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First post LCHF HbA1c not as good as hoped for

R

ringi

Well-Known Member
Messages
3,365
Type of diabetes
Type 2
BG (in mmol/L)
3 Feb 1016 4.4
16 May 2017 14.3 doctor did not explain risk of drinking orange juice.
2 June 2017 midday 32.4 – drank a lot of orange juice just before the test!
2 June 2017 11pm 24
3 June 2017 17 started 1000mg Matformin
7 June 2017 14 started 2 weeks of 40mg glipizide (stopped after 10 days)
LCHF started
Week ending 23rd July 2017 all readings under 6 about 2hr after evening meal.

HbA1c
Normal Below 42 mmol/mol
Prediabetes 42 to 47 mmol/mol
Diabetes 48 mmol/mol or over

11 Feb 2015 38 mmol/mol - average BG 6.4
2 June 2017 88 mmol/mol - average BG 13.6
24 July 2017 51 mmol/mol - average BG 8.3

Other
16 May 2017
Serum cholesterol 8.7 mmol/L
Serum HDL cholesterol level 0.8 mmol/L
Serum triglycerides 19.6 mmol/L
Serum LDL cholesterol level ---
Serum cholesterol/HDL ratio 10.88
Se non HDL cholesterol level 7.9 mmol/L
Liver ALT/SGPT serum level 48 U/L

24 July 2017
Serum cholesterol 3.5 mmol/L
Serum HDL cholesterol level 0.8 mmol/
Serum triglycerides 1.5 mmol/L
Serum LDL cholesterol level 2 mmol/L
Serum cholesterol/HDL ratio 4.38
Se non HDL cholesterol level 2.7 mmol/L
Liver ALT/SGPT serum level 33 U/L


Weight have remained the same at about 17 stone.

Blood tests show HbA1c a bit better, no longer have “fatty liver” and triglycerides have greatly dropped. I have not yet phoned my GP to see if they want appointment, I got the results on line. Given what I know now, I would not have taken the glipizide and just fasted for 3 days instead.
 
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Wow those are amazing results.. HbA1c is very good after such a short space of time and triglycerides are brilliant..you should be very proud of yourself.
 
To go from a HbA1C of 88 to 51 in seven weeks is very good going. Since this is a measure of 3 months average blood glucose levels, you need to wait for a reading 12 weeks after you started LCHF to get a representative reading. Probably this will be around 40 if your BG is now typically under 6.
 
The triglycerides are the best they have every been, the problem is getting the HbA1c back to what it was in 2015. (The HbA1c is not a simple average over the last 13 weeks and tend to be effected more by recent BG levels.) I have a underactive thyroid hence have test results going back about 10 years.

The doctor that looked at the July 2017 results refereed me to 3 different services as she did not look for what was in common between them. I now know enough to say it is clearly fructose from me drinking an increasing amount of orange juice along with lots of other carbs. It will be interesting to see what the lipid consultant says and if I can get a particle size distribution test done.

I had it easy as I had to reverse less then 1 year's of damage.
 
ringi said:
The triglycerides are the best they have every been, the problem is getting the HbA1c back to what it was in 2015
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Try and get another one in three months time if you continue with the LCHF way of eating.. I bet it will be even better..
 
The doctor has put on that I should get a HbA1c in 6 months time and keep with the diet+meds, I may have to tell her what the diet is at some point.
 
That's a really good improvement in such a short space of time. Well done :)
 
ringi said:
BG (in mmol/L)
3 Feb 1016 4.4
16 May 2017 14.3 doctor did not explain risk of drinking orange juice.
2 June 2017 midday 32.4 – drank a lot of orange juice just before the test!
2 June 2017 11pm 24
3 June 2017 17 started 1000mg Matformin
7 June 2017 14 started 2 weeks of 40mg glipizide (stopped after 10 days)
LCHF started
Week ending 23rd July 2017 all readings under 6 about 2hr after evening meal.

HbA1c
Normal Below 42 mmol/mol
Prediabetes 42 to 47 mmol/mol
Diabetes 48 mmol/mol or over

11 Feb 2015 38 mmol/mol - average BG 6.4
2 June 2017 88 mmol/mol - average BG 13.6
24 July 2017 51 mmol/mol - average BG 8.3

Other
16 May 2017
Serum cholesterol 8.7 mmol/L
Serum HDL cholesterol level 0.8 mmol/L
Serum triglycerides 19.6 mmol/L
Serum LDL cholesterol level ---
Serum cholesterol/HDL ratio 10.88
Se non HDL cholesterol level 7.9 mmol/L
Liver ALT/SGPT serum level 48 U/L

24 July 2017
Serum cholesterol 3.5 mmol/L
Serum HDL cholesterol level 0.8 mmol/
Serum triglycerides 1.5 mmol/L
Serum LDL cholesterol level 2 mmol/L
Serum cholesterol/HDL ratio 4.38
Se non HDL cholesterol level 2.7 mmol/L
Liver ALT/SGPT serum level 33 U/L


Weight have remained the same at about 17 stone.

Blood tests show HbA1c a bit better, no longer have “fatty liver” and triglycerides have greatly dropped. I have not yet phoned my GP to see if they want appointment, I got the results on line. Given what I know now, I would not have taken the glipizide and just fasted for 3 days instead.
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That is an excellent HbA1c drop in just less than 2 months. Some of your previous excesses will be included in that , even though the HbA1c is weighted towards the latter end, it isn't all latter end stuff. Brilliant reduction in trigs and ALT levels too.

I'd be more concerned about the low HDL, which hasn't improved, but I'm sure you are on to this already.
 
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bulkbiker said:
I just book myself in for a test... but then again my surgery is pretty clueless..
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Given that my wife is the"Chief Financial Analyst" (PLC, SLR, reference costs etc) at the local hospital I can't be risk being seen to waist NHS money requesting tests etc that the GP does not want. Having a new HbA1c number sooner is very unlikely to change any action me or my doctor takes, as I can monitor BG myself anyway.
 
ringi said:
Look back the only time it was better was when I worked in a office were we all did 10k runs at lunch time a few days a week. (My knee is not happy for me to run these days.) The Art and Science of Low Carbohydrate Living says HDL takes longer to respond to LCHF.
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I use spices in my cookery, so I can't say from personal experience, but apparently turmeric/cumin and black pepper is supposed to be anti-inflammatory and good for joints which have become inflamed due to running on hard surfaces. Do be sure that your footwear is suitable for the high impact exercise - but maybe adding an extra shock absorbing innersole would be advisable for all your footwear.
When I had a damaged knee - due to an idiot in a car reversing in to me - I used walking poles all the time to reduce the possibility of falling but still getting the exercise. Actually having to use my arms all the time was a better exercise and it also increased how far, how fast and how long I could walk quite significantly.
 
ringi said:
Given that my wife is the"Chief Financial Analyst" (PLC, SLR, reference costs etc) at the local hospital I can't be risk being seen to waist NHS money requesting tests etc that the GP does not want. Having a new HbA1c number sooner is very unlikely to change any action me or my doctor takes, as I can monitor BG myself anyway.
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Fair enough ...the way I look at it is that I ask very little of my surgery so reckon a test twice a year isn't so bad.. no drugs no consultation (although I have booked in the see the new "Diabetes Nurse" if that indeed is what she is tomorrow to see what she says re low carb). For you with major dietary changes I don't think that asking for a repeat test in three months especially if unmedicated is a waste of NHS resources.
 
I agree with @bulkbiker

You are on a diet that is very new to you, and one that isn't easy to balance vitamins and minerals.. I think it is very reasonable to ask for blood tests in 3 months. No need to see a nurse or GP if results are good. I would ask for the HbA1c, cholesterol and lipids, full blood count, liver & kidneys, and throw in some vitamin and mineral tests, especially B12 if on Metformin. When I was moved from my initial 3 monthly tests to 6 monthly I asked for an interim set of tests because I wanted to make sure my cholesterol breakdown was OK after increasing my fats. I was granted this without argument. It was a bit like a safety net for me, at the time. I wasn't a bit bothered about an HbA1c, and I'm still not.

All the usual antioxidants seem to be good for increasing HDL. (avocados, olive oil, strawberries, dark chocolate etc etc) and carbs are known to deplete it.
 
Thanks for everyone's support, real shame the NHS does not setup support groups for "none geeks" as most people are not happy using forums.

Vitamin and mineral tests are not standard for my CCG but I will make the case for B12 if I remain on Metformin long term, however as we eat lots of greens, I expect B12 is not an issue. Otherwise my GP wants the next set in 6 months, if she wanted them in 12 months, then I would be pushing to have them sooner.

I can't see myself changing my diet even if the HDL has not improved, BG I can monitor myself, everything is going in the right direction and I am not planning any changes to diet over the next year. I have chosen to eat LCHF in a way that both me and my wife is happy to eat for the rest of our lives - hence not losing weight. (Otherwise I would have to cook two meals, as she has CP and also works very long hours.)

The only change I am planning is a few more days when I skip breakfast and lunch with a 20 mile walk to see if I can lose some weight.
 
Resurgam said:
I use spices in my cookery, so I can't say from personal experience, but apparently turmeric/cumin and black pepper is supposed to be anti-inflammatory and good for joints which have become inflamed due to running on hard surfaces. Do be sure that your footwear is suitable for the high impact exercise - but maybe adding an extra shock absorbing innersole would be advisable for all your footwear.
When I had a damaged knee - due to an idiot in a car reversing in to me - I used walking poles all the time to reduce the possibility of falling but still getting the exercise. Actually having to use my arms all the time was a better exercise and it also increased how far, how fast and how long I could walk quite significantly.
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The issue I have is that if I try running much, then my knee does not like walking or swimming for the best part of a week, but I can walk 20 miles and my knee with be OK within half a day. Maybe I should get a bike in use, as I have not cycled since moving from Cambridge about 7 years ago, otherwise it will have to be swimming or a cross trainer at the gym to really get my hart working.
 
You do not get enough B12 necessarily from lots of greens. Especially with metformin.
The best source of B12 is actually eating foods that have been fortified with it. So if suddenly breads and cereal are depleted from diets then it can seriously deplete levels. Then you can get forgetful and low in mood and chronic fatigue.

Well worth getting tested. It is not wasting GPs funds.

I had tests two months ago for so many things... my GP was going to refer me on but forgot. So just had another 4 vials taken today, just 2 months later. Even wasting money on fasting glucose tests that really should not be done on a T1.. complete waste of money again!!

Hubby also gets his done every 3 months no problem for thyroid, full bloods and cholesterol no prob as docs know we are doing our best to avoid prescription drugs.

I'm also in process of organising private analysis
of my bloods for more detailed vitamin / onega 3/6/9 breakdown than nhs do.. doc says they will take for me no problem as he said it will save them money long term as they know I will adjyst my diet somehow.
 
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