95, BPM 85, 13st 8lbs, waist 34" (2012 - 17st 7lbs, w 42").

16/6/16: FBG AV 4.6, Trigs 1.5, HDL 2.0, LDL 3.0, BP 112/68, BPM 6O, 11st 5lbs, waist 30", PWV 7.0. Lifelong migraines and hay fever gone.

Regime: 20g LCHF, run 1 mile daily, weekly fasting, occasionally longer fasts.

 

[Pinkorchid]

Don't beat yourself up that is a really good result just keep doing what you are doing and I bet next time you will be even lower.It is not something that happens overnight it takes time to get where you want to be but it will happen so well done for what you have achieved so far

 

[Brunneria]

Absolutely, @Sirmione

Every time I mention a 'I eat xxx carbs a day' that is a rough guesstimate, for two reasons. Firstly, as you said, accurate calculations are impossible (I once read that food packaging labels are likely to be as much as 30% out, for any given item!!!), plus, my body reacts differently to different foods. Grains, sugar and starchy veg produce different spikes (speed and duration) so the no. of grams becomes meaningless.

 

[Dougie22]

Update..... Visited my doctor this morning and we had a really good discussion on progress. We jointly decided to leave the Ramipril at 5mg per day and reduce the Metformin from 2000mg to 1000mg per day for now. I think that if I had really pushed him, he might have stopped the Metformin and reduced the Ramipril to 2.5mg, but I was happy with the changes made for now. I feel I have to get my weight down to get my BP below 80, with a view to eventually ditching the Ramipril altogether and that I need to see what, if any, change the reduced Metformin makes to my BG readings (I read somewhere that you can get 85% of the 2000mg benefit at 1000mg). Unfortunately this doctor is leaving the practice in August which is a real shame as I feel we've got to a good understanding of each other. Oh well! So, feeling much happier and motivated now. Thank you all again for your comments and support.

 

[Keesha]

One question for Dougie22, if you decide to ditch the Ramipril would your blood pressure creep up slowly unless you go on a salt free diet? I always thought that once on Ramipril, then you are suppose to be on it for life, the same with Metformin.


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[Mary_m]

Keep going - you have come so far already


Type 2
No medication - diet & exercise
Hba1c Jan 2016 - 46
Hba1c Jun 2016 - 43 (avg 6.1)

 

[Brunneria]

One question for Dougie22, if you decide to ditch the Ramipril would your blood pressure creep up slowly unless you go on a salt free diet? I always thought that once on Ramipril, then you are suppose to be on it for life, the same with Metformin.


Sent from my iPad using DCUK Forum

Blood pressure is about a lot more than salt. In fact for many people the amount of salt in the diet has no effect on blood pressure at all - unless they go too low or too high in salt.

http://articles.mercola.com/sites/articles/archive/2012/03/05/end-war-on-salt.aspx

 

[Dougie22]

One question for Dougie22, if you decide to ditch the Ramipril would your blood pressure creep up slowly unless you go on a salt free diet? I always thought that once on Ramipril, then you are suppose to be on it for life, the same with Metformin.


Sent from my iPad using DCUK Forum

I'm no expert on blood pressure, but in my case it seems very well correlated to my weight. When my weight goes down (or up) so does my BP. I personally don't believe in any "medicine for life". It's there to relieve a condition. If you can fix the underlying condition ( for example by reducing your weight to the point where your BP would be normal without medication), why would you continue prescribing/taking it? I'm sure that there's plenty of advice from the drug companies to doctors about why they should continue to prescribe their drugs but they really can't be considered unbiased, can they?

 

[noblehead]

@Dougie22, some of the obvious reasons for high bp are being overweight, inactivity, smoking and stress but some people are predisposed to having high bp (just the same as they are with cholesterol) due to family history.

Also there are other reasons why a bp med may be prescribed when bp levels are below normal, when my diabetic retinopathy was active I was prescribed the drug Ramipril (this despite my bp being below 140/80), the reason being that my gp and Ophthalmologist wanted my bp below 130/70 to keep the pressure off my eyes so put me on a low dose of the drug.

Patients who have a declining kidney function or who may be at risk are often prescribed a Ace-Inhibitor, but losing weight will reduce bp levels as will increasing the amount of exercise you do. Well done on yout HbA1c.

 

[Dougie22]

@Dougie22, some of the obvious reasons for high bp are being overweight, inactivity, smoking and stress but some people are predisposed to having high bp (just the same as they are with cholesterol) due to family history.

Also there are other reasons why a bp med may be prescribed when bp levels are below normal, when my diabetic retinopathy was active I was prescribed the drug Ramipril (this despite my bp being below 140/80), the reason being that my gp and Ophthalmologist wanted my bp below 130/70 to keep the pressure off my eyes so put me on a low dose of the drug.

Patients who have a declining kidney function or who may be at risk are often prescribed a Ace-Inhibitor, but losing weight will reduce bp levels as will increasing the amount of exercise you do. Well done on yout HbA1c.

Yes, I'm one of the people who've always had an off the graph level of cholesterol but , rightly or wrongly, I'm a statin refuser so it doesn't worry me. In my case, my BP is mainly down to weight. I exercise fairly often but I need to get some more weight off.

 

[KevinPotts]

Update..... Visited my doctor this morning and we had a really good discussion on progress. We jointly decided to leave the Ramipril at 5mg per day and reduce the Metformin from 2000mg to 1000mg per day for now. I think that if I had really pushed him, he might have stopped the Metformin and reduced the Ramipril to 2.5mg, but I was happy with the changes made for now. I feel I have to get my weight down to get my BP below 80, with a view to eventually ditching the Ramipril altogether and that I need to see what, if any, change the reduced Metformin makes to my BG readings (I read somewhere that you can get 85% of the 2000mg benefit at 1000mg). Unfortunately this doctor is leaving the practice in August which is a real shame as I feel we've got to a good understanding of each other. Oh well! So, feeling much happier and motivated now. Thank you all again for your comments and support.

Wonderful, I'm so pleased for you


DIAGNOSED: 13/4/16: T2, no meds, HbA1c 53, FBG 12.6, Trigs 3.6, HDL .75, LDL 4.0, BP 169/95, BPM 85, 13st 8lbs, waist 34" (2012 - 17st 7lbs, w 42").

UPDATE: 16/6/16: FBG AV 4.6, Trigs 1.5, HDL 2.0, LDL 3.0, BP 112/68, BPM 6O, 11st 5lbs, waist 30", PWV 7.0. Lifelong migraines and hay fever gone.

Regime: 25g LCHF, run 1 mile daily, weekly fasting, occasionally longer fasts.