Type 2 Hba1c rising options

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Hi.
D2 for 4 years or so eat healthy
and quite active swim, walk and gardening and also not overweight
Eat low carb and watch GI rating of food but A1c still rising.
My practice nurse at last visit said no concern once it gets to 65 we will change or add medication I'm on 3 500mg Metformin daily.
I was hoping for some advice told her my energy levels were below par just informed me to eat more carbs ???? Yes this should get me to A1c level of 65 faster some help please
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
When you say low carb do you know roughly how many grams of carb per day?
You mention the GI levels which implies to me you may be a bit higher than a lot of us...
65 sounds very high to have "no concern" ,
Carbs for energy.. hmmm not what I would go for myself..
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
Hi @kyler

It would help if you could give us an idea of what you eat/drink in a typical day,, and maybe we can spot something.

Also, do you have your own meter? If so, what does this tell you about your food choices (testing before and 2 hours after first bite tells you what your food has done to your levels). Without a meter you are working blind, hobbling from one HbA1c to another with no real idea of why they are increasing and what you can do to lower them.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Hi @kyler

It would help if you could give us an idea of what you eat/drink in a typical day,, and maybe we can spot something.

Also, do you have your own meter? If so, what does this tell you about your food choices (testing before and 2 hours after first bite tells you what your food has done to your levels). Without a meter you are working blind, hobbling from one HbA1c to another with no real idea of why they are increasing and what you can do to lower them.
Hi bluetit 1802.
Sorry for not coming back earlier but after seeing my doctor again well in fact a new doctor who now handles diabetic patients in our practice who I would point out is very good and approachable he change my medication from 2000 SR Metformin tablets when I informed him I could not venture far from a loo.
I now take 2*500Sr and 1 25mg Vipidia alogliptin and my 2018 A1C came down to 51 with in about 6 months of taking these tablet I could tell the improvement as noted my morning reading were again in the 6 range and only rose by max of 2 after my normal breakfast of porrage and a half apple.
Unfortunately over this last 3 to 4 months my levels are on the rise again although I keep cutting back on carbs and mainly eat meat and non root vegetables.
My morning reading are now more in the 7 and can easily be up to 13-14 2hrs after the same identical breakfast hence just had my yearly a1c which came out at 61 not good I have doc appointment next week so maybe alogliptin no longer working or more of my beta cells are failing I have noted my energy levels are falling as I note by walking and swiming but otherwise I feel fine we shall see where we go from here.
Kyler
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
Hi bluetit 1802.
Sorry for not coming back earlier but after seeing my doctor again well in fact a new doctor who now handles diabetic patients in our practice who I would point out is very good and approachable he change my medication from 2000 SR Metformin tablets when I informed him I could not venture far from a loo.
I now take 2*500Sr and 1 25mg Vipidia alogliptin and my 2018 A1C came down to 51 with in about 6 months of taking these tablet I could tell the improvement as noted my morning reading were again in the 6 range and only rose by max of 2 after my normal breakfast of porrage and a half apple.
Unfortunately over this last 3 to 4 months my levels are on the rise again although I keep cutting back on carbs and mainly eat meat and non root vegetables.
My morning reading are now more in the 7 and can easily be up to 13-14 2hrs after the same identical breakfast hence just had my yearly a1c which came out at 61 not good I have doc appointment next week so maybe alogliptin no longer working or more of my beta cells are failing I have noted my energy levels are falling as I note by walking and swiming but otherwise I feel fine we shall see where we go from here.
Kyler
Maybe cut out the porridge and apple and go for bacon and eggs instead..no resultant glucose spike... or even better skip breakfast entirely and extend your overnight fast a bit longer until lunchtime.
 

Resurgam

Expert
Messages
9,849
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
When I tested porridge I think that was one of the longest elevations of blood glucose I found, plus my insulin resistance seemed higher in the mornings - so starting your day with porridge and an apple could be why your Hba1c is high. It is an average, so could be hoisting your numbers up a bit all the time.
Could you try substituting a breakfast more on the lines of bacon egg mushrooms tomato and see if your numbers drop? It could take a couple of days to show a difference if your reactions are like mine.
I still have about 1/4 of daily carbs in the morning and the rest in the evening in case of lingering IR.
 

Rachox

Oracle
Retired Moderator
Messages
15,810
Type of diabetes
I reversed my Type 2
Treatment type
Tablets (oral)
Hi Kyler
You say you’re eating low carb, I do too (30 - 50g/day). However I wouldn’t entertain eating porridge for breakfast. Do you test before and after breakfast, I’d be surprised if your level doesn’t rise unacceptably after the porridge and apple.
Can you write out what exactly you ate yesterday, we may be able to help you tweak your diet further.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Maybe cut out the porridge and apple and go for bacon and eggs instead..no resultant glucose spike... or even better skip breakfast entirely and extend your overnight fast a bit longer until lunchtime.
Hi Bulkbiker.
Yes did try this breakfast option and it does give slight improvement hence I sometime have it I'm just struggling to work out why a porrage option breakfast which I had for years raises my BG so high at this rate my diet choice keeps dwindling thanks for reply I'm going to ask doc if I can have another C-peptide test as when 1st diagnosed some 5 years ago it came back very low although my a1c was about 108 hence doc thought I was T1 until further test said no we'll call it T2.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Hi Kyler
You say you’re eating low carb, I do too (30 - 50g/day). However I wouldn’t entertain eating porridge for breakfast. Do you test before and after breakfast, I’d be surprised if your level doesn’t rise unacceptably after the porridge and apple.
Can you write out what exactly you ate yesterday, we may be able to help you tweak your diet further.
Porrage has always been ok raising my BG at max by 2 it's only over last few months when it's now raising by 5 to 7 same porrage same quantity etc.
Yes I will change to bacon egg etc but why does the porrage effect my level now when in the past it has been no problem.
I've noted other foods which now raise my level higher than they once did before yes testing before and same 2hr later
Cheers Kyler and thanks for pointers
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Porrage has always been ok raising my BG at max by 2 it's only over last few months when it's now raising by 5 to 7 same porrage same quantity etc.
Yes I will change to bacon egg etc but why does the porrage effect my level now when in the past it has been no problem.
I've noted other foods which now raise my level higher than they once did before yes testing before and same 2hr later
Cheers Kyler and thanks for pointers
Porridge I eat is genuine stuff which works out at 30g of cabs per serving.
My daily carb intake is about 80g yes I know some will still class this as high but it's as low as I would like to go and still have a life.
I do regular work out 6 days a week dog walking and swimming which all helps and reducing carbs further has a knock on effect for me especially with swimming.
Thanks once again will ditch porridge for a few weeks and see how it goes as I said I still feel fine overall but have noted my drop off in swimming hence I have stopped over last couple of weeks.
 

HSSS

Expert
Messages
7,465
Type of diabetes
Type 2
Treatment type
Diet only
but why does the porrage effect my level now when in the past it has been no problem.
If you are a type 2 I would say because your insulin resistance has worsened over time possibly as a result of stressing a broken system (ie type 2) with the very thing that it struggles to do, process carbs.

Alternatively if there was originally some question about your diagnosis and now it’s deteriorated I’d be asking for it to be rechecked. Sorry I know little about that process as I’ve just gone down the type 2 alone route.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
If you are a type 2 I would say because your insulin resistance has worsened over time possibly as a result of stressing a broken system (ie type 2) with the very thing that it struggles to do, process carbs.

Alternatively if there was originally some question about your diagnosis and now it’s deteriorated I’d be asking for it to be rechecked. Sorry I know little about that process as I’ve just gone down the type 2 alone route.
Thanks HSSS.
As I have doctors appointment later this week I will be asking his thoughts and also see if I can have another C-peptide test to see if any changes of insulin production against my last test some 5 years ago.
Our doctor who now handles the practice diabetic patient since the other doctor retired appears to be more up to date.
Ps I will send update once I know more
Thanks Kyler
 
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DCUKMod

Master
Staff Member
Messages
14,298
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Thanks HSSS.
As I have doctors appointment later this week I will be asking his thoughts and also see if I can have another C-peptide test to see if any changes of insulin production against my last test some 5 years ago.
Our doctor who now handles the practice diabetic patient since the other doctor retired appears to be more up to date.
Ps I will send update once I know more
Thanks Kyler
Kyler, when you see your Doc, it could be worthwhile to ask for a good broad panel of blood tests to be done. In there, I'd hope to see test for anemia, looking at your hormones (particularly thyroid), vitamins and so on.

Unfortunately our metabolisms are very complex and when one par goes off-par, it can have quite a wide impact. For example, if certain vitamins are low, our thyroids can struggle to work efficiently, and out thyroids are key to metabolic health.

Obviously, I'm not suggesting you have a wonky thyroid and, or, vitamin deficiencies, but if investigations are to be done, it's good to cover those areas too.

Good luck with it all.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Kyler, when you see your Doc, it could be worthwhile to ask for a good broad panel of blood tests to be done. In there, I'd hope to see test for anemia, looking at your hormones (particularly thyroid), vitamins and so on.

Unfortunately our metabolisms are very complex and when one par goes off-par, it can have quite a wide impact. For example, if certain vitamins are low, our thyroids can struggle to work efficiently, and out thyroids are key to metabolic health.

Obviously, I'm not suggesting you have a wonky thyroid and, or, vitamin deficiencies, but if investigations are to be done, it's good to cover those areas too.

Good luck with it all.
Thanks I'll have good chat to doc well with time allocated which is only 10min at our surgery prob the same all over UK now although doc very thorough so sure he'll sort me out even though my problem not very urgent and not giving me major worries at this stage it's more of a query how some thing can change yet I have not made any changes to cause the change.
Maybe the answer is take nothing for granted diabetes is not necessary plane sailing to keep under good control and we may need to keep fine tuning out diet to compensate.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Well.
After nearly 5 weeks just got my c peptide result back talk about confusion I had my blood sample taken 21st March at our doctors then got a phone call hour later to say sorry we are unable to do our our surgery you need to go to hospital for this test fair enough I picked paper work up same day and went to hospital where I was told result should be back in a week which turned into 5 weeks.
Anyway result came back as 1.82 I informed person on phone why can labs not use same format with ranges my last result was 450 with range of 340 to 1800 hence near bottom of range so I asked for range and they informed me 340 to 1800 I said well this is not good and was informed no problem you are producing over at 1820 but I said you said my reading was 1.82 why not say 1820 I'm due for another blood test in a week so will look myself at readings on pc screen at this rate my reading 5 years ago most have been 450000 and if so doc would not have said very low hence confused now but pleased if production over top of range.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Well.
After nearly 5 weeks just got my c peptide result back talk about confusion I had my blood sample taken 21st March at our doctors then got a phone call hour later to say sorry we are unable to do our our surgery you need to go to hospital for this test fair enough I picked paper work up same day and went to hospital where I was told result should be back in a week which turned into 5 weeks.
Anyway result came back as 1.82 I informed person on phone why can labs not use same format with ranges my last result was 450 with range of 340 to 1800 hence near bottom of range so I asked for range and they informed me 340 to 1800 I said well this is not good and was informed no problem you are producing over at 1820 but I said you said my reading was 1.82 why not say 1820 I'm due for another blood test in a week so will look myself at readings on pc screen at this rate my reading 5 years ago most have been 450000 and if so doc would not have said very low hence confused now but pleased if production over top of range.
Just like to add re C-peptide readings I have now got a print out of my results and readings are not confusing when one reads them correct.
The range the lab used is 0.34 to 1.80 my reading this time came out at 1.82 which is a large jump from 5 years ago when my test reading was 0.45 and lab used same range 0.34 to 1.80
My medication is two 500 Metformin and one 25 Alogliptin per day as Metformin does not help us to produce extra insulin I can only put it down to the Alogliptin and diet diabetic nurse had no idea why the increase.
Let's hope my A1c will start to show a reduction at my next diabetic doctor's visit.
 

kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
Alogliptan is a dpp4 inhibitor isn’t it? which helps you make more insulin. Presumably that’s why you are are producing more. Very odd that your diabetic nurse would not know this or at least suspect it.

https://www.diabetes.co.uk/diabetes-medication/dpp-4-inhibitors.html
Well.
When I told nurse I had ditched porridge on a morning she said unlikely it was driving my reading up and you should not monitor your own daily levels as we do not advise T2 to do this.
 

HSSS

Expert
Messages
7,465
Type of diabetes
Type 2
Treatment type
Diet only
Well.
When I told nurse I had ditched porridge on a morning she said unlikely it was driving my reading up and you should not monitor your own daily levels as we do not advise T2 to do this.
If your nurse truly believes porridge doesn’t drive most diabetics levels up then maybe she needs some refresher training, or to watch someone eat some testing before and after.

Does she tell people to cross the road with their eyes crossed too?

Your nurse isn’t making a good impression of her knowledge base to me.
 
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kyler

Active Member
Messages
37
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Nothing really
If your nurse truly believes porridge doesn’t drive most diabetics levels up then maybe she needs some refresher training, or to watch someone eat some testing before and after.

Does she tell people to cross the road with their eyes crossed too?

Your nurse isn’t making a good impression of her knowledge base to me.
Well nurse only in her early 20s and her stock answer in the past has always been wait until your level is this or that and we can then change your medication.
She has never heard the saying prevention is better than the cure.
 
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