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HBAC1 lulled me into a false sense of security! Help.

F

faeeyes

Member
Messages
8
Type of diabetes
Type 2
Treatment type
Tablets (oral)
May last year, I'd been newly diagnosed with Type 2 and put on Metformin. After a few HBAC1 tests and some diet advice etc. The Doc signed me off until the next year as my HBAC1 levels had come down from 100 to 52 and they thought that they were on a suitable downward trend to meet target.

No such luck. I go back for my annual check up and they're back up to 78 and the doc has now put me on dipaglaflozin as well. My teeth are suffering from awful gum disease, which the dentist puts down to the diabetes and I've had to have two wisdom teeth out.

The thing is, before being signed off for the year, I'd been monitoring my sugar levels at home with a test meter and that had been helping, but the doctor told me not to worry about testing and that the Metformin was doing its job. Keep up the sensible diet etc etc.

So I stopped. I may have had the odd naughty thing diet wise, but I wasn't guzzling sugar/carbs every day and I'd given up on the things that I new made my sugar levels spike.

This morning I started testing again. 9.9 fasting blood sugars after eating no carbs at all yesterday! 7.7 after a low carb lunch and it remains to be seen what happens going forward. This is after nearly a month of being super sensible with diet (lost half a stone) and taking the dipaglaflozin and a maximum dose of Metformin.

I know infection (wisdom teeth problem) can cause things to spike, but not best impressed that I was signed off for so long when things weren't really under control.

Any ideas as to what might be happening?
 
NICE guidance says 6 monthly hba1c once stable (3 mths til then). How can you be classed as stable after only 2 tests? At most it should have been 6 months and really 3. So many drs try and cut the costs in the short term but end up cost the nhs more in £ and patients more in health. Ignorant. As is the advice not to self test. Hopefully your story will help others avoid the same outcome and you get back on track soon.
 
In here (and in the 'blue' forum as well), I and many others keep saying that we personally find it vital to self test. Because that's the only thing that takes the guesswork out of controlling Type 2. It is absolutely no use knowing that in the past year, or 6 months or even 3months you on average had some meals that were not very good for you. It's like driving with no speedometer and relying on speeding tickets to tell you that you go too fast !

Even now when in remission for nearly 3 years I still self test occasionally - just no longer for every meal like I did when still working toward remission.
 
faeeyes said:
.............................................

The thing is, before being signed off for the year, I'd been monitoring my sugar levels at home with a test meter and that had been helping, but the doctor told me not to worry about testing and that the Metformin was doing its job. Keep up the sensible diet etc etc.

So I stopped. I may have had the odd naughty thing diet wise, but I wasn't guzzling sugar/carbs every day and I'd given up on the things that I new made my sugar levels spike.

This morning I started testing again. 9.9 fasting blood sugars after eating no carbs at all yesterday! 7.7 after a low carb lunch and it remains to be seen what happens going forward. This is after nearly a month of being super sensible with diet (lost half a stone) and taking the dipaglaflozin and a maximum dose of Metformin.

I know infection (wisdom teeth problem) can cause things to spike, but not best impressed that I was signed off for so long when things weren't really under control.

Any ideas as to what might be happening?
Click to expand...

I'm now going to be a bad moderator and talk from my own reading rather than from my own experience:
Metformin (like exercise) has only a small effect on Blood Glucose. If you eat carbohydrates, Metformin won't help you deal with them. Its main function is just to discourage your liver from dumping extra glucose into your bloodstream! Thus it helps with FOTF or DP, but in no way could get you from an HbA1C of 100 to one of 52 - that was all your own doing with your dietary changes !

What caused the HbA1C to go back up to 75? - Pt's impossible to say for certain after so many months. Probably carbohydrates creeping back into your diet, but other factors raise Blood Glucose, such as
Infection, injury, stress lack of sleep, and medications such as Statins and Steroids.
There are several more, but those are the major ones.
Also it's also possible (but unlikely) that your body isn't producing as much insulin as it used to.

But try self testing your meals first and that way you eliminate the most likely problem first!
 
ianf0ster said:
I'm now going to be a bad moderator and talk from my own reading rather than from my own experience:
Metformin (like exercise) has only a small effect on Blood Glucose. If you eat carbohydrates, Metformin won't help you deal with them. Its main function is just to discourage your liver from dumping extra glucose into your bloodstream! Thus it helps with FOTF or DP, but in no way could get you from an HbA1C of 100 to one of 52 - that was all your own doing with your dietary changes !

What caused the HbA1C to go back up to 75? - Pt's impossible to say for certain after so many months. Probably carbohydrates creeping back into your diet, but other factors raise Blood Glucose, such as
Infection, injury, stress lack of sleep, and medications such as Statins and Steroids.
There are several more, but those are the major ones.
Also it's also possible (but unlikely) that your body isn't producing as much insulin as it used to.

But try self testing your meals first and that way you eliminate the most likely problem first!
Click to expand...
That's really helpful. I have other conditions and am on statins, hrt, migraine preventative medications, non SSRI antidepressants, antibiotics, topical steroids and antihistamines long term. I do wonder whether insomnia, infections etc have had an impact recently. Yes, carbs may have crept back in too, but it'd be the odd piece of wholemeal bread or wholemeal pasta. Not cakes or orange juice!

Going to keep testing, insist on regular check ups and go from there I guess.
 
Fasting high again today, but I know I didn't eat any Carbs at all, so going to put it down to fighting infection over night.

My blood sugars came down significantly after each low carb meal yesterday, so there's hope. I was under 7 by the end of the day, which is promising. Just need to get it lower in the morning.

Teeth gradually getting less infected too, so fingers crossed. Will book another appointment at the doctors today. Latest doctor seems to understand the NICE guidelines at least!
 
faeeyes said:
I'd been monitoring my sugar levels at home with a test meter and that had been helping, but the doctor told me not to worry about testing and that the Metformin was doing its job.
Click to expand...
I don't understand the attitude of your doctor! How on earth can he/she know how well the Metformin is working unless you are testing regularly?
 
I compare not testing as like crossing a busy road with a blindfold on. Testing sometimes as the same. If I had to give a quick bit of advice it would be ditch the starches of any colour, very hard I know. I allow myself one tiny bit of LC toast every morning because I can’t deal with anything else at that time of day (if I don’t eat my DP keeps rising but thats just me) but ONLY one slice because it is my treat. Oc we all eat something we shouldn’t sometimes but habit then return. Why don’t you take a look at some of the “what have you eaten today” low carbs threads for ideas. Best wishes.
 
faeeyes said:
May last year, I'd been newly diagnosed with Type 2 and put on Metformin. After a few HBAC1 tests and some diet advice etc. The Doc signed me off until the next year as my HBAC1 levels had come down from 100 to 52 and they thought that they were on a suitable downward trend to meet target.

No such luck. I go back for my annual check up and they're back up to 78 and the doc has now put me on dipaglaflozin as well. My teeth are suffering from awful gum disease, which the dentist puts down to the diabetes and I've had to have two wisdom teeth out.

The thing is, before being signed off for the year, I'd been monitoring my sugar levels at home with a test meter and that had been helping, but the doctor told me not to worry about testing and that the Metformin was doing its job. Keep up the sensible diet etc etc.

So I stopped. I may have had the odd naughty thing diet wise, but I wasn't guzzling sugar/carbs every day and I'd given up on the things that I new made my sugar levels spike.

This morning I started testing again. 9.9 fasting blood sugars after eating no carbs at all yesterday! 7.7 after a low carb lunch and it remains to be seen what happens going forward. This is after nearly a month of being super sensible with diet (lost half a stone) and taking the dipaglaflozin and a maximum dose of Metformin.

I know infection (wisdom teeth problem) can cause things to spike, but not best impressed that I was signed off for so long when things weren't really under control.

Any ideas as to what might be happening?
Click to expand...
Hi,

You need to ask for 3 month Hba1c tests for at least a year. You - and your doctor needs to see a profile. You also need to know which direction you are going in. You can ask for this in your care package. Everything is about cost these days which is my opinion as to why they seem so reluctant to send us for HBA1cs anymore.
 
faeeyes said:
May last year, I'd been newly diagnosed with Type 2 and put on Metformin. After a few HBAC1 tests and some diet advice etc. The Doc signed me off until the next year as my HBAC1 levels had come down from 100 to 52 and they thought that they were on a suitable downward trend to meet target.

No such luck. I go back for my annual check up and they're back up to 78 and the doc has now put me on dipaglaflozin as well. My teeth are suffering from awful gum disease, which the dentist puts down to the diabetes and I've had to have two wisdom teeth out.

The thing is, before being signed off for the year, I'd been monitoring my sugar levels at home with a test meter and that had been helping, but the doctor told me not to worry about testing and that the Metformin was doing its job. Keep up the sensible diet etc etc.

So I stopped. I may have had the odd naughty thing diet wise, but I wasn't guzzling sugar/carbs every day and I'd given up on the things that I new made my sugar levels spike.

This morning I started testing again. 9.9 fasting blood sugars after eating no carbs at all yesterday! 7.7 after a low carb lunch and it remains to be seen what happens going forward. This is after nearly a month of being super sensible with diet (lost half a stone) and taking the dipaglaflozin and a maximum dose of Metformin.

I know infection (wisdom teeth problem) can cause things to spike, but not best impressed that I was signed off for so long when things weren't really under control.

Any ideas as to what might be happening?
Click to expand...
My GP and diabetes nurse also told me not to keep testing my levels!! I take no notice and do it anyway. Lot of people here said the same, take no notice of being told not to test!
 
I've also been told not to test regularly before but agree with the above that that as well as going Low carb is the only way I can kick this thing which I'm determined to do. My last HBaC1 scared me though I'm glad for this forum.
It's really helpful what the person above said about metformin not being much help without eating low carb.
 
HSSS said:
NICE guidance says 6 monthly hba1c once stable (3 mths til then). How can you be classed as stable after only 2 tests? At most it should have been 6 months and really 3. So many drs try and cut the costs in the short term but end up cost the nhs more in £ and patients more in health. Ignorant. As is the advice not to self test. Hopefully your story will help others avoid the same outcome and you get back on track soon.
Click to expand...
Wow I never knew this! I have always had just the one yearly check, right from onset in 2016!
 
faeeyes said:
May last year, I'd been newly diagnosed with Type 2 and put on Metformin. After a few HBAC1 tests and some diet advice etc. The Doc signed me off until the next year as my HBAC1 levels had come down from 100 to 52 and they thought that they were on a suitable downward trend to meet target.

No such luck. I go back for my annual check up and they're back up to 78 and the doc has now put me on dipaglaflozin as well. My teeth are suffering from awful gum disease, which the dentist puts down to the diabetes and I've had to have two wisdom teeth out.

The thing is, before being signed off for the year, I'd been monitoring my sugar levels at home with a test meter and that had been helping, but the doctor told me not to worry about testing and that the Metformin was doing its job. Keep up the sensible diet etc etc.

So I stopped. I may have had the odd naughty thing diet wise, but I wasn't guzzling sugar/carbs every day and I'd given up on the things that I new made my sugar levels spike.

This morning I started testing again. 9.9 fasting blood sugars after eating no carbs at all yesterday! 7.7 after a low carb lunch and it remains to be seen what happens going forward. This is after nearly a month of being super sensible with diet (lost half a stone) and taking the dipaglaflozin and a maximum dose of Metformin.

I know infection (wisdom teeth problem) can cause things to spike, but not best impressed that I was signed off for so long when things weren't really under control.

Any ideas as to what might be happening?
Click to expand...
Unfortunately Diabetes is a lifelong/lifestyle daily challenge: we may win a battle BUT it is a lifetime WAR! From my own personal experience, the danger zones to watch out for is when we are on the threshold of victory then are we most vulnerable to take our eye of the enemy…
 
ellesangel said:
I've also been told not to test regularly before but agree with the above that that as well as going Low carb is the only way I can kick this thing which I'm determined to do. My last HBaC1 scared me though I'm glad for this forum.
It's really helpful what the person above said about metformin not being much help without eating low carb.
Click to expand...
My HBa1C was 134, I was an ambulance case, no indications what so ever
 
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