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Consultant visit/high a1c

seanj67

Well-Known Member
Messages
283
Location
Lincoln
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Morning all,

I went to see an Endo consultant a while back. The upshot was that she wanted me to go onto Trulicity injections and was going to tell my GP to arrange it. Now, I went to see the GP and said that I'm not interested having looked at the side effects and we agreed to see what my next review showed. Sadly that showed the my a1c was up - I knew it would be as I was getting readings of 12~18 most of the time. Not too sure why, but whatever I did diet wise made no difference. I did wonder if my pancreas is finally giving up....

Anyway, I was told that if I couldn't get the numbers down in 3 months we'd have to look at insulin. In the meantime I went back to the consultant who asked how the Trulicity was going? and she wan't too impressed when I said I wan't on it. The consultant has now written to my GP again and I have been asked to go in to "discuss".

I really don't want to go on it, but I have to accept that it may be the only way. But, before I make the appt I'm going back to low carb/keto basics. I'm going to give it 2 weeks and see if I can get the numbers falling again. If so then I know I can sort it. If not then I may have to reluctantly take the meds offered..... sigh.
 

Sean - Obviously I don't know all about you and any specific challenges you might face, and nor does anyone else here, but the bottom line is if you don't want to take the meds on offer, the chances of your compliance with any regime involving it will be poor. That's human nature, and why it is important to understand and "embrace" any regime.

I have no idea which other options have been tried, but a while ago I attended a presentation from a hospital consultant in T2, who stated that whilst insulin is a very useful and invaluable tool for treating T2, in the correct circumstances, but there are over 400 (yes, 400) combinations of meds available to tackle T2, before insulin.

If I were in your shoes and Trulicity didn't float my metaphoric boat, I'd want to fully understand the rationale for focusing on that particular choice of treatment, and how that is preferred to other options.

Sometimes once we understand the rationale to a recommendation it makes a compromise more compatible, but if not, it makes it clearer what our argument against it might be!

Does that make sense?

Of course, going back to absolute basics of reviewing diet, testing and record keeping makes all manner of sense whilst in this period of uncertainty.
 
DCUKMod said:
If I were in your shoes and Trulicity didn't float my metaphoric boat, I'd want to fully understand the rationale for focusing on that particular choice of treatment, and how that is preferred to other options.
Click to expand...

Well her comment was " It will stop you feeling hungry and eating all day" - neither of which is true.
 
bulkbiker said:
Bit of a red light for me.. what have you been eating in the interim?
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Hi BB, well I've been moderate low carbing but not keto - so I can only assume my carb intake is still too high, I avoid the obvious carbs like bread & pasta etc. When I say back to basics I guess I mean simple meals. I think sometimes if a meal is too involved in the prep then it's easy not to bother. The sugar changes were quite sudden, over the course of a week - no change in the diet which was seemingly ok, the numbers just climbed and stayed there. However, I will get on top of it!
 
Yes, get on top of it Sean. We can do it! I find that watching loads of Lowcarb and keto talks on Youtube helps to keep me informed and motivated. Start with the lowcarbdownunder conferences. Try Tim Noakes, David Unwin, Jason Fung . . .
 
mariavontrapp said:
Yes, get on top of it Sean. We can do it! I find that watching loads of Lowcarb and keto talks on Youtube helps to keep me informed and motivated. Start with the lowcarbdownunder conferences. Try Tim Noakes, David Unwin, Jason Fung . . .
Click to expand...

Thanks! I do watch a lot and most of those - I also really like Dr Ken Berry & Keto Christina, and I'm a paying member of Diet Doctor
 
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I found going keto did curb my appetite. No urge to snack. It did take me around 4 weeks to get over carb addiction then, bingo! I fell off the wagon a few times during the first few weeks with my body screaming for carbs. The change in diet, weight loss, improvement in numbers so impressed sceptical hubby, he is now semi low carb and losing weight.
 
Sounds like a reason to ask for a c-peptide test just to check on endogenous insulin production.. ?
 
If your c-peptide is low, Trulicity may be the least bad option.
 
seanj67 said:
Well her comment was " It will stop you feeling hungry and eating all day" - neither of which is true.
Click to expand...
How do you know this if you have not tried Trulicity?
And from reading dietdoctor.com you would know that in 2 weeks on a low carb diet ( and how low do you propose to go).? Is not likely to change your HBA1C.
It takes long term committment i woukd suggest to reap the benefits of such diets - no quick, temporary fixes.
 
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Apologies, I meant that I do not feel hungry all the time, nor do I eat all day. I wasn't referring to the medication, but re reading it I can see it reads that way perhaps. I'm not looking for a temporary fix either, but 2 weeks is enough for me to know if the numbers are coming down.
 
A fasting insulin test might be useful to you too - although since it isn't found on the NHS, your doc probably won't have heard of it, or know how to interpret it.
*** education opportunity *** (if they are open to it)

You can get very reasonably priced private Fasting Insulin Tests (or Any Other Time Insulin Tests, depending on when you take the blood sample) from several companies including Medichecks and Thriva.

The result of the test would inform you how much insulin you have circulating at the time of the test - which you can compare with what you had eaten, and give you a rough idea whether you are insulin resistant, or insulin deficient.

No idea if you doc or consultant would be willing to take that info on board, but it might provide you with the info you need to make an informed decision.
 


Fasting insulin was the best £40 I ever spent.
 
seanj67 said:
It;s only £29 on Thriva just now ... although it looks like it may be a subscription set up.
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Sean, I'm not a Thriva customer, but I understand you can "suspend" your subscription any time and pick it up on will.
 
seanj67 said:
It;s only £29 on Thriva just now ... although it looks like it may be a subscription set up.
Click to expand...

Yes, I have one of those subscriptions, but once you have signed up they offer you the option to change your test frequency.
I initially set mine up for 6 monthly, but have now dropped it to annually, with the option of bringing it forward or back as necessary.
They also send you a reminder email a week before sending the kit out, asking you if the timing suits you. So you get plenty of opportunity to dodge it, if you want.
 

Brilliant, thank you!
 
I live with T1DM so your challenges are unknown to me but I adopted Keto 4 months ago and my HbA1c estimate (from my Flash Glucose Monitor) is 5.0% or 31 mmol/mol - I would definitely recommend researching this and would also mentin that the key to sustainability seems to be eating enough fat rather than only restricting carb calories.
The research before starting is really important to assess how it will affect you and to bring the HCPs along with you and if you can put T2DM into remission with low HbA1c and reduce your medication to zero over time I have no doubt you'll be healthier - even if you're healthy now.
 

Thanks you - I was doing low carb/keto before but I let it slip. I do get a sense of apathy at times, which does frustrate me. However, I got back on the horse and in 48 hours saw a 50% drop in BG's. It's still up on normal but I'm seeing 8's in the morning and 7's but mid afternoon. I'm going to start working out again too and that will hopefully help mop up more of the pesky glucose.
 
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