Type 2 Newbie: Confusing advice

SJS1965

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hello all,

I was diagnosed with type 2 in May this year with an HBA1c of 118. Bit of a shock because I went to doctors to discuss what I thought were menopause symptoms (I am 54). I was immediately put on 500mg slow release metformin, upped to 1000mg after a week, ending up at 2000mg after about four weeks. Stomach upsets for a few days each time my dose increased and interestingly every time thereafter that I was issued a different brand of metformin. I am tolerating the drug but still have occasional days with a bad stomach, unpleasant taste in mouth, indigestion etc.

When I was first diagnosed, I asked the doctor about remission and was told that I was not really a candidate. I explained that I would be willing to lose weight and try diet and exercise but was told that I didn’t have enough excess weight to lose and with levels that high I should expect to be on medication for life.

However, I read loads and found this website and decided to attempt it anyway. I have drastically cut back on my carb and sugar intake; no fruit juice, no breakfast cereals, no rice, potatoes, pasta, cakes etc etc. As a general rule my breakfast is a small about of berries with milled flax and 5% Greek yoghurt, lunch maybe a low carb soup or sandwich made with low carb bread and dinner; salads, stir fries, eggs, meat and veg trying to have what the rest of the family are having but without as much carbohydrate. Since May, I have lost 2 stone 5lbs and just had my first full blood test ready for my diabetic review; my new HBA1c is 47.

I was elated. My review is November 1st but coincidentally l had a doctors appointment to review my repeat prescription. A different doctor but much the same advice...she said I could drop 1 x 500mg metformin but only because I am sometimes having stomach issues. She wasn’t interested in my weight loss or my dietary changes. My cholesterol level showed as slightly high (although the ratio was fine) but because of this she wanted to put me on statins and pushed the standard low fat, healthy eating message.

Now I’m just confused. The “rewards” making low carb tolerable for me were cheese, butter, cream, peanuts etc and it seems obvious to me that it’s working in that my blood sugar is that much better and I’ve lost all that weight. I’ve resisted the statins and asked to be retested again in another three months because then if my blood sugar stays low, I feel I can make a case to reduce the metformin again. I know I might not get into remission, but I feel it’s worth pushing to try getting off metformin altogether - what have I got to lose?

I actually feel better for just writing this down! Any advice or experiences would be really appreciated, thanks.
 
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poemagraphic

Well-Known Member
Messages
689
Type of diabetes
Treatment type
Diet only
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WIFI, Mobile phones. Smart metres... in fact anything 'smart'
Read what other people here have achieved, then explore the way they achieved it.

Of course some folk can stop meds altogether often it is all about what you eat and what you avoid.

Sounds simple. It is for some, and impossible for others.

Bottom line is YOU are the captain of your ship and you plot the course.

For me, I hit uncharted waters at first, got shipped wreaked and was thrown a life line, map and a compass LCHF
Now I just need to stay on course.

You may like to read my signature to see what I did, and how I did it.

Remember: The only silly question, is the one you do not ask.
Po

Oh! and Hello welcome to a safe harbor At the end of the day we are all on the same journey.
Some of us are in speed boat, others in a sail boat, whilst some are looking for a life raft.

You will find lots of fellow ship mates here and light houses that will shine a light on your course and show the rocks to avoid
the salty old sea dogs.

Smile and enjoy your journey
 
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Metabolism_Boss

Well-Known Member
Messages
170
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Reality TV shows. Celebrities that are famous for being famous
Congratulations on this amazing improvement, especially as you were not especially over weight. I was diagnosed with an HbA1c of 108 and it has taken me three years to reduce it to 47. People who have little subcutaneous fat, but have the more dangerous abdominal fat are considered less likely to improve their blood glucose numbers. We are known as TOFI -Thin Outside Fat Inside. We also tend to have more "active" fat, meaning the fat produces hormones, as well as surrounding our organs. You have done amazingly well and I am sorry that your health professionals have not acknowledged that. My priority has been to reduce my abdominal fat, to build muscle to take up some of the blood sugar that seems to enter my system at the slightest strong emotion and to improve the health of my poor liver. I do not worry too much about cholesterol, due to the accumulating evidence that it is fat and sugar together which leads to dangerous inflammatory responses. Listen to some of Dr Fung's lectures on You Tube, if you want another perspective on this issue. I do hope that you will continue to build on your success and confound your negative practice staff.
 

ziggy_w

Well-Known Member
Messages
3,019
Type of diabetes
Type 2
Treatment type
Diet only
Welcome to the forum, @ SJS1965.

You're an absolute winner in my book. Congrats on your results. Absolutely inspiring.

I absolute empathize with you. I was also diagnosed with a very high HbA1c and was told that for me diet and exercise wouldn't an option (was also not very much overweight). I sometimes wonder if HCPs appreciate how discouraging their advice can be.

Stick with your new diet and very likely your next HbA1c will be even lower than 47 mmol. Many of us T2s have been able to maintain normal HbA1c for years on a low-carb/keto diet.
 

bulkbiker

BANNED
Messages
19,575
Type of diabetes
Type 2
Treatment type
Diet only
what have I got to lose?
Absolutely nothing and you have your health to regain..
You have had amazing results already and they can get even better..
Cholesterol levels are all over the place when you are losing weight so to take an ineffective pill at that stage is madness.
 
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HSSS

Expert
Messages
7,471
Type of diabetes
Type 2
Treatment type
Diet only
I refused further cholesterol testing until weight stabilised. As bulk biker says weight loss (by any method ) causes raised levels in many. And even then if you have done the research and don’t want them you don’t have to take them.


I’m sorry the dr didn’t do a jig for you as you deserved it and quite frankly it’s appalling they didn’t express how well you’ve done. Sadly some just can’t see past the end of their noses and can only recite the low fat statin script they learnt and never revisit.
 

SJS1965

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Welcome to the forum, @ SJS1965.

You're an absolute winner in my book. Congrats on your results. Absolutely inspiring.

I absolute empathize with you. I was also diagnosed with a very high HbA1c and was told that for me diet and exercise wouldn't an option (was also not very much overweight). I sometimes wonder if HCPs appreciate how discouraging their advice can be.

Stick with your new diet and very likely your next HbA1c will be even lower than 47 mmol. Many of us T2s have been able to maintain normal HbA1c for years on a low-carb/keto diet.


I see from your levels that you still had to take metformin even when your BG was in the 30s? I find another problem with the different opinions of medical professionals is that there’s no consistent voice to help manage my expectations. I realised they were unlikely to be supportive of going from 2 x 1000mg to zero but thought that if I can get to 2 x 500mg now and then have another blood test in the new year, maybe and I know it’s a big maybe!, I could be off the meds one year on from diagnosis. Now I think maybe not. I’m all over the place with this because I don’t know whether I’m over fixating on getting off metformin because then I’ll feel like I don’t have anything wrong with me anymore. Anyway thanks for taking the time to talk to me, I fully intend to keep going!
 

SJS1965

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
The thing is, I did have excess weight to lose. I started off at nearly 14 stone so definitely in the overweight for my height if not the obese section...that’s why I don’t understand why the doctor would say that the wasn’t much point in losing weight!
 

JoKalsbeek

Expert
Messages
5,960
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Hello all,

I was diagnosed with type 2 in May this year with an HBA1c of 118. Bit of a shock because I went to doctors to discuss what I thought were menopause symptoms (I am 54). I was immediately put on 500mg slow release metformin, upped to 1000mg after a week, ending up at 2000mg after about four weeks. Stomach upsets for a few days each time my dose increased and interestingly every time thereafter that I was issued a different brand of metformin. I am tolerating the drug but still have occasional days with a bad stomach, unpleasant taste in mouth, indigestion etc.

When I was first diagnosed, I asked the doctor about remission and was told that I was not really a candidate. I explained that I would be willing to lose weight and try diet and exercise but was told that I didn’t have enough excess weight to lose and with levels that high I should expect to be on medication for life.

However, I read loads and found this website and decided to attempt it anyway. I have drastically cut back on my carb and sugar intake; no fruit juice, no breakfast cereals, no rice, potatoes, pasta, cakes etc etc. As a general rule my breakfast is a small about of berries with milled flax and 5% Greek yoghurt, lunch maybe a low carb soup or sandwich made with low carb bread and dinner; salads, stir fries, eggs, meat and veg trying to have what the rest of the family are having but without as much carbohydrate. Since May, I have lost 2 stone 5lbs and just had my first full blood test ready for my diabetic review; my new HBA1c is 47.

I was elated. My review is November 1st but coincidentally l had a doctors appointment to review my repeat prescription. A different doctor but much the same advice...she said I could drop 1 x 500mg metformin but only because I am sometimes having stomach issues. She wasn’t interested in my weight loss or my dietary changes. My cholesterol level showed as slightly high (although the ratio was fine) but because of this she wanted to put me on statins and pushed the standard low fat, healthy eating message.

Now I’m just confused. The “rewards” making low carb tolerable for me were cheese, butter, cream, peanuts etc and it seems obvious to me that it’s working in that my blood sugar is that much better and I’ve lost all that weight. I’ve resisted the statins and asked to be retested again in another three months because then if my blood sugar stays low, I feel I can make a case to reduce the metformin again. I know I might not get into remission, but I feel it’s worth pushing to try getting off metformin altogether - what have I got to lose?

I actually feel better for just writing this down! Any advice or experiences would be really appreciated, thanks.
You're not... Not really a candidate? Wonderful, when a GP gives up on a patient from the get-go. Not to mention the other one...
Maybe this'll help a little, it's my own LCHF quick start guide. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ And go nuts with the cheeses, they're good for you. (The hard ones are zero carb, the soft ones are low. Knock yourself out. The bulk of us here do. ;) )

All in all... You're doing fine and I hope you'll get to see that first doc next time and prove them quite amazingly wrong! ;)
Hugs,
Jo
 

ziggy_w

Well-Known Member
Messages
3,019
Type of diabetes
Type 2
Treatment type
Diet only
I see from your levels that you still had to take metformin even when your BG was in the 30s? I find another problem with the different opinions of medical professionals is that there’s no consistent voice to help manage my expectations. I realised they were unlikely to be supportive of going from 2 x 1000mg to zero but thought that if I can get to 2 x 500mg now and then have another blood test in the new year, maybe and I know it’s a big maybe!, I could be off the meds one year on from diagnosis. Now I think maybe not. I’m all over the place with this because I don’t know whether I’m over fixating on getting off metformin because then I’ll feel like I don’t have anything wrong with me anymore. Anyway thanks for taking the time to talk to me, I fully intend to keep going!

I really get your frustration, @SJS1965.

Part of the problem with respect to confusing advice might be that imo the field of T2 diabetes is very much in flux right now.

The following study (https://care.diabetesjournals.org/content/37/12/3188), for example, quotes the incidence of diabetes long-term remission at a fraction of 1% -- and this is probably for those that had a relatively low HbA1c. So, seeing diabetes remission from relatively high levels of blood sugars is probably still a relatively new thing for most HCPs. (At least, it was in my case.)

Now, with the Virta Health numbers and also those of the Newcastle diet having been published, it is becoming ever more obvious that remission is not only possible, but also quite common, even from high numbers. This information has filtered through to some HCPs, but definitely not to all (or maybe even the majority) and this is probably were the contradictory advice sets in.

As to the metformin, you are right -- my GP initially left me on this medication. (Maybe he thought my first results in the 30s following the high blood sugar levels was a lab error, who knows.) However, he halved it after my next test (half a year after diagnosis) and took my off it altogether after one year. I didn't really mind staying on it a bit longer since metformin didn't give me any problems.

If you don't terribly mind being on metformin a little while longer, I am confident you will be off it by the end of one year if you continue to have good results. (Also remember, in the end it is very much your decision whether to take any medication or not -- all HCPs can do is suggest.)

Again, congrats on your fabulous achievement.
 
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ianf0ster

Moderator
Staff Member
Messages
2,423
Type of diabetes
Treatment type
Diet only
Dislikes
exercise, phone calls
The thing is, I did have excess weight to lose. I started off at nearly 14 stone so definitely in the overweight for my height if not the obese section...that’s why I don’t understand why the doctor would say that the wasn’t much point in losing weight!
Hi SJS1965,
I'm a TOFI, so at first I was going to reply about Fat reduction and thus HbA1C reduction being harder for us, but I now see that you aren't a TOFI after all - just have a worse than usual doctor!

Your progress is great and to some GPs might seem either miraculous or a mistake due to a faulty test!
But in here there are many who have already achieved your goals -yours is a well trodden path.

Don't get obsessive about 'remission' or getting of al diabetes meds (if well tolerated). Because although long term (even lifetime) remission is possible, you will never be able to go back to your previous 'way of eating' without raising your Blood Glucose again. Once sensitive to high Carbs, always sensitive to high Carbs unfortunately!
So there is no 'cure' for T2D.

Also, I agree with previous posters that higher LDL is to be expected while you are in the 'weight-loss phase' of Low Carb diet. Others have assured me that this will be corrected once into the 'weight stabilisation phase'. But this may not happen as soon as you may expect (getting into the 'normal' BMI range) since TOFIs like me were already in that range when diagnosed!
 
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