Consultant's surprising action/help?

Hi everyone,

I was diagnosed a couple of years ago with type 2 diabetes. My hbA1c was 77 at diagnosis. From there It was suggested I try dietary changes before looking to Metformin. I radically altered my diet and at my next test I was 53. A few months later 47 and then 43. I had been told all this was cery good and in fact the last test result was pre diabetic. I have slipped a little over the last 3 months with the diet having not been as well and had a little more in the way of carbohydrates (have been on a high fat low carbohydrate diet). Anyway I have just been sent a copy of the letter my consultant has sent to my gp. It says place the patient on metformin.

Is it just me or does this seem a little quick off the bat? I mean this is one, singular hbA1c result, a blip and is 50 that high anyway? I mean is that so high as to say move the patient (me) onto metformin? I instinctively feel a little resistant to this.

Firmly? It is one result, and if 48 is the point at which it is categorised as diabetic, how is that firmly?

As an average over the last year, I am below that categorisation anyway, if taking the mean, rather than the highest result. I'm completely perplexed.

What would metformin mean, rather than diet alone. What effects would it have on my hbA1c, blood sugar and general health? What is better about going lower without metformin, over and above use of that medication? Difficult questions I know.

Thx for the previous answer/thoughts by the way.

Thx for all the replies. Still super surprised, because I thought my control was very good with the diet. I have only heard of a couple of people ever achieving pre diabetic scores, so one blood test just tipping me over...well I thought that wouldn't have been regarded as significant unless it happened a few times. Even then most of the people I know generally have terrible diabetic control in comparison.

Are there really no adverse effects of Metformin itself? I mean, wouldn't diet alone be preferable if I was typically around 45/47nmol/mol HbA1c

I must be missing something...

Wow, you're diligent/on the ball with the prior postings Deejay, I bet little gets past you. Of course I feel the same, and your response is the one I was possibly hoping for. It is easy to find agreement in what you have said, yet I don't want to be too quick to dismiss voices that differ from my own (aware of that danger). Trying to be open minded, but not so open minded that the brain in likely to fall out.

I certainly thank you and the others for taking the time out to thoughtfully respond, and in particular to yourself, for looking to my prior postings which is very considerate and thoughtful of you.

P.S

It should be said I probably do have an aversion to metformin and this might not be entirely rational, but instinctively I have come to seriously distrust the consultant concerned.

Well an awful lot to think about.

For clarification. My test results did not jump from 43 to 50 in 3 months. I didn't have a hbA1c test for over 6 months. I was well and I think my control good upto the last 3 months. It was 6/7 months prior I had 43 and 6 months before that where I had 47. I suppose my initial explanation was a little ambiguous. When I said ill over the last 3 months I meant significantly. I have had multiple cancers and suffer long term problems as a result. My reason for seeing the consultant is not for diabetes, though he is a diabetes consultant. I see him for Growth Hormone medication as I suffer from adult Growth hormone deficiency as a result of chemotherapy. He has lowered my dose of GH and this coincides with increasing ill health and the upward blip with my hbA1c result. I suspect the lowering of the GH level is partly responsible for my increased hbA1c, rather than dietary changes alone.

I see another private consultant in London and he has told me altering GH can affect diabetes positively or negatively, depending upon the situation. All I know is, I was on a set medication and well/healthy enough and doing very well in terms of hbA1c. Then my medication was reduced and I have been exhausted and my hbA1c has increased.

I don't trust the NHS/diabetic consultant generally because I know the statistics when it comes to Adult Growth Hormone Deficiency. 84% of people in the UK go untreated by the NHS and morbidity is 13% higher than the populous as a result. Or put another way, 13 more people in every 100 with GH deficiency die in comparison to the regular population and most people are refused treatment and those that are treated are often kicked off treatment for various excuses. Most untreated or under-treated snuff it from cardio vascular disease. I feel the consultant and the NHS is always looking to withdraw treatment/find excuses not to treat...mainly because the treatment costs over four thousand pounds a year. That doesn't seem much money, but one look at the N.I.C.E guidelines reveals 3/4 pages are devotee to cost benefit analysis :-/


The risk of complications from GH deficiency if anything outweighs the risks of the diabetes, but the consultant would like nothing more than to pull the plug on that funding.

So trust is frankly, non existent.

When one variable is changed and mayhem occurs afterwards, it makes me think, go back and undo the singukar change and see what happens. So I am thinking of trying to argue the case for putting the dose of GH back up. That seems to make some logical/rational sense to me. Whether it makes a difference or not, whether this has been significant or contributory is something I can't really know right now.

Think. I might speak to my gp and talk about re-testing hba1c before making a decision.

I realise my results prior were nothing out of this world, just simply good/respectable. They were something I hoped to build on and do even better with. It is true though that outside of forums, with the people whom you typically meet...the results were generally far better than most people I heard about. That is something I put down to the high fat low carb diet.

Thx again for all the thoughts and time taken, appreciated.

P.S

One of the cancers was liver cancer - two thirds of my liver removed at 17 (having never had alcohol). 11 hour op to remove that. Second cancer unrelated primary too. Chemotherapy Cisplatinum causes kidney damage. So my liver and kidneys might not be so great. Lastly osteoporosis of the spine from the chemotherapy. So diet is doable exercise is not.