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Change in Diet, Change in Numbers - Should I Worry?

B

bigalxyz

Active Member
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Hello forum,

I was diagnosed T2 diabetic 3 years ago. At the time I had an HbA1c number of around 9.5% (80mmol/mol), not pretty. Prescribed 1500mg metformin daily.

A lot has changed since then. Pretty much quit drinking (I was drinking an awful lot then), more physically active, etc.

Until a few months ago I was very wary of carbohydrates and was following a very low carb diet. My HbA1c numbers dropped to around 5.8% (40mmol/mol) and stayed there, which I was very pleased about. But I didn't lose any weight.

I changed my diet somewhat a few months ago, introducing a few carbs, mostly as potatoes.

Since then I've lost about 25 pounds - it fell off very quickly initially and then plateaued. Good news.

About a month ago I saw the diabetic nurse. She noted my weight loss and my much improved HbA1c numbers and suggested reducing the dose of metformin to 1000mg/day. I felt pleased with that. However she took blood and sent it to be tested, and when the results came back, my HbA1c level had climbed to 6.3% (45mmol/mol). Swings and roundabouts...

I saw her earlier this week and asked her if she was still happy with the 1000mg/day dosage given that my HbA1c had gone up. She said that she was.

I've also recently got hold of a blood glucose meter, which is showing numbers typically between 5 and 6.5 on an empty stomach, rising to between 8 and 9 after a meal. I asked the nurse about this, said that I had the impression that "normal" people saw numbers usually in a range of 4 to 7 ish, and asked again if she was comfortable with my reduced dose of meds. She said yes, the numbers you're getting are ok, no particular need to obsess over getting them any lower.

I have a vague sense of unease about it all. Does anyone have any thoughts?

Thank you,
Alan.
 
Your after meal is a bit high but not too bad. I think it is personal choice. If you think that increasing the Metformin would give you better control speak to your Dr. It probably is the carbs you have reintroduced, but your weight loss is fantastic. Well done.


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Thanks Karen.

I guess the "hidden" question in my original posting is: what to do about my diet. I bought into the low carb way of thinking in a big way, studied the chemistry, etc. and was endlessly frustrated when I didn't lose weight. I must have missed something. And do I now get rid of the carbs again in order to bring my numbers under better control, even if I gain some weight?

2 week walking holiday in The Pennines is imminent. I think everyone will agree that exercise is a good idea for BG control! *crosses fingers*

Alan.
 
remember calories in < calories out to lose weight. You probably just needed to reduce your fat content slightly (1g fat=9kcal)
 
Ok in respect of your diet - do you keep an eye on your calories? I use MyFitnessPal and I eat around 1,400-1,6,00 calories a day - however I also walk quite a lot/exercise and burn off 1,100-1,200 calories a day. At the moment I am losing 1lb to 2lbs a week. I don't carb count - however I no longer eat as many carbs as I used to do - I seem to have 50% carbs/20% protein/30% fat. Which is probably a lot higher than most. Exercise has always worked best for me and it all depends on each individual person doesn't it.

Enjoy your walking holiday :-)
 
Personally, blood sugar comes before everything else, maybe the extra carbs shock up the system and sparked off the weight loss, there's no saying the weight will plateaux again or not go back on, I spose there's only one way to find out but (again personally) I would not be happy getting higher numbers like that
 
Alan great news about your weight loss it is difficult no mater what.

As for the BG, it is my opinion that the best course in general is to keep the BG numbers as close to normal as practical - especially if you are relatively young.

Here my GP touts that studies that report that tight control A1C <6 do not produce 'better' outcomes. IMO and that of others -Jenny Ruhl http://www.bloodsugar101.com - the standard medical interpretation of the data is flawed.

If you can control your numbers with weight loss and diet I would definitely try. Also I would be testing after every meal to try and determine what foods spike my BG and eliminate them. IMO the A1C is important, but as important or more is the spiking of BG after eating in helping to reduce long term complications.

Over the year since I was diagnosed - hospitalized with a 13.6 A1C - I've been eating per Dr.Bernstein's recommendation except more veggies and less animal products.

I'm still on insulin but good control - not as low as he recommends - but my durning feet and eye sight are back to almost normal and reading glasses went from 2.50 to 1.50

Not saying this is the best, but for me it works.

The thing I've learned personally and from the forum is that the health care and opinions of the medical 'experts' vary greatly.

We as diabetics need to research and then advocate relentlessly for the type of care we believe will work for us - otherwise we will be left to blow in the wind by the experts who are not up to date or are bending to standard care practices that are more focused on reducing cost than preventing future complications

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