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Diagnosed with 13.6% HbAlc one month ago?

Discussion in 'Newly Diagnosed' started by cbhandari, Dec 1, 2018.

  1. cbhandari

    cbhandari · Member

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    Doctor has given me metformin 500 mg (3 times a day) and Januvia 50 (2 times a day) , and i have been on a low carb diet since, would i need to take insulin theraphy or just medication and diet can help lower my blood sugar levels. Thanks

    When i started medication , I saw a lot of diabetes symptoms such as being excessively thirsty
    and Passing more urine, but i do not experience these symptoms anymore, am i on the right track ?
     
  2. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    This is probably best answered with regular glucose testing.
    1) Fasting glucose
    2) Pre/2hr Post meal glucose.
    These would give a fair indication of how much metabolic flexibility has been restored.
     
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  3. Daibell

    Daibell LADA · Master

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    Hi. A lot depends on whether you are a bit overweight and likely to be T2 or slim and possibly a LADA or somewhere in the middle. I was at that HBA1C level at diagnosis but slim and losing weight. I have turned out to be a LADA with long honeymoon period and now on insulin after years of the all the tablets. The tablets held my HBA1C down until the point at which insulin was vital. Others with a high HBA1C find that the low-carb diet and perhaps Metformin can avoid moving to insulin as their insulin resistance reduces. At present just keep going and testing and if your BS becomes difficult to control and you are not overweight then ask for the tests for LADA
     
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  4. Kailee56

    Kailee56 LADA · Well-Known Member

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    Totally agree with @kokhongw. Hopefully your doctor also gave you a glucometer or instructions to get one. If not, please get a glucometer, strips, and lancets.
    Since the effectiveness of your Diabetes management revolves around your blood glucose, you can’t know how you are doing without that information. Test often, especially at first, so you can see how foods and activities effect your glucose and how glucose effects the way you feel.

    As to your initial question, yes, but that is not an absolute. You will find lots of people here who manage their diabetes with oral medications and diet, never needing insulin. You will also find a large group who are considered to be in remission, eating low carb and losing weight.

    BTW. Welcome. This is a great place. Read the forums and ask questions. There is a lot of information and lots of people to support you on this journey. You can do this. :)
     
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  5. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Hi @cbhandari and welcome! First I’ll tag in @daisy1 for her useful info post.
    Were you told what Type of Diabetes they think you have? If Type 2 then it seems these days it’s perfectly possible to control your blood sugar levels with oral meds and diet or diet alone, no insulin, so low carbing is a good way to start. The lessening of symptoms is a good indication that you’ve lowered your levels but as others have said you can’t be 100% sure without testing, so I would urge you to get a meter and start some methodical testing to see how different foods affect you.
     
  6. daisy1

    daisy1 Type 2 · Legend

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    @cbhandari
    Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you need to and someone will be able to help.

    BASIC INFORMATION FOR NEW MEMBERS

    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 well over 235,000 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

    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.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    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 blood glucose 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.
    Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
  7. cbhandari

    cbhandari · Member

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    Thanks @Rachox
    I got myself a glucometer and have been measuring blood glucose levels since. My blood sugar level was at 5.5 mmol/l before taking my last meal of the day, and retaking measurements 2hrs later (after last meal) resulted in blood sugar of 6.8 mmol/l. However, after checking my blood sugar levels after 6 hrs ( after sleeping) , my blood sugar was still at 6.8 mmol/l. Is this normal? Shouldn't this measurment be slightly less after being in fasting mode.

    Any answers appreciated. Thanks
     
  8. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hi @cbhandari

    These are some very good numbers and if you keep them up your next HbA1c should be in the non-diabetic range. Congrats and well done.

    You are correct, six hours after eating, usually blood sugars would be back to what they were before eating. This being said, our bodies aren't like clockwork. For me, sometimes blood sugars drop for three hours after eating and then rise again slightly. (Don't know why, but maybe this is the body trying to maintain homostasis.) Try not to worry about this too much. Who knows, with time your blood sugars might even drop to a lower setpoint.

    Edited to add: Sorry -- I missed the "after sleeping" -- see Rachox' post below.
     
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    #8 ziggy_w, Dec 2, 2018 at 5:34 PM
    Last edited: Dec 2, 2018
  9. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Don’t worry that your level on waking is higher than before going to bed. This is due to dawn phenomenon, a perfectly natural occurrence. Have a read about it here:
    https://www.diabetes.co.uk/blood-glucose/dawn-phenomenon.html
    Your fasting levels will be the last to settle down.
     
  10. cbhandari

    cbhandari · Member

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    Thanks for great detial @ziggy_w & @Rachox , just one more concern, I ran out of my diabetes medication over the weekend, and will not be able to get it until tomorrow as I have to see my doctor for repeats. Just wondering how much my sugar level should raise by in (mmol/l) if I do not take my medication for one day. I am asking this as before dinner time, my blood glucose was at 6.1 , however 3 hrs after eating my tea , my blood sugar was seen at 12.2 , which is very concerning.
     
  11. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    So I would avoid what you just had for tea..would you mind sharing what they were?
     
  12. cbhandari

    cbhandari · Member

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    for tea, i had one small home made vegetarian pizza made on a high fibre and low carb (15 carb) wrap, plus 5 dominos low carb buffalo wings ( 15 carb ), and a small high fibre beans salad ( 20 carbs),
     
  13. kokhongw

    kokhongw I reversed my Type 2 · Well-Known Member

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    Given the sharp glucose rise of 6 mmols post meal...I would think the carb value assigned to the food don't match up.
     
  14. ringi

    ringi Type 2 · Well-Known Member

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    Thst is more carbs then many of us have over two days.
     
  15. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hi @cbhandari,

    Forty grams a carbs is probably more than many of us T2s not on insulin can handle in a single sitting. The good news are that there are many low carb alternatives to meals that we used to have before diagnosis.

    For example, on Sunday I made some flatbread using lupin bean flour, almond flour, chia flour and psyllium husks. The resulting bread is only about 3g of carbs per 100g. There is also some low carb protein bread available commercially. As to the beans, lupin beans are also very low carb, but even chick peas or other beans might not be oo bad if you keep the quantity low (maybe 30g @ 10g of carbs per 100g) and bulk up with other low carb vegetables or protein (cheese, fish, eggs, meat).

    Have you had a look at the dietdoctor.com website for recipes?

    As to your other question, this is difficult to say. As I used to be on metformin myself, I would probably say skipping metformin for a day shouldn't make that much of difference. As I have no personal experience with your other medication (if I remember correctly, your other medication is a DDP4 inhibitor), I am afraid I can't say how much of an impact skipping this would have. Generally though, it might be good idea to try to limit carbs until you can fill your prescription.
     
    #15 ziggy_w, Dec 3, 2018 at 3:23 PM
    Last edited: Dec 3, 2018
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