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To medicate or not to medicate, that is the question

N

niblue

Well-Known Member
Messages
172
Type of diabetes
Type 2
Treatment type
Tablets (oral)
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
 
Short answer is it would depend, as I've never been in your circumstances. On (eventual) diagnosis I was offered metformin which I refused and was urged to take a statin, which I've also always refused. Metformin will lower BG a little and a statin will raise it. They might balance.

I wanted to lower my BG by a lot, and having read about people's experiences on this forum it seemed like a low carb/keto diet was the thing to do. It was essentially Atkins, which I'd done in the past and which had worked for me in terms of weight loss - no idea about blood glucose then. So that's what I did, and it worked (and continues to work).

If it hadn't - of course I'd have tried medication, whatever was available. I had some pretty bad diabetes-related symptoms and anything that got rid of them would have been welcome.
 
One of the slight oddities is that I've never had any symptoms of diabetes, instead when I was in for something else (an issue with my hip) the doctor decided to give me a full battery of tests as I hadn't ever had them (and in fact hadn't been to see a doctor in a decade or more).I was put on metformin and statins immediately at that point, and not really given any other advice other than to stop taking sugar in my coffee...

After doing my own research It's also my preference to progress with a low-carb diet, which is what I'm doing now. That's partly to reduce my blood sugar but also to lose some weight (which I think will also have a beneficial effect on my blood pressure as well).

Anyway, we will see what the score is when I get my next blood test done.
 
I am happy to take any of the pills offered to me. I struggle with my diet, always have, but I am aware that losing weight is very beneficial to BG control.
 
Often it works the other way about - you get a grip on your blood glucose, and the weight naturally comes off.
 
I'm happy to take diabetes meds (but not statins as they take my cholesterol too low) and I don't have high blood pressure so don't need meds for that.

My reasoning for taking diabetes meds is that the higher your blood sugar levels, the more potential damage may occur to my arteries, more risk of retinopathy in my eyes and more damage to the nerves in my feet.

I also restrict the amount of carbs I eat to stop my blood sugar spiking,
 
Hi
Since I developed T2 5 years ago I have followed a Low Carb diet, usually quite low when I bother to put my foods into the ‘FitnesPal’ app. Like you, I’ve recently had blood tests, myHbA1c is about 57 and GP STILL talking about me getting it lower!! I barely eat anything!
I keep getting told that I don’t need to monitor my daily blood glucose levels!! GP said only the HbA1c is relevant and average glucose reading
 
When I was first diagnosed a three years ago I got my HB1AC down from 106 to 53 in under 3 months - mainly by going low carb and losing a lot of weight, then down to 43 in another 3 months. So I know it can be done, I just need to do it again and then not get complacent this time. After a 3rd lowish test of 53 I then moved onto annual tests, with the next one being 80, and the one after that being the latest at 68. I'd pretty much stopped doing any testing or tracking my weight so this time, once I get back to where I need to be, the plan is to do at last weekly blood and weight checks.

This is how my own home blood sugar tests have been trending since my last HB1AC in mid March, so the appear to generally be heading in the right direction. I've also dropped nearly a stone in weight over that period as well.

blood_sugar_09052026.png
 
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