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At what HbA1c level did your doctor want you to go on meds?

Discussion in 'Type 2 Diabetes' started by NicoleB189, Nov 28, 2012.

  1. NicoleB189

    NicoleB189 · Member

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    I had my first meeting with the diabetic nurse recently. (Diagnosed in March of this year). I have lost 27 lbs so far due to increased exercise and change in diet (using a lot of advice from this forum.) My HbA1c was 6.7% when I was diagnosed and it was 5.9% when it was checked a couple of months ago.

    The diabetic nurse asked me to have another HbA1c and was saying that if levels started to drift up to 42/43 mmol that I will have to go on medication. Is that anyone else's experience? It seemed like such a low level to start medication. For obvious reasons I was hoping to stay off of medication for as long as possible.

    She basically said that no matter what you do, your levels will eventually go up as it is a progressive disease. Depressing thought.
     
  2. daisy1

    daisy1 Type 2 · Legend

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    Re: At what HbA1c level did your doctor want you to go on me

    Hi Nicole and welcome to the forum :)

    My first HbA1c was 5.6 (38) and my doctor put me on Metformin straight away as it also has benefits to the heart. It only has a small effect on the levels. I was diagnosed by high fasting levels. I later had to stop taking them because of side effects. Now my HbA1c is 5.3 (34) and she didn't give me any medication to replace the Met. My husband's doctor put him on Metformin too even though he is not even pre-diabetic, just not far off. I don't agree that levels will inevitably go up for everyone. It can depend on how people look after themselves, especially diet, weight. I think you will find this thread interesting:
    viewtopic.php?f=15&t=35273. Have you any idea which meds she was talking about? Being on medication is not necessarily a bad thing. You seem to have been making very good progress with your weight.

    On your reading around the forum you may already have read this information we give to new members but if not, here it is.


    BASIC INFORMATION FOR NEW MEMBERS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
    There are two approaches to controlling your carbs:

    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
    http://www.diabetes.co.uk/food/diabetes ... rains.html

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips
    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic

    Note: This post has been edited from Sue/Ken's post to include up to date information.
     
  3. Napolyon1

    Napolyon1 Type 1 · Well-Known Member

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    Re: At what HbA1c level did your doctor want you to go on me

    When I was diagnosed a few years ago the Dr told me I had enough sugar in my blood to start a sugar plant up. Tablets worked but 5years on my pancreas has stopped working so it's insulin injections.
     
  4. hallii

    hallii · Well-Known Member

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    Re: At what HbA1c level did your doctor want you to go on me

    Starting on Metformin earlier rather than later is more effective in the long term. It has also been reported to have protective properties on not just the heart but other organs to.(Liver and Kdneys and some reports suggest the brain as well!) it depends on which bit of research you read.

    I was given Metformin at 5.3%, not to reduce BGs but solely for the protective effects.

    I suggest that a low dose of Metformin is a good and proactive way to manage T2 diabetes, regardless of HbA1c results, and many doctors agree with this.

    Of course, as with any treatment, it is always up to the patient as to whether or not to accept the advice and treatment offered by the doctor.

    As to whether T2 is progressive, my opinion is that it is, but with careful control it can be slowed right down to imperceptable speed.

    H
     
  5. NicoleB189

    NicoleB189 · Member

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    Re: At what HbA1c level did your doctor want you to go on me

    Thank you Hallii. It sounds from your answer like going on medication is nothing to be worried about. Maybe I am thinking about it the wrong way.
     
  6. Hrw1959

    Hrw1959 Type 2 · Well-Known Member

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    Re: At what HbA1c level did your doctor want you to go on me

    My HbA1c level was 95 when I was diagnosed and my doctor put me on Gliclazide straight away. My glucose level on fasting was 14.8. My BG levels have gone down and I now have very low levels, 2.4 being at it lowest at one point, although I have no symptoms of a hypo, something that does worry me a bit. I was diagnosed on sept 19 2012.
     
  7. RobsterinSheff

    RobsterinSheff · Well-Known Member

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    Re: At what HbA1c level did your doctor want you to go on me

    Immediately!! I presented after 3 weeks of the classic drink-'n'-pee symptoms and with my own self-diagnosis based on my observations and internet research. HBA1c blood drawn that day- with results 48 hours later giving the great number of 122 (13.5 in old UK money)

    So straight onto 2000mg metformin a day = 2 in the morning one in the late afternoon and one last thing at night.

    That was 6 months ago. Currently on 1000mg a day and if next HBA1c is sub 5.7 we agreed I am going to try 500mg a day.
     
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