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To medicate or not to medicate, that is the question

My last weeks BP readings have averaged 123/72 so lets hope that continues.

Average blood sugar over the last 3 days has been 6.2 according to the Dexcom (which also matches the average of my finger prick tests over the period I've had the Dexcom fitted), so is also getting where I need it to be.
 
I had my hb1ac test on Friday last week and while I've had no contact from the surgery yet the "my diabetes my way" site is showing that as being 45. I handed in a week of blood pressure readings as well and in the week leading up to the blood test they averaged 120/72 with the one I took just before the appointment being 118/72. None of the readings that week were over 130/80, with the highest being 128/77. My BMI has also dropped a fair bit - down to 26.2 on the day of the test.

So my view is that the lifestyle stuff (i.e. eating lower carb along with reducing my weight) seems to have done quite well in that 10 week period i.e.
HB1AC: down from 68 to 45
BP: down from 138/81 to 120/72
BMI: down from 28.5 to 26.2

It'll be interesting to hear what the doc will say if he does follow up (which I suspect he probably won't), but anyway I'm quite happy with those results and am going to continue what I'm doing (including targeting getting my BMI down under 25 within the next few months) and staying with just the 1x500mg of Metformin for now and without starting BP meds.
 
Outlier said:
Often it works the other way about - you get a grip on your blood glucose, and the weight naturally comes off.
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Maybe the weight comes off because if a low carb diet is followed to reduce bgs then the weight may come off as a result of that?
 
KennyA said:
As with many things in the NHS, activity is driven by the Quality and Outcomes Framework which in turn is derived from the NICE guidelines which are supposed to represent best practice. There are many things about the diabetes indicators, for example, that might have been best practice when introduced over twenty years ago, but which I don't regard as being in my own best interests.

So (to take the example of high blood pressure) practices are incentivised to achieve certain levels in certain groups - for example -

HYP010. The percentage of patients with hypertension aged 79 years or under, without moderate or severe frailty, in whom the last blood pressure reading (measured in the preceding 12 months) is 140/90 mmHg or less (or equivalent home blood pressure reading).

For this, practices start being rewarded when 40% of the target group achieve the figure, and get maximum reward when 85% achieve it.

Full QOF for 26/27 is here:
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How are the practices being rewarded for achieving 40%+ compliance to bp targets? Isn't there a risk that patients will be pressured because the practices want to receive those rewards?
 
niblue said:
I had my hb1ac test on Friday last week and while I've had no contact from the surgery yet the "my diabetes my way" site is showing that as being 45. I handed in a week of blood pressure readings as well and in the week leading up to the blood test they averaged 120/72 with the one I took just before the appointment being 118/72. None of the readings that week were over 130/80, with the highest being 128/77. My BMI has also dropped a fair bit - down to 26.2 on the day of the test.

So my view is that the lifestyle stuff (i.e. eating lower carb along with reducing my weight) seems to have done quite well in that 10 week period i.e.
HB1AC: down from 68 to 45
BP: down from 138/81 to 120/72
BMI: down from 28.5 to 26.2

It'll be interesting to hear what the doc will say if he does follow up (which I suspect he probably won't), but anyway I'm quite happy with those results and am going to continue what I'm doing (including targeting getting my BMI down under 25 within the next few months) and staying with just the 1x500mg of Metformin for now and without starting BP meds.
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You're doing really well!. I don't know how long since you've been dx'd but the sooner you get those figures down to best levels the easier it will be. I was dx'd in 1997 and really didn't take your approach until a few years ago (with a few good periods in between) but now I'm getting results but it's a struggle.
 
I was diagnosed with an HB1AC of 106 in March 2023. 3 months later I'd got that down to 53 (using the same approach as I've again this time) and then down to 43 after another 3 months.

I then got complacent and let it climb back up (along with my weight), so this time I need to put measures in place to avoid that (which likely be to continue to do regular weight and blood sugar checks).
 
niblue said:
I was diagnosed with an HB1AC of 106 in March 2023. 3 months later I'd got that down to 53 (using the same approach as I've again this time) and then down to 43 after another 3 months.

I then got complacent and let it climb back up (along with my weight), so this time I need to put measures in place to avoid that (which likely be to continue to do regular weight and blood sugar checks).
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The complacency thing is deadly. It creeps up on you and I've had the strange experience of watching my bgs climb transfixed like a deer caught in the headlights of a car - transfixed as in taking no action to reduce the bgs!
 
At home my blood pressure is around 110 to 120 and 60 to 70 - I think that is due to the very low carb diet I keep to. It is higher at the surgery but I suspect that the climb up the stairs is the culprit. I used to run over mountains, but that was long ago now.
My husband has been put on blood pressure medication and has had it changed several times as he starts to forget words, slur words - quite alarming at first until I realised why.
@niblue I am fairly certain that eating low carb can mean people become over medicated with blood pressure tablets. On the low carb list there have been reports of falls, some quite serious as the low carbing takes effect and people go dizzy on slopes and stairs.
 
CarbMaster said:
How are the practices being rewarded for achieving 40%+ compliance to bp targets? Isn't there a risk that patients will be pressured because the practices want to receive those rewards?
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The QoF uses a points system and the cash value of the points changes every year. Of course practices want to achieve the targets and of course patients will be encouraged to do the things needed.

That's essential to the system - that was what it was designed to achieve.
 
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Resurgam said:
On the low carb list there have been reports of falls, some quite serious as the low carbing takes effect and people go dizzy on slopes and stairs.
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could you explain what the low carb list is please? with a link to your claim where the list suggests a low carb diet can cause falls and records the number & type of falls?


ETA add a missed word
 
lovinglife said:
could you explain what the low carb list is please? with a link to your claim where the list suggests a low carb diet can cause falls and records the number & type of falls?


ETA add a missed word
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it is the Low Carb Support group on Facebook - but it is years since I was active on there as it is not directed at diabetics so I would not know how far back you'd need to go to find any information.

It was not the diet causing the trouble it was people already taking BP lowering medication starting low carb and in a couple of cases being told to keep taking the tablets as they'd be on them for life, and then being found to have dangerously low levels, and one person had a serious fall on concrete steps and a couple at home.

The BP lowering effect is outlined in a case study on pg 110 et seq. of the 2003 edition of Dr Atkins New Diet Revolution and the phenomenon is mentioned elsewhere in the book as ascention - something, presumably the US term, which I cannot spell, it is orthostatic hypotension in the UK.
 
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