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Coming up for first diabetes review and seeking advice

Discussion in 'Type 2 Diabetes' started by simo_M, May 17, 2021.

  1. simo_M

    simo_M · Active Member

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    Hello,

    I'm 45 and coming up for my first diabetes review and am considering what I want from it, so though I'd ask some people who have already been down this road.

    I was diagnosed 10 months ago with an hba1c of 97 (ish - quoted to me as 11.3), put on 2g/day of metformin and 20mg/day atorvastatin. Since then I have lost 20kg and my latest hba1c was 40, achieved through a mix of low calorie (earlier) and low carb (last 6 months) diet. I'm not quite sure how many carbs per day, as I don't weigh them, but I'm intermittently in a low level of ketosis. I test blood sugars regularly before and after each meal and normally wake with a score in the 6s and typically maintain 5s or 6s over the course of the day. I see the odd 7 (maybe 1 a week out of 40-50 readings), virtually always on waking (always my highest reading), and haven't seen an 8+ for months.

    My ideal goal is to get into remission, preferably without medication. While I'm happy to have got hba1c down to 40 I would like lower.

    I am inclined to request to stop statins as my recent cholesterol was HDL ratio 2.4, with HDL of 1.76, LDL of 2.3, triglycerides 0.55, which I understand to be normal. QRISK suggests that I don't meet the threshold for statin prescription. I'm missing some information so far as I don't know what previous cholesterol readings were (hope to get this soon).

    Regarding metformin, is there any reason to want to cut dosage if I'm still trying to reduce hba1c? My gut reaction is to ask for it to be halved, but I don't have any solid foundation for this other than a general wish to not take medication if I don't need to, but not wanting to eliminate it while I still want hba1c to drop. I'm now coping with metformin without issue so I'm not worried about short term side effects, though I'm unsure how much metformin may be contributing to my lower numbers.

    I know that medication is my choice, but will try and work with my surgery where possible. I've not met the diabetic nurse before, but GP hasn't been anti low-carb, so I'm hopeful he'll be supportive.

    What would you do and why?
    Thanks for reading this far,

    Simon
     
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  2. Antje77

    Antje77 LADA · Moderator
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    Sounds like sensible thoughts to me, I think I'd do exactly what you describe. Or perhaps I'd ask them to keep prescribing the full dose of metformin for now with 'permission' to reduce as your meter guides you.

    Congratulations on what you have achieved in the past ten months, very impressive and something to be proud of!
     
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  3. Goonergal

    Goonergal Type 2 · Moderator
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    Congratulations, excellent weight loss and HbA1c reduction.

    I’d agree with your assessment on the cholesterol front - great trigs - and the metformin is completely your call.

    Sure you’ll be back with even better news in the not too distant future.
     
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  4. bulkbiker

    bulkbiker Type 2 · Oracle

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    It should always be your decision as to what goes into your body.

    Your HCP's are there to advise.
     
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  5. simo_M

    simo_M · Active Member

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    Thank you for the advice. I do need a bit more information on how cholesterol numbers have changed over the last year but hopefully can get this alongside recommendations from practice to inform my decision.
     
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