I had a visit for blood testing etc. with the diabetic nurse at my local medical practice last week, with a follow-up call to discuss the results yesterday. Key points were:
- HB1AC: Not great at 68, but down a fair bit from 80 the last time
- Blood pressure: A week of my own measurements (the nurse didn't check blood pressure herself) averaged 138/81 but down from an average of 143/82 the last time
- BMI: 28.5 so still too high, however down from 30.3 the last time
- All my other checks including cholesterol etc. are OKish (e.g. total cholesterol of 4.4)
I’ve got my next scheduled blood test in early July but had a bit of a difference of opinion with my GP (who’s the diabetic specialist at the local surgery) on what to do now. Given I’ve been making reasonable progress my preference is to leave my medications the same for now (I’m currently taking 1 x 500mg metformin plus a statin daily) and continue with lifestyle changes. The GP however, (who from previous experience does tend to like to prescribe) wants to:
- Increase my metformin to 2 x 500mg per day
- Put me on blood pressure medication (which I’ve never been on before)
On the lifestyle side of things I’m on a reduced carb (and lower calorie) diet and also continuing to shift some weight (I’ve lost another kg in weight since I was in for tests last week, so BMI is now 28.1) as I know that’ll be beneficial for both my blood sugar and blood pressure. In the week since the blood test my own blood sugar readings have averaged 7.9, and my blood pressure 129/79 which would appear to indicate things are heading in the right direction.
Anyway we’ve agreed(!) to do it my way for now (although I expect he has me down a trouble maker) and then review again after the next blood test. I’m interested to know what other folks would have done though! Part of me isn’t that keen on going against a doctors advice, however in reality I’ve perhaps got better access to current data than he does, including on the direction of travel that my own tests are showing.
So what would you have done in those circumstances?
Regards
Steve
You have asked about issues that are pertinent.
Unfortunately as much as the medical profession wishes to assist us get better, especially on the NHS in the UK, they have limited resources, and time. So much pressure on them.
As someone who resisted taking medication for a good while, in the hope that I would be able to use lifestyle changes, to bring down my HbA1c, blood pressure, cholesterol, etc. but eventually have started taking medication for blood pressure, here is my candid advice, which they may not have explicitly highlighted.
High blood pressure and diabetes, generally have medication that can address even high off the scale number, so these have a solution. Lifestyle or medication or both.
The more important issue is the impact that not managing weight, blood pressure, diabetes, etc, etc, have on more serious issues like eyesight, extremities like the toes or feet which can be amputated in a worst case scenario, and our kidney function decline is accelerated by these other causal factors.
Sadly the full implications of poor management of the issues which are easily managed via medication, such as blood pressure and diabetes, are not always properly explained. Poor kidney function - leading to dialysis, that is definitely something one MUST do everything to avoid. Worsening eyesight and neuropathy - same. These other end stage ailments from persistent high blood pressure and diabetes, are not so easily managed via medication, cos the harm is probably irreversible, or difficult to reverse.
My suggestion. Work with your medical partners, to immediately start taking medication for diabetes, cholesterol, and high blood pressure, until you no longer need medication, or your medication is reduced, because lifestyle improvements have been sufficient to bring down all your markers (blood pressure, weight/BMI, cholesterol and HbA1c) back to within normal levels.
I forgot to mention, there are other issues - related to arteries, brain, and heart. Cardiovascular, Peripheral Artery Disease, Strokes, heart attacks, Coronary Heart disease, and more, all caused (root causes) by too much glucose in the blood and high blood pressure, and cholesterol/plaques clogging up arteries. Which are even more difficult or impossible to reverse.
A stitch in time saves 9.
Avoiding the long term possibility of a downward spiral to these more serious conditions, should be enough to convince you to take the medication, as an insurance policy against a worse future. Lifestyle changes take time to adopt and also take time to perfect, and take time to become effective. In the interim, until no longer needed, please take ALL the medication prescribed, so that you can avoid consequences that are far worse than high blood pressure or diabetes.
I'll add, we definitely DO NOT want the blood pressure or diabetes to get worse, and medication may be required. My own sister deferred taking medication for diabetes, until it got so bad, she is now on insulin - without a choice in the matter, to get her diabetes under control.
I blame the government, who should have done more to educate us on the real dangers of so many things we eat, drink or do.
For example I discovered that alcohol is classified by the World Health Organisation as a carcinogen, sometime this morning, and has been so classified for a while. How come that piece of information is not shouted from the roof tops, by the BBC, ITV, SKY.
How come we are not told that wholewheat bread is actually worse than white bread, when it comes to blood glucose control. So many of us ate wholewheat bread for many years, thinking that it is healthy.!! And drank the highest quality of juice, not realising how unhealthy that was. So it is not for lack of effort, but we are where we are, predominantly cos we were ignorant and not well informed. I blame the government for that.
The true harms of the things we eat, drink and do, deserve far more publicity, so we can avoid getting sick.
How come we do not know anything about the phosphates in our carbonated drinks (coca cola), fruit juices, and in our processed meats, which lead to kidney damage?? How come we are not informed that all dairy is high in phosphates, which can have an impact on our kidney health?
We are made to walk blindly into these situations, and only when the harm is done, are we informed, that all our best efforts have been a waste of time, cos a lot of information was hidden away from us.
At the very 1st indication of prediabetes/diabetes, or high blood pressure, we should be fully informed of the potential dangers from poor management of these conditions, not just the worsening of these main two, but the downward slope affecting almost every other organ in the body, eyes, liver, pancreas, arteries, brain, heart, etc, etc. If people knew what was at stake we would take better prevention steps, one of which would be adopt medication as early as possible to avoid making things worse.
Please take the medication. That is my best advice.
