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HbA1c result

Hi - thanks for the tag @Lupf

That's an amazing reduction. Well done.

The thing about metformin is that it has zero impact on carb/glucose in your food or bloodstream. What it does is stop your liver making glucose when it thinks you need it. Modern science knows it does this, but how it does this "isn't fully understood" (Bilous and Donnelly Handbook of Diabetes). What that means in practice is that often people find that their BG (HbA1c) will rise a little if they stop taking metformin because the liver will try to push BG levels up to where it thinks they should be - and that might be quite a bit higher than where you currently are.

I have no personal experience of this myself (never having taken any medication) but I do wonder if building up a bit of "experience" at the normal BG level might make the liver less inclined to try to raise levels if/when metformin is stopped.

I would disagree with the nurse about crisps. They're potato - and about 70% carb. I know they're only 13-14g carb a (small) bag but personally one bag is never enough and two is too many. Bear in mind that I aim for around 20g carb/day total, so one bag is nearly a full day ration. I also don't go near bread at all, for much the same reason. I do buy low carb rolls and bagels at about 3g carb each, which you definitely aren't going to be fooled into thinking are "real bread" but do allow for bacon sandwiches etc.

Is it sustainable? I'm over five years in, and if anything it's got much easier as time has passed. My BG was normal within four months of starting low carb, and in the years following I have lost around six stone (not entirely sure where I was when I started, some estimates in sig block). I can say I've never been hungry in that time, but then I eat a lot of fat with my protein.

I eat meat (all kinds) fish, dairy (cream, cheese etc, but not milk) green vegetables (I think my carb intake is all from veg) and in smaller quantities pulses/legumes - which seems to have no impact on my BG. Low carb beer, red wine, spirits, and a lot of coffee. None of the things that are normally used to bulk up meals - eg pasta, bread, pastry, potatoes, rice, and nothing sugary, including most fruit (berries an occasional exception).

After I'd lost enough weight I went back to playing football again and while I'm still losing size/bodyfat (much more slowly than in 2022/3) I am gaining a bit of weight which is clearly due to new muscle. I'm not bothered by that because the weight itself doesn't matter, it's the bodyfat, and especially visceral bodyfat, that I want/need to avoid.

Does that help?
 
Thanks to all of you for your responses. It's a lot to think about, but I will start looking into to it all. To be honest, I sort of buried my head in the sand a bit but did make big changes. I was originally 20 stones and had already got that down to 14 stones thanks to my wife who went on a bit of a health kick for both of us and still made delicious food but a lot better for us. Unfortunately once I was diagnosed our marriage changed a lot - I sort of understood as her father was very ill before he died. He had all sorts of things wrong with him including diabetes but wouldn't make any changes to his lifestyle at all, became very ill and died quite a horrible death. I loved him very much, he was a larger than life person and both my wife and I were devastated when he died. She thought that she would have to go through all of that again with me and to be honest I couldn't and can't really blame her as it was really very hard to see him go through it and not help himself at all.

It's funny that we've now been divorced for a year and I've never spoken to anyone about the breakup - people do ask but I just say it is one of those things. We do have a wonderful daughter, she really is fabulous, so I still see my ex maybe once or twice every 6 months when I'm picking up my daughter from her house (she is at Uni for another year). It's weird seeing her after being married 22 years. I don't really know why I'm telling you all this, haha.

Anyway, the food I eat doesn't make me feel any hungrier than I used to feel when I would eat all the time - I would still be starving and now I do look forward to the meals I have but I am very strict with myself and never snack between meals. I really don't know if it is sustainable or not but I still love life and want to stick around for as long as possible. I will start eating more fish I think as I do like that. I did mention to the diabetic nurse that I'd like tunafish but she insisted I shouldn't have it as it was bad for diabetes (she was talking about the canned tuna and not fresh tuna). Is that right?, or should I be able to eat it.

The reason I am still on metformin is because when I saw the nurse in December I had got down to 49 and she said I shoiuld stay on it for the rest of my life as there were no down sides to it whatsoever and it had been used for so many decades without any side effects really. It is true that I haven't suffered any (apart from the number 2 toilet stuff but maybe that is because I took the tablets with the meal).

Maybe when I meet the nurse next week she will suggest coming off it (I had the blood test last week so I saw the results of 38). I am meeting the diabetic nurse who took my blood and she did seem really nice - but I always do say to people that I'd rather they were brutally honest than sugar coat stuff. I am never bothered about getting the riot act or anything like that as we all make mistakes.

I am completely confident that we've cracked the liver results. With it going down by over 500 in 8 days I think I've got to the root cause and won't be that daft again.
 
@peterb999 totally wrong. Tuna is absolutely fine. There is absolutely no reason from the point of view of diabetes that you should avoid any meat or fish - or eggs, cheese or other dairy if it has not had something containing carbs added to it.
I had dreadful side effects from taking Metformin and Atorvastatin - I stopped it as things were becoming seriously problematic - never needed them in the first place and had to do quite a bit of work to get back what I lost - and do a lot of cleaning of carpets and upholstery as well. I did get a really good quality cleaning machine though, so it is an ill wind.....
I am glad you sorted out the problem with your liver - must have been concerning - overdosing on supplements is quite common, I am told, as people think if it is good, more must be better. A former neighbour of mine killed their pregnant ***** by doubling up on multivitamin and minerals.
 
Hi.

Is this the same nurse that said crisps were OK? I don't remotely see how tuna is "bad for diabetes". It doesn't contain any carbs. We eat large amounts of canned, bottled and fresh tuna. Bilous and Donnelly (Handbook of Diabetes) say:

Fish oils are rich in n‐3 fatty acids and have lower triglyceride levels, and there is evidence that higher fish intake is associated with less CVD in diabetes; accordingly, 2–3 servings of fish per week are recommended.

On the metformin - there are well known side effects which you seem to have experienced and they are reasonably common. Bilous and Donnelly say:

Metformin increases insulin action (the exact mechanism is unclear), lowering glucose mainly by decreasing hepatic glucose output. Unlike sulfonylureas, it does not cause hypoglycaemia or weight gain and, indeed, has some appetite‐suppressing activity that may encourage weight loss.....Major side effects are nausea, anorexia, or diarrhoea, which affect about one‐third of patients. Lactic acidosis is a rare but serious side‐effect that carries high mortality. It can be avoided by not giving metformin to patients with renal, hepatic, cardiac, or respiratory failure or those with a history of alcohol abuse.

Personally, I don't see why I'd take a medication that I didn't need.
 
Thanks, I thought it was odd about the tunafish but it was my first meeting with her so it was all a bit much taking all of it in.

I'll see what the new nurse says next week regarding the metformin. I'm just a bit concerned about coming off it but I'll see what her advice is and then have a good think about it.
 
Go with your gut. (In the case of metformin, quite literally!) I was on metformin and gliclazide, and could ditch both because my diet got things sorted... But that's me. Conventional advice sayd once you're on diabetes medication, you're on it for life, but many, many people here have proved otherwise... Even people who were on insulin. In the end, you're the patient, it's your body, you decide what you put in it... Not a bunch of faceless strangers on a forum like us, not the nurse, new or otherwise, you. So just gather as much information as you can/want, see what you feel comfortable with and suits your needs, test to see what works for you, and go with that.

Personally though, if canned tuna was a no-go, I'd be in trouble, because I eat at least 3 tins a week... Always with oil, as the brine tends to make the whole thing taste like the can it came in. I wouldn't know what to do with fresh tuna, to be honest.

I'm sorry about the divorce... The trauma of her father might've been a bit much, when it seemed like she would have to go through the same thing all over again with another loved one... I think you did deserve a chance to show you weren't just going to do nothing about it. Still... Easy to say, hindsight being 20/20 and you having taken this bull by the horns, which I suppose she didn't expect. If even doctors still believe T2 is per definition a progressive condition, rather than one that is progressive if no action is taken by the patient, well... Can't blame her for running scared. You're taking it rather well though, it seems. Good on you.

Have a great weekend!
Jo
 
Usually, on the forum, I'd advise people not to take supplements unless a blood test showed a massive deficit, and then to go with the doc's prescribed dosages... Vit D toxicity is a thing, as are other vitamins that can get stacked in the liver in toxic doses. So I know this. I do. I also read about a certain treatment with, amongst other things, extremely high dosages of vitamins A and E for a condition I suspect I have, but can't get confirmed without surgery, which I won't submit to. So I went my own way, took the ridiculously high dosages of A and E, and didn't connect the dots until yesterday... About the sudden massive bruising, my eyesight going to hell in a handbasket (I'm currently wearing +3.5 reading specs and I am still crawling into my screen, squinting), the constant headaches, red flushed face etc, etc. Had another look at A & E toxicity, and sure enough...

So even people who should -and do!- know better, still make mistakes. You found out, and your liver is recovering. Yay! Why read a riot act when you're human and we tend to make mistakes? You're sorting it, so just kudos from me, in any case.

Glad you found out it wasn't anything that couldn't be fixed with time!
Jo
 
Thanks Jo. She was a great wife for well over 20 years so I realise how blessed I was. I do feel sad that we're not together anymore but I also won't ever be with anyone who doesn't want to be with me. I've not seen her for a few months but I do get updates from my daughter so I know she is ok.

I've just had my lunch with tuna, haha. It was very nice - though unlike you I really like the brine for some odd reason.
I'm glad you've found out about the A&E toxicity, I don't know if you are like me but I just take the tablets and don't even really think about it - life can be so busy. I just can't believe how lucky I am as I had no symptoms of anything (I didn't about the diabetes either) - it is a bit scary to think if I hadn't have had the blood test it could have been really bad.

Have a great weekend too.
 
Your nurse must be referring to the high Mercury content that is found naturally in Tuna fish. The Tuna fish species is a very large fish. I believe these massive fish absorb a disproportionate amount of mercury that's found in the oceans. I'm at work at the moment, but I'll dig out a reference for that.

In the mean time this is an old article, but it shows the mercury content of different fish including a number if Tuna species.

Mercury Levels in Commercial Fish and Shellfish (1990-2012)

Mercury Levels in Commercial Fish and Shellfish from 1990-2012 by Species
www.fda.gov


Edited to remove a confusing FDA advisory on fish .

Adding a Canadian Government advisory on Tuna consumption.
Tuna is fished off our East and West coasts, particularly Blue fin off the East coast and Albacore off our West coast.

Mercury in Fish - Questions and Answers - Canada.ca

Health Canada consumption advice regarding mercury in fish
www.canada.ca
 
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Thanks for this, it is interesting reading.

I don't think that she meant the mercury but I don't really know.

I probably make her sound really bad but she really did help me. She was great with the medication, she'd said she should put me on all sorts as I was 110 - however, she said she thought it was a good idea for me to try and get it down for 3 months and then see. I got it down to 65 in the three months and she said I only really needed metformin. I was very grateful for that.
 
If it wasn’t mercury, maybe she meant tuna’s high in protein or calories. Either way, dropping from 110 to 65 is impressive.
 
Thanks for saying that about it dropping. I guess we'll never know what she meant about the tuna as I won't see her again. I'm now down to 38 so it took 2 years and 6 months to get to that.
 
I would money on it being the mercury content. It's definitely a thing when you eat fish like tuna in large quantities.
 
Just to update this thread.

I had my follow up blood test yesterday and then results have just appeared in my NHS app.

My Serum alanine aminotransferase level is now down to 17 U/L which is well within the normal level of between 0 - 45. As you can imagine I am incredibly relieved and have certainly learnt my lesson. No more Vitamin D3 supplements for me anymore - I'll just have to spend more time in the sun.
 
I bet that is a relief for you @peterb999.
 
Firstly, congratulations to @peterb999 for successfully overcoming something that could have been difficult to accept and doing what was necessary to manage it. I am delighted that you have a wonderful daughter of whom you can be so proud.

As for your wife, I am very sorry. I have been diabetic for most of my life, but I always believed that my illness would not affect my wife, and yet some of my problems (due to being diabetic) have affected her. And that hurts me. It seems as if I ‘cheated on her in a way’ because I never thought she would have to suffer because of my diabetes (seeing someone in a coma is not pleasant, especially if it is someone you love, although I have not seen it myself, I did see it with my brother, who was also diabetic). So I understand you completely. Although in my case she is still with me (I think unfortunately for her: You don't want the person you love to suffer).

Lupf said:
Hi @peterb999, Diabetes is a marathon, not a sprint.
Click to expand...
You are right.
But this also applies when you are trying to lose weight or achieve a goal in life. Before of the 3 last years I was a person with diabetes, but for the last three years or so, my life has been focused solely on being diabetic, and I have almost ceased to be a person: I am only diabetic and nothing else. Before of this and later od this I lost 1/3 of my weight, I was a happy person with overweight. Now I am at my ideal weight or even slightly underweight, but I lost a lot of things in the way:
To maintain your weight, you can't go back to your old habits. And one of the things I loved was eating. And now I can't (and I don't care), but if you take away more and more incentives from life, only to die in the end (that's the only indisputable truth in this life), why waste time getting to the same place?
Those of us who have had a chronic illness for as long as we can remember have had to deal with the problems that chronic illness has caused us throughout our lives, added to the so-called ‘ailments of old age’, which makes it seem as if we have been dealt a double dose of bad cards.

By the way, a very interesting answer to a question I was asking myself: How many carbohydrates can a good diet have when it is kept to a minimum? I found it in this thread: @KennyA say "Bear in mind that I aim for around 20g carb/day total".

And I felt happy because I was managing to eat less than 40 total carbohydrates a day. Although some weeks I was close to that goal of 20 carbohydrates per day on average.

I hope I haven't bored you with my mental ramblings .

Greetings to everyone
 

You really have to cut out the carbs. Leave a gap of 4 hours on between meals. What medication are you on? Eat whole meal not processed
 
mansingh01 said:
You really have to cut out the carbs. Leave a gap of 4 hours on between meals. What medication are you on? Eat whole meal not processed
Click to expand...
I get the impression the OP has cut out most carbs and has seen some excellent results. What on earth is this blanket "4 hours between meals" nonsense and what does it have to do with the topic?

I'm interested as I've also been taking Vit D3 4000iu/100µg tablets for years (not every day, more like 5-6 per week) and have slightly elevated liver function results. My GP says it's likely to be due to high BG - my initial HbA1c was 113 - but has agreed to test my vit D levels when my HbA1c is below 70. I'd feared I was still low as I almost never leave the house but having read this thread perhaps I'm now too high? Good to know that it's an easy fix if that's the case!
 
mansingh01 said:
You really have to cut out the carbs. Leave a gap of 4 hours on between meals. What medication are you on? Eat whole meal not processed
Click to expand...
Hi, I have cut out a lot of carbs and it's helped me get down to HbA1c of 38 which is a non-diabetic level.

My diabetic nurse told me to actually eat more often but a lot less portions. I thought that sounded quite sensible as then I wouldn't get as many spikes or anything.
 
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