HbA1c 61

[johnoo]

That was the result I was told today.
I'm on medication to control, Metformin/Gliclazide.
Is now the time to start thinking about Insulin?

 

[bulkbiker]

Why?

Mine was 87 on diagnosis and I dumped metformin after 3 weeks.
Completely changed what I ate instead.

 

[johnoo]

Why?

Mine was 87 on diagnosis and I dumped metformin after 3 weeks.
Completely changed what I ate instead.

Because I could not stick to a low carb diet.
So would the Medics suggest insulin with a Hba1c of 61?

 

[lucylocket61]

Because I could not stick to a low carb diet.
So would the Medics suggest insulin with a Hba1c of 61?

I dont know, you would need to discuss it with your medical team. Could you perhaps make some small tweaks to your diet in some way, just to help the situation a bit?

If you feel comfortable with this idea, would you share what you found difficult about lowering your carbs, and maybe I can come up with some suggestions.

My brother is a T2 now on insulin, but his sugar levels were far higher than yours and he had been on gradually increased other diabetes meds for 10 years, so I think insulin may be something they consider later, if other meds dont work for you.

 

[TriciaWs]

Why did you find low carb too hard? If you let us know what you'd miss we may be able to help
I knew it could be challenging but spent time thinking about the foods I would find difficult to give up and found suitable substitutes for most of them, and then I also bought some of the foods I'd avoided for decades once I knew I could eat double cream, cheeses, full fat milk, bacon, etc.
This week I have a fake crumble, filled with blackberries, to have with cream, last week I made a lemon cake with ground almonds instead of flour and sweetened with erythritol.
Pre covid I'd ask for subs with meals out eg have chicken burgers without the bun, take a small portion of cheese or nuts to nibble on if needed, take home made sugar free choc mousse for dessert at friends homes, ...
.

 

[KK123]

That was the result I was told today.
I'm on medication to control, Metformin/Gliclazide.
Is now the time to start thinking about Insulin?

Hi there, you probably know this already and if you need it you need it, but it's certainly no picnic. Irrespective of how injected insulin may affect a person (type 2 in your case) that already produces plenty, I would just say to think very carefully how this will affect your life. Whether it's when driving, or at work, or life insurance or the myriad of actions that come from being on it, it's a life changer. You cannot afford to let your guard down, it pretty much influences everything you do, how to inject, what to inject, when to inject, how to factor in exercise or going for a walk. What to eat, how much to eat, when to eat, and if you think it's a question of it meaning you can eat what you want, well maybe in theory, but in reality it's very difficult. You are probably producing plenty of your own insulin so in a manner similar to a honeymoon period, that could kick in at any time adding a whole new level of chaos. Please don't think I'm criticising in any way, and of course plenty of type 2s do go onto insulin for a variety of reasons. I don't want to sound as if I am a miserable type 1 either, it's just that if I had a choice as it were, I would prefer to do it by diet only, (again, I know that's not possible for every type 2 by any means). Did I mention the hypos, the hypers, the devastating effect of them, the worry that you might suddenly have one and fall to the ground. Just some things to think about before making your choice.

 

[johnoo]

KK, that is my problem, I realise going onto Insulin could be dramatic & have many aspects that impact life to a negative degree.
Your words sum up my fears!!
But what level of Hba1c is the point where Insulin is suggested?

 

[ianpspurs]

Hi there, you probably know this already and if you need it you need it, but it's certainly no picnic. Irrespective of how injected insulin may affect a person (type 2 in your case) that already produces plenty, I would just say to think very carefully how this will affect your life. Whether it's when driving, or at work, or life insurance or the myriad of actions that come from being on it, it's a life changer. You cannot afford to let your guard down, it pretty much influences everything you do, how to inject, what to inject, when to inject, how to factor in exercise or going for a walk. What to eat, how much to eat, when to eat, and if you think it's a question of it meaning you can eat what you want, well maybe in theory, but in reality it's very difficult. You are probably producing plenty of your own insulin so in a manner similar to a honeymoon period, that could kick in at any time adding a whole new level of chaos. Please don't think I'm criticising in any way, and of course plenty of type 2s do go onto insulin for a variety of reasons. I don't want to sound as if I am a miserable type 1 either, it's just that if I had a choice as it were, I would prefer to do it by diet only, (again, I know that's not possible for every type 2 by any means). Did I mention the hypos, the hypers, the devastating effect of them, the worry that you might suddenly have one and fall to the ground. Just some things to think about before making your choice.

@KK123 wow what a powerful and moving post. I have a love hate relationship with LC despite being "in remission" - diet only for 6 years - I find it "challenging" to put it mildly - see my signature. Reading that is enough motivation to live with it for as long as possible. You - and all on insulin- have my total admiration and sincere thanks for that post. @johnoo I'd work on a way to stick on LC after reading that. I started at 61 in June 2015 - down to normal in 3 months.

 

[Resurgam]

KK, that is my problem, I realise going onto Insulin could be dramatic & have many aspects that impact life to a negative degree.
Your words sum up my fears!!
But what level of Hba1c is the point where Insulin is suggested?

There isn't one - if you don't need extra insulin then there is no point injecting it.

 

[johnoo]

Don't get it, there must be some point where the Medics say- it's Insulin for you as tablets/diet are not working.
So from the experts, what is this point Hba1C 61?

 

[zand]

Hi there, you probably know this already and if you need it you need it, but it's certainly no picnic. Irrespective of how injected insulin may affect a person (type 2 in your case) that already produces plenty, I would just say to think very carefully how this will affect your life. Whether it's when driving, or at work, or life insurance or the myriad of actions that come from being on it, it's a life changer. You cannot afford to let your guard down, it pretty much influences everything you do, how to inject, what to inject, when to inject, how to factor in exercise or going for a walk. What to eat, how much to eat, when to eat, and if you think it's a question of it meaning you can eat what you want, well maybe in theory, but in reality it's very difficult. You are probably producing plenty of your own insulin so in a manner similar to a honeymoon period, that could kick in at any time adding a whole new level of chaos. Please don't think I'm criticising in any way, and of course plenty of type 2s do go onto insulin for a variety of reasons. I don't want to sound as if I am a miserable type 1 either, it's just that if I had a choice as it were, I would prefer to do it by diet only, (again, I know that's not possible for every type 2 by any means). Did I mention the hypos, the hypers, the devastating effect of them, the worry that you might suddenly have one and fall to the ground. Just some things to think about before making your choice.

One of the best posts I have ever read. Thank you.

 

[ianpspurs]

One of the best posts I have ever read. Thank you.

I echo that - brilliant post.

 

[lucylocket61]

Don't get it, there must be some point where the Medics say- it's Insulin for you as tablets/diet are not working.
So from the experts, what is this point Hba1C 61?

Are you in the UK? What meds have you tried, how long have you been diagnosed?

Do you want to go on insulin, or are you seeking information so you can avoid it if possible? Type 2 diabetes control is a long term thing.

 

[lucylocket61]

Don't get it, there must be some point where the Medics say- it's Insulin for you as tablets/diet are not working.
So from the experts, what is this point Hba1C 61?

Just realized, are you still on chemo?

 

[LittleGreyCat]

I used to cycle with someone who at the time was recently diagnosed T2.
He was, um, robustly built.
He decided that he would go straight onto insulin.
He reasoned that he was a numbers person, and he could just check his BG and decide how much insulin to inject.
No change in what he ate.

Sadly, a few years later that didn't seem to be working for him.

I would personally only go onto insulin if I wasn't producing enough of my own whatever I did.

Eating low carbohydrate is a tough call emotionally but I think it is best for my long term health.

 

[ianf0ster]

Don't get it, there must be some point where the Medics say- it's Insulin for you as tablets/diet are not working.
So from the experts, what is this point Hba1C 61?

There is no set level. Doctors vary considerably as to what they prescribe for Type 2 and when they prescribe it (which HbA1C threshold).
Many allow all on an HbA1C under 60 up to 3 months grace to try Diet and Lifestyle, but some prescribe Metfomin and Gliclazide straight away for people on levels as low as the 50.
I've never heard of Insulin being prescribed until it's more than obvious that tablets or other less dangerous (thinking of Hypos) medication has failed.

 

[JoKalsbeek]

That was the result I was told today.
I'm on medication to control, Metformin/Gliclazide.
Is now the time to start thinking about Insulin?

Insulin is a rather big step, as has been quite eloquently put... I don't think it's the absolute next stop as there are other medications and combinations thereof out there, but if you want to go over your meals with us and explain what exactly it is about low carb you find too big of a hurdle...? Maybe there's work-arounds or solutions you hadn't thought of yet. (Like low carb bread, wraps, celeriac or cauliflower rice instead of spuds and rice...) Your HbA1c isn't shockingly high, maybe just a few changes would work rather than doing anything so drastic as starting injections. As T2, the likelihood of insulin insensitivity is great.... So you'd likely need ever increasing amounts of insulin. Which then in turn would do nothing to help alleviate that insensitivity. I don't know what the cut-off point is for starting injections, but I'd give other meds and maybe a diet tweak a chance before going down that road.

Good luck eh, and if there's anything we can help with...

 

[DEBBIESCOTT]

Hi there, you probably know this already and if you need it you need it, but it's certainly no picnic. Irrespective of how injected insulin may affect a person (type 2 in your case) that already produces plenty, I would just say to think very carefully how this will affect your life. Whether it's when driving, or at work, or life insurance or the myriad of actions that come from being on it, it's a life changer. You cannot afford to let your guard down, it pretty much influences everything you do, how to inject, what to inject, when to inject, how to factor in exercise or going for a walk. What to eat, how much to eat, when to eat, and if you think it's a question of it meaning you can eat what you want, well maybe in theory, but in reality it's very difficult. You are probably producing plenty of your own insulin so in a manner similar to a honeymoon period, that could kick in at any time adding a whole new level of chaos. Please don't think I'm criticising in any way, and of course plenty of type 2s do go onto insulin for a variety of reasons. I don't want to sound as if I am a miserable type 1 either, it's just that if I had a choice as it were, I would prefer to do it by diet only, (again, I know that's not possible for every type 2 by any means). Did I mention the hypos, the hypers, the devastating effect of them, the worry that you might suddenly have one and fall to the ground. Just some things to think about before making your choice.

Thank you for writing this, never realised how hard you type 1’s have it, it’s made me more determined to stick to less than 20g carbs a day. Hope you don’t mind I’ve taken a screenshot of it just so I can read it again & again if I ever feel like having anything I shouldn’t

 

[becca59]

@KK123 so so true! The irony is @johnoo that many many Type 1s low carb too just to make their control easier. Without insulin I would ultimately die. If I could just change what I ate to avoid it I would do it in a heartbeat. It rules your life and can at times be very depressing.