Great HbA1c result but got told off for it...

Alexandra100

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This is factually incorrect.

There are other drugs than insulin which cause hypos, and some of them are drugs routinely prescribed to T2s.

In addition, there are medical conditions which can cause hypos, whether that person has diabetes or not. These conditions include, but are not restricted to, insulinoma, reactive hypoglycaemia, and as complications of bariatric surgery.
https://academic.oup.com/jcem/article/98/10/39A/2833336

I realise that these conditions are comparatively rare, but they are common enough that stating 'only insulin dependents get hypos' is misleading and potentially dangerous.
Would it be OK to say that if a T2 is not already subject to hypos, s/he will not start having them as a result of taking Metformin?
 
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Brunneria

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Would it be OK to say that if a T2 is not already subject to hypos, s/he will not start having them as a result of taking Metformin?

I think that is probably the case, but then there will always be the exception.
I remember years ago @Scandichic posted on the forum about an occasion when she suffered a hypo, including ambulance call out. She was new to Metformin at the time she had the hypo, and she was absolutely convinced that the hypo had been caused by Metformin.

So really I suppose it all boils down to the fact that some people get rare contraindications, and anyone can have a hypo in the right circumstances...
 
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ickihun

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Would it be OK to say that if a T2 is not already subject to hypos, s/he will not start having them as a result of taking Metformin?
I never had hypos, other than from alcohol when I wasn't diagnosed.
After diagnosis I had hypos at any time but not severe hypos as I had a meter, in those days.... GP issued strips and I bought meter from a chemist.
Mind you I did work on the railways so I was safety critical.
 
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Alexandra100

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anyone can have a hypo in the right circumstances...
Or maybe one should say, "In the wrong circumstances"! All the same, IMO it would be daft for anyone wanting to take Metformin to be deterred by fear of hypos. Unless that is they were determined to get drunk every night.
 

Draco16

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I have been attacked by T1s for posting on a thread that was not on the T1 sub Forum. What I posted was not irrelevant to the OP and included referring them to that stalwart T1 Dr Bernstein. I can understand that as a minority T1s resent intrusion by T2s onto their territory, especially if it results in advice being given that is not appropriate. However IMO anyone looking to criticise someone else's post should take care at least to read it carefully first. I have the impression that some T1s may be a touch trigger happy. By contrast I don't think I have ever seen a T2 objecting to a T1's contribution to any thread or Forum.

Not sure if that was for me? I was actually commending you for your clarification in post 129 of the irrelevant 125&126 re ACCORD study of T2's. Though i'm sensing now that post 129 was more sardonic than serious...
 

Fairygodmother

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Very-low-carb diet shows promise in type 1 diabetes - Science Magazinehttps://apple.news/A6w0eU50cSVWqNX36OeasEg

Saw this on the Apple News app this morning. It seems relevant.
 
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Fairygodmother

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I don’t think it’s very easy to download. Looks like they don’t really want it shared. Wonder why.
 

Fairygodmother

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Very-low-carb diet shows promise in type 1 diabetes - Science Magazinehttps://apple.news/A6w0eU50cSVWqNX36OeasEg

Tried again but still can’t get it to work properly - grrrrrrr
 

kev-w

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Very-low-carb diet shows promise in type 1 diabetes - Science Magazinehttps://apple.news/A6w0eU50cSVWqNX36OeasEg

Tried again but still can’t get it to work properly - grrrrrrr

I saw
Thank the Lord at least it’s not being touted as a “cure”
1f60a.png
As an adjunct? Possibly Yes ( for those who want/can afford/sustain) As a substitute for insulin? No- that’s quackery advice
as a comment from a well respected Docs Twitter account, and I'm guessing they're the same article.
 
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maureen5752

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:mad: Rant alert :mad:

I had a raft of blood tests last Friday to investigate why I’ve been getting blood pressure drops when I stand up, and the nurse asked if I’d like her to take an HbA1c while she was at it - I jumped at it because my last one covered one month of no Libre and lots of carbs (and Christmas) plus two with Libre and keto, so didn’t really give me an accurate picture of how things have improved since I got it.

Phone rang this afternoon, it was the practice nurse. She just said that they’d got my results and my HbA1c was 43. And then silence. I assumed it was to give me time to gush, and I said how thrilled I was with such a good result. More silence.

They want me to drop my insulin and get it back up to 50.

I said no way, that 43 comes under “excellent control” on the chart they have on their wall, and that I was delighted. Cue a lecture about hypos, and I tried to explain that I don’t really have any, maybe one mild one a week (never at night), and that I never drop below 3mmol. She actually said she didn’t believe me! And wants me to come in so I can have hypos explained to me. I explained that having had T1 for 20 years, I was very experienced at having hypos, but I’m now managing it in such a way with my Libre as to make sure I don’t get them, and explained the “sugar surfing” methods of a glucose tab here, half a unit there to nudge my sugars into range if they’re drifting off. Apparently I must be having night hypos! I’m going to have to go in armed with printouts of my Libre traces to prove that I’m not - I haven’t had a night hypo since flippin’ January! We had the driving conversation and I explained that I run my sugars a little higher (6-7mmol) to drive, and she said I should be aiming for TEN :mad:

So that’s rather taken the shine off a result I’ve been working so hard to accomplish.

:banghead::banghead::banghead:

I also got cholesterol numbers, but I’m not quite sure how to interpret them, can the hive mind help? She didn’t seem too happy about those either.

Total 6.2; HDL 4.2; LDL 3.7; Trigs 1.2

Anyway, I’m seeing my GP at the end of the month to discuss it all, looks like I’ll have to go armed with my lever arch file of results and dig out the battle handbag again :)

/rant
Hi. Just read your txt. Few months ago I was told same thing. My hbc1a was 41. I felt great but was told it was to low & to get it higher!!! Was told 41 could cause hypos. I take 2 metformin each day only, we work hard to get good results then get told off. Congrats by the way. Good work
 
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Bluetit1802

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Hi. Just read your txt. Few months ago I was told same thing. My hbc1a was 41. I felt great but was told it was to low & to get it higher!!! Was told 41 could cause hypos. I take 2 metformin each day only, we work hard to get good results then get told off. Congrats by the way. Good work

That is the most ridiculous thing I have heard. You are a T2 on Metformin, which is hardly a hypo risk. :banghead:
 
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maureen5752

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That is the most ridiculous thing I have heard. You are a T2 on Metformin, which is hardly a hypo risk. :banghead:
Hi. I agree but what can you do. I've lost faith in doctors/nurses now, I just do what I think is good for me now, I have my blips who doesn't.
 
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Biggles2

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Anyway, I’m seeing my GP at the end of the month to discuss it all, looks like I’ll have to go armed with my lever arch file of results and dig out the battle handbag again :)
@Mel dCP be sure to bring a copy of this small study just published today in the journal Pediatrics with you:

Management of Type 1 Diabetes With a Very Low–Carbohydrate Diet
Belinda S. Lennerz, Anna Barton, Richard K. Bernstein, R. David Dikeman, Carrie Diulus, Sarah Hallberg, Erinn T. Rhodes, Cara B. Ebbeling, Eric C. Westman, William S. Yancy Jr, David S. Ludwig

http://pediatrics.aappublications.org/content/early/2018/05/03/peds.2017-3349

It was a small sample size with a highly motivated group, but it highlights the improvements that can be achieved on a low-carb diet. Also, there are some well-known names in the list of authors:).
 

LooperCat

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Hi. Just read your txt. Few months ago I was told same thing. My hbc1a was 41. I felt great but was told it was to low & to get it higher!!! Was told 41 could cause hypos. I take 2 metformin each day only, we work hard to get good results then get told off. Congrats by the way. Good work
Aye, I was told to get it back up to 50. But that’s an average level on the meter of 8.1mmol! So b*gger that.
 

Alexandra100

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Not sure if that was for me? I was actually commending you for your clarification in post 129 of the irrelevant 125&126 re ACCORD study of T2's. Though i'm sensing now that post 129 was more sardonic than serious...
Hello Draco, sorry, I meant to reply earlier but got side-tracked and then lost the thread (literally and figuratively!) No, my remarks had nothing to do with you or this thread. I'm struggling to identify the posts you mention because in my browser as far as I can see posts are not numbered.
Very-low-carb diet shows promise in type 1 diabetes - Science Magazinehttps://apple.news/A6w0eU50cSVWqNX36OeasEg

Tried again but still can’t get it to work properly - grrrrrrr
Read the original paper here:
https://www.dropbox.com/s/a1zr9eb8675hfk1/How to Normalize Blood Sugars for Type 1 Diabetics.pdf?dl=0
 
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