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Hba1c of 7.2 - Medication Necessary?

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ozzie7

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My Hba1c level in January this year was 7.2 and my GP prescribed metformin. I tried the regular for 1 month, had to come off due to digestive problems, then tried slow release but after 2 months it too seemed to neutralise my digestion and I felt pretty awful; in fact my blood sugar readings worsened, and I came off, with an initial IMPROVEMENT in levels. In my July test, after 3 months of no medication, reading was again 7.2 but my doctor still wants me to medicate, and suggests sitagliptin. I am reluctant to try something that is also reported to give digestive problems. I have had mild digestive problems most of my life, now 54.
However am fully aware of the dangers of diabetes. Is 7.2 a level at which I need to medicate, or can it be postponed? I did feel that the digestive problems seemed to make me sufficiently ill that the cure was as bad or worse than the diabetes, but I am of course just not sure. My GP is even suggesting insulin, but surely 7.2 is too low a level to justify that?
I was first diagnosed pre-diabetic 8 years ago and lost a lot of weight giving 2 years of perfect non-diabetic results, and a "you are not diabetic" from my GP, but although have kept most of weight off it seems to have eventually caught up with me.
 
Welcome to the forum,Ozzie. What sort of diet do you follow? it is possible to control diabetes by diet only but requires cutting back on a lot of foods that you may well enjoy!
 
I was diagnosed earlier this year with an HbA1c of 7.8% in March.

That was down to 7% at the end of May after eliminating all added sugar, sweet treats, most crisps and junk food and by adding a lot more fresh and raw. I was trying to follow a low glyceamic index diet at that point.

After the last Hba1c I went low carb, eliminating bread, pasta, rice, potatoes and anything obviously starchy and testing my blood several times a day with the aim of lowering it.

While the blood work that has been done has shown a general improvement in my numbers my GP would still like me to take the tablets, but I have refused so far. I'm aiming to bring it down by diet alone and based on my meter reading average and the conversion tool on the website I hope to be closer to 6% when I get my HbA1c done again at the end of the month. However, I'm now considering taking metformin as it will help me to get where I want to be a bit quicker, I think.

Interestingly, since I dropped the starchy carbohydrates both the heartburn I used to get and the mild acid reflux I had are gone, along with the fatigue and the headaches and fuzzyheadedness.

Looking at your diet would help a lot and whatever dietary apporach you take, a succesful diabetic reduces their carbohydrate intake.
 
Spiral,
interested to read your post re reflux and heartburn, I used to have terrible acid reflux, would wake up in the choking! I wasn't at all overweight and didn't eat too much, but after drastically cutting down my carbs I no longer suffer at all, bliss! I can drink wine, eat really spicy food and curries nothing at all.
It is just the first time I have read on this forum of anyone else having this problem alleviated by cutting down carbs.
 
Neither was a serious problem, but I am aware that it was getting worse over the last couple of years, and it wasn't until a couple of weeks ago, when I found some of the antacid tablets hiding at the bottom of a drawer that I realised how long it had been since I'd needed to use them.

I do have masses of weight to lose and I am a "work in progress".

Good luck with whatever you decide to do - today is my last day here as I'm about to go on holiday. Welcome aboard, lots of great advice here. It certainly helped me turn my diabetes around.
 
sugarless sue said:
Welcome to the forum,Ozzie. What sort of diet do you follow? it is possible to control diabetes by diet only but requires cutting back on a lot of foods that you may well enjoy!
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Thankyou, Sue, and I suppose you have hit the nail on the head there. From when I was diagnsed pre-diabetic 8 years ago, I eat "little and often", no big meals, don't have a frying pan in the house, eat potatoes in any form rarely, and eat a lot of fish/chicken, some vegetables every day, plus a little fruit (never keen) BUT my downfall would be cakes. For a while I managed with sugarless scones, but lately cakes have crept back in, and some plain chocolate, the odd biscuit, flapjack. I have 4-6 slices wholemeal bread a day.
I find as I get older I am such a creature of habit, and clearly addicted to carbohydrates to some degree, that I wonder if I do need medication now.
Even so, I wonder if the diabetic nurse was wrong to be sugesting insulin at my stage.
I also have a habit of eating a snack with TV (usually toast/jam + cheese) about 10.30/11 every night. Tonight am going without!
 
Personally i do not see the need for insulin at this stage,I would not accept that!
If you can reduce the amount of carbs that you eat then potentially you could reduce your daily blood sugars and your overall hba1c.
Try the Collins Gem carb counter book,cost s about a £5, and see what you can have for snacks that does not involve carbs but will satisfy you and stop you nibbling. Once you cut down carbs you actually stop craving them!!(it's true! :D ) Late night snack,well the cheese is good but not the toast!!
 
You have a fairly straightforward choice to make Ozzie.
7.2% HbA1c is a certain sign that your blood glucose is significantly elevated. That will cause you harm in all the typical ways over time. The question therefore is how to reduce it to a healthier level?

Insulin would do it of course, but is really treating the symptoms, not the cause. The cause I'm afraid is probably the carbohydrate in your diet. A scone, (low sugar?) is almost entirely a simple starch which your body turns to glucose very quickly. There's no such thing as a low sugar scone in other words.

Just as Spiral is doing, ditch the empty starches, the cakes, the scones, the biscuits and the bread.
Then your blood glucose will begin to fall to a better level and you'll feel better too. Believe me, it's a much better deal than a lifetime of insulin injections!

fergus
 
sugarless sue said:
it is possible to control diabetes by diet only but requires cutting back on a lot of foods that you may well enjoy!
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Would this true in all cases of diabetes Sue?



..
 
Ok Sue thanks for qualifying that
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And as a steroid induced diabetic I had to go straight onto insulin and I am pretty sure that even if I completely eliminated the meagre 90g of carbs a day I eat I couldn't reduce the ave 32units of insulin I take to zero. So its not just Type 1's....

I would be as surprised as you if ozzie7 needed to start on insulin with an HB A1c of 7.2

ozzie7, could your doctor be so unsympathetic to your digestive problems that he/she is threatening insulin because they cant be bothered to explore other alternatives, Byetta etc?

Just a thought...
 
Hi Sid.

just thought I would further qualify things.
Steroid Induced Diabetes. Treatment.
Depending on the severity this will be the same as for other types of diabetes, either by diet, oral medication or insulin.

For most people the good news is that once they reduce or stop the steroids the problem will go away. They have also received the warning that they have an 'at risk' pancreas and can act upon that knowledge.

However in some unfortunate people the beta cells of the pancreas have been destroyed to the point where there are not enough left and they now have diabetes for life and need injected insulin.


So Sid you are one of the unfortunate ones that had to go straight onto Insulin. Others can manage with diet providing it isn't severe.

Ken.
 
I guess its all about degrees Ken, I am currently reducing my steroid use, in fact I am down to just 3mg per day, reducing at 1mg per month. As yet it has made no difference to my insulin use, shame really as I had hoped it would. Still there are many people much worse off than me so I cant grumble :)
 
Hi Sid.

Do you know if you get off the steroids will you be able to get off the Insulin ? More to the point were you ever told before having steroids what could happen ?

Ken
 
Hi Ken, yes I was well aware of the side effects of corticosteroid treatment although there is always an element of it will never happen to me :D I do now wish that I had had more frequent blood tests done, once a year was clearly not enough, but without the steroids I wouldn't be here. I was in intensive care with acute respiratory failure, intubated for 6 days and given Ketamine every 3 hours to keep me sedated, they ran out of Ketamine three times :lol:

That is where the steroid treatment started 2 1/2 years ago, first it was 300mg a day intravenously :shock: along with an intravenous drip of insulin. The steroid was then reduced to 100mg a day orally, which my consultant was alarmed about and instantly reduced it to 40mg a day and stopped the insulin, then after about a month the steroid was reduced slowly down to a maintenance dose of 5mg a day. And it is that maintenance dose that I remained on until a couple of months ago when it was reduced 1mg per month.

I am now on 3mg and the 2mg I have reduced since being on insulin has made no difference to the insulin I have been using and I doubt that the next 3mg will make a significant change either. Too little too late I guess, but as I said earlier, without it I wouldn't have walked out of the ICU.

What upsets me most is when I read about peoples "diabetes teams", my team consists of a very knowledgeable hospital diabetes nurse who spent about 3 hours talking me through diabetes, talking insulin, diets and lifestyle changes and then promptly it seems forgot about me, my GP who, bless him, is very good but not too clued up about diabetes and the practice diabetic nurse who admitted to me that she didn't know much about insulin!!!
headbang.gif
Pretty much everything I have learned about diabetes since my diagnosis in March I have learned through the books I have read, the web pages I have trawled through and this and a couple of other forums. Oh how I would love to have a "team" all clued up and working for the common good of their patient, me :roll:

Sorry for rambling on and hijacking this thread :oops:
 
Hi Sid.

You have not hijacked the thread at all. Thanks very much for all the information.

It is clear that without the steroids you wouldn't be around ? Like you, I think i would rather be a walking, breathing Diabetic than 'pushing up daisies ?' I presume it must be a challenge to keep the Bg levels stable because of the ongoing treatment ?

As for your ' Diabetes Team' comment. I know exactly what you mean. I too despair at some of the things that people are told by GP's and Nurses. It just makes you wonder what sort, if any, training in Diabetes these people are getting, if that is the right word ?

I'm fortunate that my team are at a local Diabetic Clinic and they ARE experts. My GP, great bloke that he is actually told me that I know more about Diabetes and other areas of stuff than he does. That man has my respect for admitting it. The Practice Nurse is lovely, but she too doesn't bother me any more. She just tickles peoples feet with a wire, takes their BP and checks the BG levels then sends off a blood sample for the routine HbA1c tests. Then hands out leaflets about diet, which for me personally are poison.

I know your diet is different Sid. Whatever works for us both has to be good ?

I am glad that this forum along with others has contributed to your knowledge and hope it will continue to do so for many years to come. Good luck to you Sid.

Ken.
 
Can I suggest you try taking Vitamin B1 initially as a high does normal b1 supplement 100mg tablets are very cheap , if this doesn't have any effect on your blood sugar try Benfotiamine see viewtopic.php?f=1&t=9454 for why I take it , Cugila said Benfotiamine did nothing for his BG levels BUT it does for mine

I was diagnosed as having type 2 recently my BG on a Glucose tolerance test was 12.6 , , I immediately started Benfotiamine as soon as I knew , when I later had a blood test and an HbA1c it was 6.2 !
 
Soundgen ,Benfotiamine is not the 'magic bullet'!! It may or may not work for some people.if members want to try it then that is their choice. You mention it so often in your posts that you are in danger of being banned for spamming the forums.Please try and remember that we try and give an all round balanced view of diabetes on this forum ,not just one aspect.
 
Soundgen ,Benfotiamine is not the 'magic bullet'!! It may or may not work for some people.if members want to try it then that is their choice. You mention it so often in your posts that you are in danger of being banned for spamming the forums.Please try and remember that we try and give an all round balanced view of diabetes on this forum ,not just one aspect.
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Hello sue thanks for the message , i am not spamming though , I have no pecuniary interest in benfotiamine , I am newly diagnosed with diabetes and only took it becuase of BBC reports I read last year ( before being diagnosed ) , I took it because of the article referring to the lack of B1 in diabetics causing the major complications , only since taking it and measuring my BG have I seen that it cuts my BG level , Cugila says it doesn't alter his , why should vitaminn B1 have this effect on mine and not his ? does anyone know ? Somone posted earlier on this thread that it was prescribed for all diabetics in Germany , how can this be verified and are there any outcomes for diabetics in Germany that are better than here? does anyone speak /read German and can search German websites for some answers ?

I agree entirely with what you say about forum members choice to use B1 in any form or not , and that also about giving an all round balance is important . but forum members can't make a choice if they don't know about something can they ? how many forum members are there , only 500 have looked at the Benfotaimine thread , what % is that ?
 
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