Struggling to get hba1c under 56 mmol

Millie74

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217
Hi and welcome. Great work on your reduction!

I would recommend that you buy a meter. That was the first thing I did. My doctor also said I didn't need one but I felt that I needed every bit of information I could get to maximise my efforts. The readings can tell you what effect your meals are having which allows you to make changes. In the beginning you may have to test regularly but after a while it is much less. It will also give you a guide as to how many arbs your body can tolerate.

Well done so far!
Ok. Will look into it. Thanks.
 

bulkbiker

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Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
Thanks for your encouragement. I can see why it’s more about diet than anything. Never really fancy eggs for breakfast, as often have omelette at lunch, but could fo this at weekends when have more time. Otherwise probably Greek Yoghurt lowest carb alternative I can think of. I just thought adding running might be a new focus and help, but I don’t really like running. Will stick with it though

I'd also heartily suggest getting your own glucose meter so you can keep an eye on things and especially what foods trigger spikes in blood glucose. A great way to use data from food diaries combined with blood sugar readings.
 
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Redshank

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132
Type of diabetes
Prediabetes
Treatment type
Diet only
There is little difference between dry white and red wine in terms of carbohydrate.
The amount is pretty low - depending on how much you drink of course.

Having a meter will allow you to see the impact it has on your blood sugar.
 
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Millie74

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217
I'd also heartily suggest getting your own glucose meter so you can keep an eye on things and especially what foods trigger spikes in blood glucose. A great way to use data from food diaries combined with blood sugar readings.
Thanks. Sounds like it could be very valuable to see what to eat and not eat. I don’t know whether to wait til November Hba1c result first as already limiting carbs to under 50g and eating little. My concern would be if I was high post meal, then I can do nothing about it as not on insulin. But see it gives me the information to not eat this again. Is it 2 hours after a meal that you test?
 

Millie74

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217
There is little difference between dry white and red wine in terms of carbohydrate.
The amount is pretty low - depending on how much you drink of course.

Having a meter will allow you to see the impact it has on your blood sugar.
I only drink 2 glasses maximum Fridays and Saturdays usually. I like both. I wouldn’t have more as lactic acidosis a risk with metformin and alcohol. Thanks for responding. I’m guessing a meter helped you. Did you buy it online or at a chemist?
 
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mojo37

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3,399
Type of diabetes
Type 2
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Tablets (oral)
Thanks. Dropping carb allowance to under 50 g and tracking on my fitness pal. I felt that I had to take the SGLT2 when nurse prescribed, but did try it in addition to metformin and felt awful. I teach dance daily. Have started couch to 5k too as may need to do more. I would prefer anything but more drugs. Thanks all for your encouragement. Feeling pretty fed up about it.
Can I ask you why you felt that you had to take the SGLT2 like bulkbiker said it's your body you have brought your Hba1c down quite a lot on low carbing and just metformin.
 

bulkbiker

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19,576
Type of diabetes
Type 2
Treatment type
Diet only
Thanks. Sounds like it could be very valuable to see what to eat and not eat. I don’t know whether to wait til November Hba1c result first as already limiting carbs to under 50g and eating little. My concern would be if I was high post meal, then I can do nothing about it as not on insulin. But see it gives me the information to not eat this again. Is it 2 hours after a meal that you test?
In the early days yes.. pre eating then 2 hours post first mouthful.. or maybe after 1, 2 then 3 hours depends how curious you are! And how many test strips you can afford. You don't need to do it all the time as you'll soon discover what's good and bad to eat and adjust diet accordingly. I still test 2 or 3 times a day even after almost 4 years.. but then again I like data and to keep an eye on things.
 
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Redshank

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Messages
132
Type of diabetes
Prediabetes
Treatment type
Diet only
I bought my meter online. The test strips are much cheaper, and they are the real cost. Check post number 13 from Bruner is suggesting two meters with reasonably priced strips.
 
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Millie74

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217
Can I ask you why you felt that you had to take the SGLT2 like bulkbiker said it's your body you have brought your Hba1c down quite a lot on low carbing and just metformin.
Hi. Because I had my annual review in August and result was 56mmol. The previous result was 52mmol in June and the nurse said although I had been an inspiration in my approach, she felt my weight had plateaued and that I have done all I could do with the low carb. She said 56mmol would be ok if older, but that 48mmol was her target for me and she thought the SGLT2 Jardiance might get me there. I burst into tears and was upset as have tried really hard, but she said it’s for the best and can always come off it in future if figures come down. She said also because I have background retinopathy my target should be 48mmol. I wasn’t told I was pre diabetic in 2016 with hba1c of 47mmol. I queried result then and they just said it’s fine. Not diabetic. Guidelines from Government have changed since then. Annoying. Probably undiagnosed for a while, as next hba1c was in Jan 2019 at diagnosis with 96mmol. I only went on her guidance. Felt I had no choice as diabetic complications scare me. Not sure what you think? SGLT2 didn’t agree with me in addition to the metformin. Felt sick and thirsty. I took it for ten days, so I tried. I think diabetic nurse ringing me weds to see how I am getting on
 

Rachox

Oracle
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Messages
15,808
Type of diabetes
I reversed my Type 2
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Tablets (oral)
Hi Millie
You’ve had some really good advice so far, I just thought I’d chip in with some info on meters,
and to be clear I have no commercial connections with any of the companies mentioned. For a meter with cheap strips go for the Tee2 + found here:

http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ with the strips found here:

http://spirit-healthcare.co.uk/product/tee2-testing-strips/


With more expensive strips is the Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

https://shop.spirit-health.co.uk/collections/caresens-dual


And to be totally transparent I used to use the SD Code Free which has the cheapest strips available. However I found itto be becoming less and less reliable. Here it is for anyone wanting to give it a go:

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips

http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

There are discount codes if you buy in bulk.

5 packs 264086

10 packs 975833


Don’t forget to check the box that you have diabetes so you can buy VAT free. (for all meters and strips)
 
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mojo37

Well-Known Member
Messages
3,399
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi. Because I had my annual review in August and result was 56mmol. The previous result was 52mmol in June and the nurse said although I had been an inspiration in my approach, she felt my weight had plateaued and that I have done all I could do with the low carb. She said 56mmol would be ok if older, but that 48mmol was her target for me and she thought the SGLT2 Jardiance might get me there. I burst into tears and was upset as have tried really hard, but she said it’s for the best and can always come off it in future if figures come down. She said also because I have background retinopathy my target should be 48mmol. I wasn’t told I was pre diabetic in 2016 with hba1c of 47mmol. I queried result then and they just said it’s fine. Not diabetic. Guidelines from Government have changed since then. Annoying. Probably undiagnosed for a while, as next hba1c was in Jan 2019 at diagnosis with 96mmol. I only went on her guidance. Felt I had no choice as diabetic complications scare me. Not sure what you think? SGLT2 didn’t agree with me in addition to the metformin. Felt sick and thirsty. I took it for ten days, so I tried. I think diabetic nurse ringing me weds to see how I am getting on

I think you have done really well to get the reduction in your hba1c so far and if you don't want to increase your meds why not give yourself more time with just the metformin.Diabetic nurses ( and lots of others in the medical profession ) have conflicting views . My own DN has her opinions I have mine lol .I wasn't told that I was diabetic I was just sent a letter for an annual diabetic review !! Maybe try lowering your carbs like some on here do be strict with your monitoring and see how you go from there .Of course only your can decide what is the best course of action . Best wishes in whatever you decide :)
 
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Millie74

Well-Known Member
Messages
217
Hi Millie
You’ve had some really good advice so far, I just thought I’d chip in with some info on meters,
and to be clear I have no commercial connections with any of the companies mentioned. For a meter with cheap strips go for the Tee2 + found here:

http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ with the strips found here:

http://spirit-healthcare.co.uk/product/tee2-testing-strips/


With more expensive strips is the Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

https://shop.spirit-health.co.uk/collections/caresens-dual


And to be totally transparent I used to use the SD Code Free which has the cheapest strips available. However I found itto be becoming less and less reliable. Here it is for anyone wanting to give it a go:

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips

http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

There are discount codes if you buy in bulk.

5 packs 264086

10 packs 975833


Don’t forget to check the box that you have diabetes so you can buy VAT free. (for all meters and strips)
Great. Thanks so much for the links.
 

Millie74

Well-Known Member
Messages
217
I think you have done really well to get the reduction in your hba1c so far and if you don't want to increase your meds why not give yourself more time with just the metformin.Diabetic nurses ( and lots of others in the medical profession ) have conflicting views . My own DN has her opinions I have mine lol .I wasn't told that I was diabetic I was just sent a letter for an annual diabetic review !! Maybe try lowering your carbs like some on here do be strict with your monitoring and see how you go from there .Of course only your can decide what is the best course of action . Best wishes in whatever you decide :)
Thanks. I’ve stopped taking it. Want to see whar next hba1c is just on metformin and lower carbs before any more decisions. She told me I may not br producing good quality insulin or enough as she knows efforts I have gone to. But I can lower carbs further. As before this test had 70/80g. Aiming now for under 50. Fingers crossed it works. SGLT2 a new drug and limited info on long term effects. Short term weren’t great. Felt terrible.
 

bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
Thanks. I’ve stopped taking it. Want to see whar next hba1c is just on metformin and lower carbs before any more decisions. She told me I may not br producing good quality insulin or enough as she knows efforts I have gone to. But I can lower carbs further. As before this test had 70/80g. Aiming now for under 50. Fingers crossed it works. SGLT2 a new drug and limited info on long term effects. Short term weren’t great. Felt terrible.

They aren't a very nice medication either

https://www.diabetes.co.uk/forum/th...-on-the-risk-of-diabetic-ketoacidosis.104325/
 

Millie74

Well-Known Member
Messages
217
No. Thanks for the link. Makes for grim reading. The DKA is frightening and the fact you are at higher risk of it on low carb. I was aware of this for the ten days I took it, so increased my carbs and put on 2 pounds. Seems silly. Don’t like risk of amputation/ fracture/ UTI/ changes in cholesterol and kidney function either. I just hope I can improve myself as been low carb since Jan and stuck in 50 mmol region. Not sure what other options are if I don’t lower it or if it is ok to stay mid to low 50s. Doesn’t seem horrendous, although I know better to be 48.
 

Resurgam

Expert
Messages
9,849
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
So much importance is put on weightloss - but the problem is the blood glucose - weightloss is, so often a side effect of good control of blood glucose. I lost all the weight without even trying - I just found that my clothes were falling off, luckily not outside. I had not been weighing myself for ages so I was a bit surprised to realize that I needed to acquire a whole new set of clothes.
 

Goonergal

Master
Retired Moderator
Messages
13,466
Type of diabetes
Type 2
Treatment type
Diet only
. I just thought adding running might be a new focus and help, but I don’t really like running. Will stick with it though

Hi @Millie74 and welcome. Great HbA1c reduction. You’ve had some great advice above, but thought I could add something on this.

I’d advise (and this applies to food choices too) finding exercise that you DO enjoy, otherwise you won’t sustain it.

For my part, I picked walking as it requires no special equipment and can be fitted around my working day. As others have said, it’s food rather than exercise that has the biggest impact on blood glucose (I’m another very low carber), but there are so many other benefits to exercise. For me the improvements in mental health that it brings have been just as important as the impact on insulin resistance (and therefore blood sugar levels) and increased overall fitness.

I’m sure you’re going to knock this out of the park! Do keep us updated.
 

Millie74

Well-Known Member
Messages
217
So much importance is put on weightloss - but the problem is the blood glucose - weightloss is, so often a side effect of good control of blood glucose. I lost all the weight without even trying - I just found that my clothes were falling off, luckily not outside. I had not been weighing myself for ages so I was a bit surprised to realize that I needed to acquire a whole new set of clothes.
Well done. I have lost a lot since January, but then hit a plateau. Have always struggled with weight loss. Low carb has been successful though. I am size 10/12 now and BMI 25. Struggling to lose more. Wasn’t huge in first place. Lost 1st 4 pounds. I just hope I can do it lowering carbs to 50g. How did you do it. 50g is tough. You can’t eat much. If it stays mid 50mmol next time, fear I will be offered more drugs. So any advice welcome.
 
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Millie74

Well-Known Member
Messages
217
Hi @Millie74 and welcome. Great HbA1c reduction. You’ve had some great advice above, but thought I could add something on this.

I’d advise (and this applies to food choices too) finding exercise that you DO enjoy, otherwise you won’t sustain it.

For my part, I picked walking as it requires no special equipment and can be fitted around my working day. As others have said, it’s food rather than exercise that has the biggest impact on blood glucose (I’m another very low carber), but there are so many other benefits to exercise. For me the improvements in mental health that it brings have been just as important as the impact on insulin resistance (and therefore blood sugar levels) and increased overall fitness.

I’m sure you’re going to knock this out of the park! Do keep us updated.
Thank you. I have been trying hard. Need to try harder. I didn’t mind the run the other day. Doing couch to 5k with my husband. Will see how it goes. I agree you need to enjoy. Running not my favourite, just thought would try something new. I go to Pilates as calming and good for mental health. I teach Dance and walk the dog when I’m not teaching. Hard to know what else to do so added running and lower carb. Are you on any medication? Or just diet? Thanks for responding. I will keep trying. I can tolerate metformin, but didn’t like or want to take the SGLT2.