Flirting with medication....

[Lainie71]

As the title says... I just wonder if I should take medication to get my levels down. At the moment I seem to be stuck in the 6s despite the exercise, diet and all the other stuff that goes with low carb.
I have learned that Metformin does not do a lot. Its just I am finding it really disheartening seeing others with levels in the 5s and lower and wonder if meds is the way. I cannot seem to get my morning levels down and I have to eat or they shoot up so fasting is hit and miss.. Its not my diet - at least I don't think it is. I am at a loss as to just whats going on in my body. Tried the Libre and had such weird and wonderful readings and an irritated sore arm I have given up. Today I had breakfast as I was starving. Was busy all day so just battled through and went past the stage of feeling hungry which is not uncommon for me. Checked my sugar level before dinner to at 4:30pm and it had hardly budged from the morning reading! Meds are not something I relish but I just don't know what else to do.

 

[MissMuffett]

I can understand the frustration as I’ve been the same but I think I’m so carb intolerant that I have to be extreme and eat less that 20g of carbs a day. Have you tried logging how many carbs you’re eating? What did you have for breakfast ? If you’re doing low carb correctly there’s no reason why you should feel starving. Full fat yogurt with berries (small handful). Or cheese omelette. Bacon and fried eggs. These are all good breakfast options that will fill you up and very little carbs so you won’t have a crash a couple of hours later.

 

[Antje77]

As the title says... I just wonder if I should take medication to get my levels down. At the moment I seem to be stuck in the 6s despite the exercise, diet and all the other stuff that goes with low carb.

I think your latest hba1c could be very relevant to this decision as well.
If you see numbers in the 6's all day, most days, you may well have an hba1c well under the diabetic range.

 

[Lainie71]

I can understand the frustration as I’ve been the same but I think I’m so carb intolerant that I have to be extreme and eat less that 20g of carbs a day. Have you tried logging how many carbs you’re eating? What did you have for breakfast ? If you’re doing low carb correctly there’s no reason why you should feel starving. Full fat yogurt with berries (small handful). Or cheese omelette. Bacon and fried eggs. These are all good breakfast options that will fill you up and very little carbs so you won’t have a crash a couple of hours later.

This morning I had a fried egg, an avocado and a cream tea. I also threw in 2 slices of top side beef. Lunch is mainly chicken breast with salads and generally meat/fish for dinner with salad or some kind of meat with a stir fry.

 

[Lainie71]

I think your latest hba1c could be very relevant to this decision as well.
If you see numbers in the 6's all day, most days, you may well have an hba1c well under the diabetic range.

You could have a point there perhaps I should just carry on as I am and have the hba1c. Libre was giving me such weirdly high readings I gave up on it and went back to the finger pricks. The finger readings were more in range 6s. The Libre was replaced 3 times and I just had enough of it, it was giving me levels of 10s -16 at one point and was playing havoc with my anxiety. Hubby was concerned as I was getting fanatical about it so I took the thing off mid morning today. Left a nasty irritated circle that is still hurting now. I have stuck some germolene on it

 

[MrsA2]

With the caveat that I am due an hba1c soon...
My morning levels, and more or less any other time I test, are usually 6s, sometimes 5s and some 7s.
If I eat carbs and test then it's higher (not surprisingly!) but my hba1cs are fine. I just try to tell myself that's the one that matters, finger pricks are too imprecise and variable (e.g.different results from different figures at same time). I can't see patterns like others seem to be able to e.g exercise, sleep etc, even with a Libre
So as long as hba1c stays in normal range I'm happy and try not to stress about the fingers pricks.
Hope this helps, and hoping I'm right!

 

[Oldvatr]

I am quite happy mixing a low carb diet with some medication. It allows me to include items that would normally be a poor choice, such as bread and root veg, This means I have a more relaxed approah to my condition, and this freeedom helps prevent me going down a rabbit hole and getting paranoid about numbers. For 7 years now my HbA1c has been below 48 and I am content with that, My GP however is not happy with it and has ordered me to bring it up to 56 since this is the new limit that NICE is recommending. NICE mayt be nice for him but their advice stinks IMO. I can achieve low levels without hypo;s and I have no weight issues.

 

[Deleted member 475901]

I am quite happy mixing a low carb diet with some medication. It allows me to include items that would normally be a poor choice, such as bread and root veg, This means I have a more relaxed approah to my condition, and this freeedom helps prevent me going down a rabbit hole and getting paranoid about numbers. For 7 years now my HbA1c has been below 48 and I am content with that, My GP however is not happy with it and has ordered me to bring it up to 56 since this is the new limit that NICE is recommending. NICE mayt be nice for him but their advice stinks IMO. I can achieve low levels without hypo;s and I have no weight issues.

I think this is the current NICE guidance "For adults whose type 2 diabetes is managed either by lifestyle and diet, or lifestyle and diet combined with a single drug not associated with hypoglycaemia, support them to aim for an HbA1c level of 48 mmol/mol (6.5%). For adults on a drug associated with hypoglycaemia, support them to aim for an HbA1c level of 53 mmol/mol (7.0%). "

Recommendations | Type 2 diabetes in adults: management | Guidance | NICE

www.nice.org.uk

 

[ianf0ster]

Hi @Lainie71
I tend to agree with @Antje77 Levels mostly in the 6's throughout the day with the occasional 7 is fine for a good HbA1C.
I still mostly get 6's and 7's when I test (which isn't more than a couple of times per month since in remission. I have fairly strong Dawn Phenomenon ( though not on Metformin - I have never taken any diabetes meds) so my Fasting BG is usually between 6.5 and 7.5. It used to be higher- the highest I remember was 8.0 back when I was still having breakfast, but a breakfast of 2 boiled eggs got it down to 7.5 pretty quickly.
How often are you testing? Could that be a part of the problem? That you get stressed about not seeing 5's so you test more often but because you are stressed that raises your BG levels a bit so making it less likely to see any 5's ?

 

[Oldvatr]

I think this is the current NICE guidance "For adults whose type 2 diabetes is managed either by lifestyle and diet, or lifestyle and diet combined with a single drug not associated with hypoglycaemia, support them to aim for an HbA1c level of 48 mmol/mol (6.5%). For adults on a drug associated with hypoglycaemia, support them to aim for an HbA1c level of 53 mmol/mol (7.0%). "

Recommendations | Type 2 diabetes in adults: management | Guidance | NICE

www.nice.org.uk

My CCG wot write the rules for all the local practices have interpreted it as 56%. I am on Gliclazide so that would make it applicable to me but I do not get hypos (except when I was dropping from max dose to min dose while counting carbs) Even then the hypos I did get were never debillitating and self corrected quite quickly.

 

[Lainie71]

Hi @Lainie71
I tend to agree with @Antje77 Levels mostly in the 6's throughout the day with the occasional 7 is fine for a good HbA1C.
I still mostly get 6's and 7's when I test (which isn't more than a couple of times per month since in remission. I have fairly strong Dawn Phenomenon ( though not on Metformin - I have never taken any diabetes meds) so my Fating BG is usually between 6.5 and 7.5. It used to be higher- the highest I remember was 8.0 back when I was still having breakfast, but a breakfast of 2 boiled eggs got it down to 7.5 pretty quickly.
How often are you testing? Could that be a part of the problem? That you get stressed about not seeing 5's so you test more often but because you are stressed that raises your BG levels a bit so making it less likely to see any 5's ?

Hia I am testing in the morning when I get up, that's generally in the 6s. I then test before lunch and around about tea time about 5-5pm. I think I am stressing to be honest. I would just like to be in the 5s and I am worrying about my hba1c that I am still having in Sept and not around my birthday. I am also stressing about later on what if I end up with all the complications of diabetes and have to take insulin etc its just all stressing me out. That's probably why I am not in the 5s - but it would be nice to wake up in the morning, take my fbg and it be a 5! Others are in the 5s why not me.

 

[MarkyP2022]

I'm on 3 metformin every tea time and each morning I'm in the 7,s testing but by tea time I'm round about 5.6 to 5.9. Just had my bloods done and down to 33. Nurse keeping me on metformin as good for protecting the heart

 

[Guilty]

Hia I am testing in the morning when I get up, that's generally in the 6s. I then test before lunch and around about tea time about 5-5pm. I think I am stressing to be honest. I would just like to be in the 5s and I am worrying about my hba1c that I am still having in Sept and not around my birthday. I am also stressing about later on what if I end up with all the complications of diabetes and have to take insulin etc its just all stressing me out. That's probably why I am not in the 5s - but it would be nice to wake up in the morning, take my fbg and it be a 5! Others are in the 5s why not me.

Hi @Lainie71 - I've done Metformin, Empagliflozin and Insulin. Diet definitely makes the biggest difference for me. But the meds do make a noticeable difference.

At the levels you are talking about, you may notice a slight improvement with Metformin. So if it's your choice, and the levels are causing you concern then why not try?

Personally though, I'd be happy with the levels you have. And stick to diet & lifestyle alone. Never had any side effects from Metformin but I got tired of the 'admin'. I'd go back on them if I was told to.