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Coming off Metformin, eGFR, A1Cnow test

Discussion in 'Metformin/Biguanides' started by LittleGreyCat, Dec 14, 2018.

  1. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    About two and a half months ago (27th September) I had my 6 monthly diabetes review with my DSN.
    She was pleased with my HbA1c of 6.4%/46 but not so happy with my eGFR at 58 mL/min.

    She recommended reducing my Metformin from 3 * 500 mg per day down to 2 to see if that would improve things. Being an investigative type I decided to come off Metformin completely - with the general idea that one tablet might make an insignificant difference so stopping completely should give the maximum information. Then add back in to see when things go bad again.

    Tested on the 4th December and the new eGFR result is 54 mL/min. So stopping Metformin hasn't improved things.
    I will be going back on the Metformin now.
    Due to various circumstances I haven't been able to test regularly or even focus very well - I am taking co-codamol for severe back pain which means I spend quite a bit of time asleep and/or away with the fairies. So I asked for an HbA1c, but didn't manage to request it through my DSN so I was refused because it was less than 3 months since my last one.

    I ordered an A1CNow test kit (2 tests) and have finally got my head together enough to use the first test.
    I was very careful to read all the instructions, comments from various threads, and also to watch the instructional video which is very good.
    https://ptsdiagnostics.wistia.com/medias/l91rvblbee?embedType=async&seo=false&videoWidth=345
    I used my own lancing device, turned it up from 2 to 3, and selected an area on a finger which I know can bleed like a stuck pig at the slightest provocation. Wise decision.
    I lanced myself and got what I thought was a large blood sample, applied the sample collector and only got half way up the tube. However the video said it was fine to squeeze out some more and top up so I did and got the blood to the line.
    I then fitted the collector into the tube thing and shook steadily for a very slow count of 5.
    Analyser thingie out of the second wrapper and into the reader, and inserted the sample just like in the video.
    5 minutes of suspense and then I got a result!
    Ummm.....64 mmol/mol or 8%.
    That is a bad, bad thing. Back on the Metformin pronto.

    The eGFR is a bit doubtful because I was taking Ibuprofen for the back pain until I saw a doctor (I was away at the time) who reminded me that I shouldn't take NSAIDs if my kidneys were struggling. So onto the co-codamol and away with the fairies. It does help a lot with the pain, though.

    The HbA1c isn't a total shock because I haven't had the will power to stick 100% to LCHF and I have started putting weight on but I didn't expect it to be that high. Added to that, of course, is that I haven't been getting a lot of exercise recently because of the bad back. However this does suggest that I need to be on Metformin or some alternative unless I am super active and super motivated.

    I was very impressed with the A1CNow test; I am assuming that it is reasonably accurate because of the reports from others on this forum. I am saving my second test kit to use on the same day that I have my next HbA1c so I can cross check with the laboratory.

    TMI: codeine makes you bungo, so if restarting Metformin has laxative effects they will be extremely welcome. Slamming back the Lactulose at the moment as if it is going out of fashion. From previous experience the dosage would usually have me wide eyed and nailed to the khazi. Now it just keeps things more or less normal. A warning to those taking opiates as pain killers. Just checked and codeine is use to treat diarrhoea - nuff said.
     
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  2. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    I did my second A1cNOW test yesterday and had my blood drawn for my HbA1c this morning. The A1cNow came out at 39. This is considerably higher than my Libre estimate of 31, but Libres are usually low although in July the Libre and the A1cNow were virtually identical and my HbA1c was 10 points higher! (Must add here that my HbA1c is always significantly higher than any other method of testing) It all adds to the confusion and excitement.

    I hope you are feeling better. Backache is a killer and greatly underestimated in the medical fraternity.

    Can you help your eGFR if you cut down on some protein?
     
  3. Brunneria

    Brunneria Other · Moderator
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    You have my sympathy on many levels, LGC. :(

    I am quite sure that your health team have explored this possiblity, and eliminated it, but is there any chance at all that your back pain may be linked to your kidneys? A rumbling kidney infection could affect function, as well as causing pretty awful pain.
     
  4. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    I think they considered the extremely tight muscles and the location of the pain as reason enough.
    I went to a private physiotherapist whilst I was away and then to an NHS one after coming home. Both waved my legs around in various directions and pushed into my back muscles. They both had the view that it was referred pain due to very tight muscles.
    The eGFR has been an issue on and off for a number of years. I don't see any symptoms and it can improve for no reason. Then get worse again. As @Bluetit1802 has noted I do have a high protein diet; that may be skewing the readings, of course. I'm not contemplating reducing the protein at the moment but it is something to be aware of.
     
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  5. Rachox

    Rachox Other · Type 2 - well controlled. Moderator.
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    Lactulose can raise blood sugars in some diabetics: https://beta.nhs.uk/medicines/lactulose/ I found it did when newly diagnosed once the effects of Metformin wore off and low carb constipation kicked in and I needed a little help! I swapped to Senna instead.
     
  6. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Thankfully (?) the Metformin is giving early indications that I can cut back on the Lactulose.
     
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  7. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Updated to note that I just had blood drawn, and also did a home HbA1c test which came back as 43/6.1%.

    I now have to wait a week for the lab results to come back.

    I am hoping that they agree with the home test because although not outstanding the number looks reasonable; just into pre-diabetic. Wonder if the practice would try to tell me I'm normal if it was a couple of points lower?
     
  8. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Fingers crossed for good results. :)
     
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  9. jjraak

    jjraak Type 2 · Well-Known Member

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    Hi @LittleGreyCat

    Sympathies for the back..(slipped a disc two years back, 3 month getting better :bigtears: co-codamol, = zonk city)

    as i understand it, exercise for T2D, is to the benefit of using up the glucose..(as well as a healthy heart lungs etc,)
    but pertaining to BG's, they say weights and resistance training offers best results..
    the muscles in use send out a mayday for more glucose and soak it up while being used more heavily.

    i've joined a gym and do weights at home, but On a recent holiday, i wanted to stay focused and continue some sort of exercise.
    Wife has some resistance bands for yoga exercises.
    i took one away with me and used most days instead of the weights, seemed to be effective, scores stayed low.

    might be of some limited use to you in your current state ?
    if pain allowed...obviously.


    Btw made me chuckle the ending about being nailed to Khazi...:hilarious:
    nice to see even in the gloom, humour looms large over your mood.

    Good luck with test results.
     
  10. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Thanks.
    Please note that the back problems were before/through Xmas and thankfully are now a distant memory.
    I blame cheap and unsupportive beds. Once back home everything quickly cleared up.

    For exercise I have a weekly Yoga class and I also cycle regularly.

    One day I will do specific upper body exercises.
     
  11. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Long time ago now but how close were the home and lab tests?
     
  12. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

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    How do some of you do an HbA1c test at home ?
     
  13. jjraak

    jjraak Type 2 · Well-Known Member

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    Ahh...should have notice of timeline .duh
    Nice to hear it's got better.

    Missus keeps tying to get me into yoga, I should probably give it a go.
    Cycling..I do enjoy

    Best wishes results are good and match the A1cNOW
     
  14. Guzzler

    Guzzler Type 2 · Master

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    You can buy a kit online.
     
  15. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    The A1cNow test mentioned in the title is one way.
     
  16. Pinkorchid

    Pinkorchid Type 2 · Well-Known Member

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    Are they as reliable as the blood test done at the doctors
     
  17. Guzzler

    Guzzler Type 2 · Master

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    I've not had one but they are reckoned to produce a result close to a lab test for most people. Members say sometimes the results are off which puts me off getting one because they are not cheap.
     
  18. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    This is one thing that this thread (amongst others) is trying to establish.
    I should have a comparison reading in about a week.
     
  19. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    First one
    A1cNow was 33.
    Lab test was 43

    Second one
    A1cNow was 39
    Lab test was 43

    You may recall that my lab tests are significantly higher than expected from all sources of data (A1cNow, Libre after adjusting for lower readings) and multiple finger pricks throughout the day. My GP agrees there is some sort of issue and arranged for my HbA1c to be analysed by 2 different labs from the same blood draw.
    Normal lab was 44
    Second lab was 40.
    Expected result approximately 36 to 38.

    For these reasons I now try to ignore my HbA1c lab test as it seems clear to me, and my GP, that I must have long lived red blood cells. I will be doing another A1cNow when I next have my lab test.
     
  20. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Thanks.
    So we aren't sure in your case if the home test is more accurate.
    Just that it is different.
     
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