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Confused by GP -- cut point for mediciation

normpeterson

Newbie
Messages
3
Location
London
Type of diabetes
Treatment type
Diet only
My annual HbA1C was 51 (6.8%). My GP said that I didn't need mediciation as I could just control my diabetes with diet. However looking through this forum it seems that some GPs ask their patients to start medication when their HBA1C levels are 43 so I am slightly confused at what my GP is suggesting. Also my cholsterol was 5.8. I am already on blood pressure medication so i very worried about my overall health. GP didn't seem to care or be too concerned.

Should I be on medication for my diabetes?
 
My annual HbA1C was 51 (6.8%). My GP said that I didn't need mediciation as I could just control my diabetes with diet. However looking through this forum it seems that some GPs ask their patients to start medication when their HBA1C levels are 43 so I am slightly confused at what my GP is suggesting. Also my cholsterol was 5.8. I am already on blood pressure medication so i very worried about my overall health. GP didn't seem to care or be too concerned.

Should I be on medication for my diabetes?

My knee jerk response was, "Lucky you!", and I meant it. So many GPS seem to first refer to the prescription pad, rather than the patient. I believe, for many GPs and areas, the routine threshold for prescribing medication includes other factors, such as whether the patient has any symptoms or not.

When I was diagnosed (stats in my signature), the nurse I initially spoke with was keen I should receive medication, but the Doc less so, based on the fact I had no symptoms whatsoever. My results have been achieved without call to any medication whatsoever, and I quote my usual GP who states I no longer have any markers whatsoever for diabetes.

I will still be having an annual HbA1c test, as having crossed the line once, it seems plausible that I remain at risk of regret hinge the line, should things slip on my part, or my body ages less favourably.

I'd advise you to take the opportunity to make the difference for yourself, without swallowing a load of chemicals which may help a bit, but do also carry the risk of causing unwanted side effects. The changes you make for yourself, you will know about. Immediate medication, to me, would have somehow blunted my aggressive approach to changing that state of my diabetes game. I may be odd, but it was important for me to know how much difference I could make for myself, before considering a pharmaceutical addition.
 
thanks - how did you manage to bring your levels under control?

I have these sort of levels 46-52 for about 3 - 4 years so maybe i need to start medication to bring it down.
 
thanks - how did you manage to bring your levels under control?

I have these sort of levels 46-52 for about 3 - 4 years so maybe i need to start medication to bring it down.
Honestly, if you change your diet by taking some simple steps, your blood glucose levels will come down.
Have a read of the low carb forum, there are some great ideas and recipes.

What you need to do is reduce your carbs, reduce your plate size, increase your exercise.
Carbohydrates and sugar turns to glucose when we eat and that is what raises your blood glucose levels.

Do have a look around the forum.
And ask questions, someone will answer you.
 
maybe i need to start medication to bring it down.
One of the most successful ways to get it lower is by modifying your diet. It seems to be fairly standard NHS practice these days to prescribe something like Metformin and tell you to stop eating sugary things and send you away for a few weeks without much further assistance. I think they feel that people generally comply better with taking a couple of pills daily than seriously changing their own eating habits.

But many T2s are doing better by modifying what they eat, rather more strictly than is generally advised. It rather depends on what you already eat, your age, weight and exercise routine. But as a generalisation, eating a lot less carbohydrates and adding even modest exercise like a daily walk will probably achieve more for you than a course of Metformin.
 
thanks - how did you manage to bring your levels under control?

I have these sort of levels 46-52 for about 3 - 4 years so maybe i need to start medication to bring it down.

I trimmed back the amount of carbohydrate I ate, upped my veggies and made sure I drank lots of water. I didn't make it a great art form.

Unless you have galloping symptoms, which you don't mention, I would urge you to make changes to your eating. First stage medication doesn't make masses of difference to the bloods and can lead to, erm,.... Digestive upsets.

Where possible, I would rather stay free of medication. I have a freer life that way.

Do you carry any spare poundage at all? If you do, trimming up a bit also helps enormously.
 
When I was diagnosed in January 2014 my HbA1c was 53. Medication was never mentioned, and hasn't been since. I had never heard of Metformin until I found this forum. I was told to go away and use diet and exercise for 3 months at which point there would be a further review. I remain med free, and my levels dropped and have remained good just by following a low carb diet and adding an extra dog walk to my routine. I hope I can remain this way for many years to come. I have no intention of going down the chemical route for as long as my body allows. However, the choice is yours, but if your GP is satisfied, then perhaps you should believe him. You are lucky.

As for your cholesterol, the total of 5.8 means very little. You need the breakdown. (HDL/LDL/Triglycerides/ratio) before contemplating medication for that. If you don't know this breakdown do ask for a copy of the computer print out.
 
Hi @normpeterson

Don't be worried about losing the meds. Congratulate yourself for looking after yourself well enough to lose them. I agree with the other posters have a look at some of the LCHF diet options and ask some questions about them on here. I have tagged @daisy1 who will send you an info post for newbies that I can't see that you have been sent.
 
@normpeterson

Hello Norm and welcome to the forum :) Here is the information we give to new members and I hope you will find it useful, especially with diet. Ask as many questions as you like and someone will be able to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 150,000 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-and-whole-grains.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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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 bloodglucose 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.
 
Not only diet, but you should to have a good lifestyle, if you running for diet but you have a bad lifestyle, it's nothing
 
Not only diet, but you should to have a good lifestyle, if you running for diet but you have a bad lifestyle, it's nothing
Could you define a good lifestyle @Egar27.
I note in another post that you say people should not drink tea, coffee or alcohol.
As you are not a diabetic then can you tell us where you are getting your information from.
 
I feel that your GP give you the right advice by looking at your condition rather than follow standard text book recommendations. Change to low carbs food you can almost instantly see your BG level drop. My 1st OGTT test indicated that I am diabetic patient but my doctor decided to give me a second time blood test in 3 months later without starting with me the medicine. In the 2nd blood test it found that my Hba1c drop to 5.9%. Actually what I have done is that i immediately started with low carbs food by following advices from this forum.
 
maybe you can ask your doctor why im said about these, first, tea and coffee have caffeine, you know caffeine...???
Could you define a good lifestyle @Egar27.
I note in another post that you say people should not drink tea, coffee or alcohol.
As you are not a diabetic then can you tell us where you are getting your information from.
caffeine will stimulate the organs of your body to keep working hard, while diabetics can not to spur the organ performance with so hard, because when your body organs to be forced to work harder, then it can makes your body organs becoming weaker as it continues to be forced to work harder, if your body organs is weakened, it will trigger the occurrence of complications of diabetes, you can drink coffee and tea, but you must reduce your intake of beverages containing caffeine, especially if you drink alcohol, it will cause your body organs is working very hard, because your body organs should to reduce the alcohol that goes into your body, so the organs that should be kept to normal, these organs will weaken due to having to parse the alcohol that enters your body, so if this continues happens it will lead to complications of diabetes. if there are any more questions .. ??
 
The question was @Egar27, Where are you getting your information from?
The members here are mostly diabetics,. Some do not drink tea , coffee and alcohol through choice but there are plenty who do and they are not suffering from any effects.
I am asking you these questions as a Moderator and would rather that you put your opinions on the board as just that, opinions rather than facts.
If you cannot provide links to your statements so that posters can make a judgment on the link, then there is not much point in your posts.
Rather than derail this thread any more you need to start a post containing the links to your statements. It will mean that posters can see where your information is coming from. We do not need to scare newly diagnosed into thinking they cannot consume these beverages.
 
Hi norm. I was diagnosed with a very high HbA1c. I was started on metformin immediately but due to becoming ill on it I stopped after a few weekd . Never taken anything else and within 3 months I was in the non-D range. You can read what I did in the link in my signature. I decided it was better to try anything before taking drugs. I think it is good you have this opportunity to reduce you HbA1c without drugs
 
maybe you can ask your doctor why im said about these, first, tea and coffee have caffeine, you know caffeine...???

caffeine will stimulate the organs of your body to keep working hard, while diabetics can not to spur the organ performance with so hard, because when your body organs to be forced to work harder, then it can makes your body organs becoming weaker as it continues to be forced to work harder, if your body organs is weakened, it will trigger the occurrence of complications of diabetes, you can drink coffee and tea, but you must reduce your intake of beverages containing caffeine, especially if you drink alcohol, it will cause your body organs is working very hard, because your body organs should to reduce the alcohol that goes into your body, so the organs that should be kept to normal, these organs will weaken due to having to parse the alcohol that enters your body, so if this continues happens it will lead to complications of diabetes. if there are any more questions .. ??

You may be surprise how effective some tea can be in lowering blood glucose. From my experience, up to 5 mmol within 3 hours.
 
I was diagnosed a few weeks ago with an HbA1C of 97. My GP talked to me about my motivation to change my lifestyle, and suggested I look on this forum for ideas and try to control my sugar levels through diet and exercise before we even thought about medication.

I'm going back for anorher HBA1C test next month and am desperate for it to have dropped so that I won't need meds. I am doing the lchf diet and have increased my exercise slightly (I was already doing quite a lot).
 
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