HB1AC Now under better control - what next?

[Prince4]

My HBA1C was as high in 96 in Feb, I tested last week and got it down to 44. I was prescribed Metformin from Feb and much to my Nurse Dismay, I refused to take it since march and have cupboards full of them given I didn't want any side effects and wanted to rely on low Carbs diet . However, over the last 6 weeks or so I must admit that I have reintroduced Carbs back in my diet and test by blood and find that for the most part I am able to keep bloods in the 6's but sometimes creeps to 10.0 if I go crazy which is rare. I still refuse to eat or drink added sugar like before. . Technically I am Prediabetic and the lowest it was been in around 15 years. Importantly I have been able to run 6 miles several times a week etc.

The question is, is it worth taking Metform to try and assist getting into the 30's as I imagine it will be tougher lowering it still? Also am I close to being "fixed"now that I can tolerate carbs. I am still pretty heavy despite some weight loss.

I have follow up with Diabetes Nurse on Monday but to be honest not sure how up to date there training is, as she wanted me to be on Metformin (2000mg a day ) from the outset.

 

[Diggers64]

My reply may not chime with many so I’m aware of that. I’m type 2 and found medical advice of limited value in my diabetic challenge.

I recently bought a cgm (I was advised against) and monitor it constantly. I’ve tested my body against single food items after fasting and when mixed with other foods. Sourdough bread caused a modest spike but when eaten toasted with mushrooms on top and side salad made marginal difference (I was advised not to eat bread except occasionally - clearly it’s not that straightforward ). I’m learning about my body and it’s not like yours. We can eat the same and different effect. I fast (advised against but actually it’s fine) and eat in a 10 hour window (again…advised against). Dropped from 8% to 6% in about 2 weeks (estimated by the cgm).

Take control and take responsibility is my motto now. I’m learning that the medical profession has limitations.

 

[Pipp]

@Prince4 , Regarding Metformin, if you haven’t needed it so far, and have been successful in reducing weight and HbA1c, (well done for that) then why do you think you need it now?
Something that alarms me, and sorry to be the bearer of bad news.. If you regard yourself as being “close to being fixed” do you really want to ‘break yourself’ again by increasing carbs to the extent that you will undo all your good work?
Low carb lifestyle is surely a better for life way of eating. Metformin won’t make much difference at all.

 

[catinahat]

Also am I close to being "fixed"now that I can tolerate carbs

I think this is a trap many of us fall into, I have a feeling that the simple truth is that for the majority of us there is no fix.
We limit carbs, lower our Hba1c and lose weight, are we fixed or just well controlled?
Encouraged by our success we relax a little, let a few extra carbs back in, why not we deserve it after all our hard work.
Carbs are addictive, a few extra carbs once in a while becomes a few more. Once in a while becomes several times a week. It's so common and we have seen it so many times over the years, there's even a name for it, carb creep.
In the title of your post you ask "what next" personally I think it depends on what you do, if you continue to allow extra carbs and occasionally going "crazy" with levels up to 10, I can only see a steady rise in your Hba1c .
If on the other hand you resume the diet that got you down to pre diabetic levels, the likelihood is that you will stay there

 

[MissMuffett]

Well done for reducing your hba1c, that’s brilliant. But like @catinahat says carbs are addictive and introducing more could mean your hba1c heading back up and that would be a great shame as you’ve done so well so far. If you used to be a drug addict and in remission you wouldn’t reintroduce heroin occasionally! It’s a lifestyle and time to get creative with food and recipes. I’m a lazy cook but I have found a low carb version for almost recipe on YouTube. Keep up the good work

 

[ajbod]

I would say not now under control, but currently under control. Your system has had a holiday away from elevated Insulin levels, this has allowed an improvement in Insulin sensitivity. So the small increase in carbs is well tolerated FOR NOW. But it is a very slippery slope that you have climbed up, and reintroducing carbs, is flirting with the danger of slipping back down as you are teetering on the edge. Please be very careful, you've done so much good work, it would be a shame to undo it now.
Keep with the low carb, if done properly your weight will drop, and with it most likely your Hba1c.

 

[stuffedolive]

Your 'signature' says you are , 'insulin-dependent T2'. So I assume you are already taking medication?
Good luck with the continued weight-loss, Best thing you can do IMHO. Staying off carbs will help with that.
Good luck

 

[Robbity]

I very much agree with other posters - actually reaching your target is simply the start of your long term low carb journey - now you're getting there it's a matter of "keep on doing what you've been doing" to be able to stay there. In the process you're discovering how many carbs you are able to tolerate not that you can scoff more of them with gay abandon and end up undoing all your good work so far.

 

[KitSileya]

I think this is a trap many of us fall into, I have a feeling that the simple truth is that for the majority of us there is no fix.
We limit carbs, lower our Hba1c and lose weight, are we fixed or just well controlled?
Encouraged by our success we relax a little, let a few extra carbs back in, why not we deserve it after all our hard work.
Carbs are addictive, a few extra carbs once in a while becomes a few more. Once in a while becomes several times a week. It's so common and we have seen it so many times over the years, there's even a name for it, carb creep.
In the title of your post you ask "what next" personally I think it depends on what you do, if you continue to allow extra carbs and occasionally going "crazy" with levels up to 10, I can only see a steady rise in your Hba1c .
If on the other hand you resume the diet that got you down to pre diabetic levels, the likelihood is that you will stay there

I think that is a very good point. I am trying to switch my mindset to see carbs as something my body doesn't tolerate, just like shellfish. The difference being, of course, that shellfish, and by extension seafood, no longer seems enticing - after throwing up enough seafood dishes because they forget to mention the fish has been poached in shellfish broth etc, even the smell of seafood puts me off. I have had no such viscerally unpleasant experiences with carbohydrates, so it is eternally tempting to think of crusty bread, crunchy roast potatoes and the like. So a mental adjustment is needed, otherwise, I will end up where I was last year again.

It does seem like most cultures have a belief that carbohydrates are necessary for well-being firmly entrenched in their view of food. Be that potatoes (my grandfather insisted on having potatoes served with pasta dishes, because it wasn't a proper dinner without potatoes) or rice for every meal, carbohydrates in the form of starches are seen as the only proper part of a meal. Anything else can be taken away - meat, fat, protein, even vegetables, but if there isn't bread, rice, pasta, potatoes, it isn't a meal. This cultural brainwashing makes it so much more difficult to cut down on carbs, and makes it so easy to 'slippery-slope' carbs back into every meal.

 

[Mallyman]

Although I agree with you to some level, many people are forever chasing carbs and not thinking of the micronutrient; many of which are borne out of carb containing foodstuffs. How many actually see these blood results. Or check the micronutrients in preparing a meal. After 11.5 years dialysis and 5 years transplanted, I learned a very important lesson. Depression in illness can set in when we become obsessed and overly compliant. I did that with dialysis. I had to watch Potassium and Phosphates. I tried to cut them out completely and made myself both ill and depressed. The advice was controlled sin. Whilst being careful to understand the level of that sin.

Some people actually have a strong willpower. Do not assume everyone will go off the rails. Personally I look for my treats then have a balancing mechanism, ie pre or post fasting or sport. I worked hard this week. I had some ice cream yesterday. I did sport before and after it and my BG never strayed over 130. I went to a party, ate some pizza. Today I did sport. I ate 22 Carbs at breakfast on a FBG of 109. I did sport afterwards. To do the sport and ensure a variety of bodily needs I prefer to take in those carbs needed that answers those micronutrients than turning to metformin or other drugs. I was 114mg after 2.5 hours. It can be done. Hence I also have a strong heart, only 5% Arteriosclerosis and a very strong lung function. Not bad for over 60.

 

[JenniferM55]

Maybe I'm OTT but I know from old that I can't be trusted with indulging in carbs. I've often seen movies where the alcoholic has an unopened bottle of whisky on the shelf, and I couldn't understand why that was keeping him strongly 'on the wagon'. I understand now, we've a glass Kilner biscuit barrel on our kitchen worktop and I'm afraid I delight in stocking it with all sorts of biscuits for my husband who luckily doesn't have a carb problem. I often take the jar lid off and reach for a couple of biscuits to give him when I make him a cup of tea. Abstaining is keeping me rigid and strong. There's no biscuit on earth that tastes so good that it's worth me breaking my resolve. We're all different, and I haven't always been strong enough to abstain. A couple of new potatoes here, and a piece of apple pie there, would quickly lead to me burying my head in the sand again.

 

[KennyA]

My HBA1C was as high in 96 in Feb, I tested last week and got it down to 44. I was prescribed Metformin from Feb and much to my Nurse Dismay, I refused to take it since march and have cupboards full of them given I didn't want any side effects and wanted to rely on low Carbs diet . However, over the last 6 weeks or so I must admit that I have reintroduced Carbs back in my diet and test by blood and find that for the most part I am able to keep bloods in the 6's but sometimes creeps to 10.0 if I go crazy which is rare. I still refuse to eat or drink added sugar like before. . Technically I am Prediabetic and the lowest it was been in around 15 years. Importantly I have been able to run 6 miles several times a week etc.

The question is, is it worth taking Metform to try and assist getting into the 30's as I imagine it will be tougher lowering it still? Also am I close to being "fixed"now that I can tolerate carbs. I am still pretty heavy despite some weight loss.

I have follow up with Diabetes Nurse on Monday but to be honest not sure how up to date there training is, as she wanted me to be on Metformin (2000mg a day ) from the outset.

I'm not sure that we're ever "fixed". I've been in remission for three years now and my insulin sensitivity has improved a little.

The problem is that I've demonstrated once already that eating a "normal" carb-rich diet will give me diabetes, raised BG, neuropathy etc. I have no evidence to suggest that eating more carbs again won't have the same result. I'm diabetic and I probably always will be. I can do a lot to avoid the worst consequences, though.

Are you being honest with yourself? - you say (about the last six weeks) "for the most part I am able to keep bloods in the 6's" and that it "sometimes creeps to 10". That is you seeing the immediate impact of the carbs in your current diet. Eat more, and the numbers should rise. Whether you choose to eat carb or not is, of course, entirely up to you.

Metformin doesn't lower blood sugar. It prevents the liver topping your blood glucose up. If you've had such success with low carb, why not continue?

 

[Ricmel]

Also am I close to being "fixed"now that I can tolerate carbs. I am still pretty heavy despite some weight loss.

I have follow up with Diabetes Nurse on Monday but to be honest not sure how up to date there training is, as she wanted me to be on Metformin (2000mg a day ) from the outset.

I was diagnosed T2 3 years ago with HbA1c at 111. I got that down really quickly (3 months) to 41 and then 37 and then 35. This was mainly weight loss and low carb. I then relaxed a bit and tested a few carby foods and my next reading came in at 47.

That was about the 18 month mark. Since then I have focused on weight and resistance training and building muscle (I'm now 62 so it takes work). For me it has been the single most impactful action I have taken against high BS. Now I find I can tolerate carbs to an extent. I eat on average 100-120gms of carbs per day and my HbA1c has been steady at 33-35 last 18 months.

I know it is just one example and everyone is different but for me, shifting my body composition from 31.5% fat to 21% and building muscle has meant my dietary changes have not had to be as drastic.

 

[0110]

I was diagnosed T2 3 years ago with HbA1c at 111. I got that down really quickly (3 months) to 41 and then 37 and then 35. This was mainly weight loss and low carb. I then relaxed a bit and tested a few carby foods and my next reading came in at 47.

That was about the 18 month mark. Since then I have focused on weight and resistance training and building muscle (I'm now 62 so it takes work). For me it has been the single most impactful action I have taken against high BS. Now I find I can tolerate carbs to an extent. I eat on average 100-120gms of carbs per day and my HbA1c has been steady at 33-35 last 18 months.

I know it is just one example and everyone is different but for me, shifting my body composition from 31.5% fat to 21% and building muscle has meant my dietary changes have not had to be as drastic.

Awesome post and very inspirational.

Being a T2 diagnosed this March @82 two months later it was @30 and 4 months latter it was @42 MMOL.

Please explain your exercise regime as I have started gym as well, I do a mixture of weight lifting 40 minutes and usually finish off with 20 minute cardio around 3 times a week although I need to increase to 4-5 sessions

 

[Ricmel]

Awesome post and very inspirational.

Being a T2 diagnosed this March @82 two months later it was @30 and 4 months latter it was @42 MMOL.

Please explain your exercise regime as I have started gym as well, I do a mixture of weight lifting 40 minutes and usually finish off with 20 minute cardio around 3 times a week although I need to increase to 4-5 sessions

I don’t do anything out of the ordinary. 3 weight sessions per week, I try and focus on compound exercises and no more than 60 minutes. I keep my diet pretty healthy and walk and swim 3 or 4 days a week.

Weight training takes time. Start slow and steady and build as you get stronger.