How long before improvement?

[Tybee]

Hi, following recent blood tests my GP telephoned me to say I had type 2 diabetes and prescribed metformin. No other info was given but he said I’d get an appointment at a diabetes clinic. That was nearly a fortnight ago. In the meantime I have been trying to reduce carbs and started going for a brisk walk most days. But, my fasting BG doesn’t seem to be reducing at all (usually between 8-9) and just goes higher after my walk. Am I expecting too much to see any change yet? How long does it take metformin to start working and should my fasting BG be in the normal range now I’m on medication? I want to help myself but finding it all very confusing. Tia.

 

[Pipp]

Hello, and welcome.

Firstly, don’t panic. You are in the right place for help and support.
You have made a good start by reducing carbs. If your only medication for diabetes is *Metformin* then that is a good way to go.

Fasting blood glucose is generally the slowest to get control of. This is due to the liver providing releasing stores of glucose in the morning in anticipation of the need for energy as you wake and get moving. A lot of us also see higher BG immediately after exercise, which is temporary and drops later.

You probably are expecting a bit too much to see big changes in under two weeks. The Metformin will have less effect than your dietary changes will. It slightly reduces the amount of glucose your liver releases, and helps improving the insulin resistance, allowing your body to make better yse of the insulin it produces. Metformin can sometimes cause abdominal discomfort, if you experience this ask you doctor for the slow release version.

Depending on how high your HbA1c was at diagnosis, you may be able to reduce to non-diabetes levels, possibly before you get your appointment at a clinic.

You will find lots of information in the forums. There is some to start in the information beneath my signature at the end of this post.. Just scroll down, have a read, then come back with any questions you have. Our members are generally very helpful, and willing to advise from their own experiences of similar issues.


edit to include medication *Metformin* which had previously been omitted

 

[Chris24Main]

Hi @vM8zrurNQzjePsTM1Twm - Welcome to the forum.

I was where you are about a year ago - it's all very confusing and alarming at the same time. You, on the other hand, have come here much quicker than I did... I had months of twisting in the wind before anything started to make sense..

Diabetes is almost by definition a situation that recognises lots of water under the bridge to start with, and while there are lots of things you can do... you need to give your body time to reverse that. The good news is that it is possible, and while it will almost certainly feel overwhelming, it doesn't need to be something you need to feel alarmed about. You have time to figure out what will work for you...

Can I ask if you have had an HbA1c test yet, and can I assume that you are wearing a blood glucose monitor?

 

[KennyA]

Hi, following recent blood tests my GP telephoned me to say I had type 2 diabetes and prescribed metformin. No other info was given but he said I’d get an appointment at a diabetes clinic. That was nearly a fortnight ago. In the meantime I have been trying to reduce carbs and started going for a brisk walk most days. But, my fasting BG doesn’t seem to be reducing at all (usually between 8-9) and just goes higher after my walk. Am I expecting too much to see any change yet? How long does it take metformin to start working and should my fasting BG be in the normal range now I’m on medication? I want to help myself but finding it all very confusing. Tia.

Hi and welcome. Did your GP tell you what your HbA1c value was? "Normal" range is 38-42 mmol/mol - that is, most non-diabetic people have an HbA1c figure in that range. I'm one of those people who thinks that as soon as you go out of that range there's evidence of a problem: the issue is that an HbA1c figure of 48 was chosen as a diagnostic backstop, but in the UK anyway it has become just about the only diagnostic criterion. So you can spend quite a bit of time with BG values that aren't normal before the NHS will officially recognise that you have an issue.

The A1c test counts the number of glycated haemoglobin molecules - these have had a glucose molecul attached to them - and it's a proxy for your blood glucose levels over the last 3-4 months. There's a big skew towards the most recent month, but it normally takes around 3-4 months for an overall reduction in BG to become evident to an Hba1c test.

The HbA1c and the fingerprick BG test (which tests the glucose in your blood at the point of test) are therefore testing different things, so it's not really possible to "average" your BG tests and predict the next A1c. You might get some idea of a ballpark figure, but that's about it. Both are also subject to some inaccuracy - I got a BG reading yesterday of 2.8 which was clearly and obviously wrong.

I have no personal experience with metformin myself, but it works (method not fully understood by medics) by affecting the liver's ability to add glucose to your blood, which it is doing all the time. Many people report that "brisk" walking will raise BGs ( the liver thinks you need the extra fuel) but a slower amble will lower them (liver not triggered into action).

Fasting BGs are generally the last to come down, because they are largely governed by your liver, and livers seem to be slow learners. Unfortunately metformin won't of itself control your blood glucose levels. The single biggest impact on BG is the carbohydrate content of your food. I have had success over nearly five years from reducing my carb intake, and it's the course I'd recommend trying.

 

[vivien1962]

Hi
I’m nearly diagnosed type 2
My hba1c is 110 mol again I was given metformin and have virtually got on with it
My vision is extremely blurry and I’ve not to drive
I’m due back at work next week to a very stressful job and extremely worried
Any help is greatly appreciated x

 

[Rachox]

@Tybee and @vivien1962 , have a read of this blog written by one of our members, I think you’ll find it helpful:

The Nutritional Thingy

There’s a few things you should know. 1. Practically all carbs turn to glucose once ingested , so not just straight sugars, but starches...

josekalsbeek.blogspot.com

 

[vivien1962]

This was a total eye opener for me great advice x

 

[Tybee]

Hello, and welcome.

Firstly, don’t panic. You are in the right place for help and support.
You have made a good start by reducing carbs. If your only medication for diabetes is *Metformin* then that is a good way to go.

Fasting blood glucose is generally the slowest to get control of. This is due to the liver providing releasing stores of glucose in the morning in anticipation of the need for energy as you wake and get moving. A lot of us also see higher BG immediately after exercise, which is temporary and drops later.

You probably are expecting a bit too much to see big changes in under two weeks. The Metformin will have less effect than your dietary changes will. It slightly reduces the amount of glucose your liver releases, and helps improving the insulin resistance, allowing your body to make better yse of the insulin it produces. Metformin can sometimes cause abdominal discomfort, if you experience this ask you doctor for the slow release version.

Depending on how high your HbA1c was at diagnosis, you may be able to reduce to non-diabetes levels, possibly before you get your appointment at a clinic.

You will find lots of information in the forums. There is some to start in the information beneath my signature at the end of this post.. Just scroll down, have a read, then come back with any questions you have. Our members are generally very helpful, and willing to advise from their own experiences of similar issues.


edit to include medication *Metformin* which had previously been omitted

Thank you for the thorough explanation, that’s really helpful. I will browse all the info available and know where to come if I have any queries. Thanks again.

 

[Tybee]

Hi @vM8zrurNQzjePsTM1Twm - Welcome to the forum.

I was where you are about a year ago - it's all very confusing and alarming at the same time. You, on the other hand, have come here much quicker than I did... I had months of twisting in the wind before anything started to make sense..

Diabetes is almost by definition a situation that recognises lots of water under the bridge to start with, and while there are lots of things you can do... you need to give your body time to reverse that. The good news is that it is possible, and while it will almost certainly feel overwhelming, it doesn't need to be something you need to feel alarmed about. You have time to figure out what will work for you...

Can I ask if you have had an HbA1c test yet, and can I assume that you are wearing a blood glucose monitor?

Hi @Chris24Main Thanks for the welcome, you are right, it’s definitely very confusing!! I’m glad you managed to get the info you needed eventually. How are you getting on now?
My HbA1c was 55 hence the diagnosis, I haven’t had any info from the doctors yet so have been finger pricking to try to understand what’s going on, although not sure how useful that is when I’m not sure what I’m aiming for. I know a lot of patients aren’t required to test, and I assume I may be one of those but I thought it would give me some insight. Thanks for your help.

 

[Tybee]

Hi and welcome. Did your GP tell you what your HbA1c value was? "Normal" range is 38-42 mmol/mol - that is, most non-diabetic people have an HbA1c figure in that range. I'm one of those people who thinks that as soon as you go out of that range there's evidence of a problem: the issue is that an HbA1c figure of 48 was chosen as a diagnostic backstop, but in the UK anyway it has become just about the only diagnostic criterion. So you can spend quite a bit of time with BG values that aren't normal before the NHS will officially recognise that you have an issue.

The A1c test counts the number of glycated haemoglobin molecules - these have had a glucose molecul attached to them - and it's a proxy for your blood glucose levels over the last 3-4 months. There's a big skew towards the most recent month, but it normally takes around 3-4 months for an overall reduction in BG to become evident to an Hba1c test.

The HbA1c and the fingerprick BG test (which tests the glucose in your blood at the point of test) are therefore testing different things, so it's not really possible to "average" your BG tests and predict the next A1c. You might get some idea of a ballpark figure, but that's about it. Both are also subject to some inaccuracy - I got a BG reading yesterday of 2.8 which was clearly and obviously wrong.

I have no personal experience with metformin myself, but it works (method not fully understood by medics) by affecting the liver's ability to add glucose to your blood, which it is doing all the time. Many people report that "brisk" walking will raise BGs ( the liver thinks you need the extra fuel) but a slower amble will lower them (liver not triggered into action).

Fasting BGs are generally the last to come down, because they are largely governed by your liver, and livers seem to be slow learners. Unfortunately metformin won't of itself control your blood glucose levels. The single biggest impact on BG is the carbohydrate content of your food. I have had success over nearly five years from reducing my carb intake, and it's the course I'd recommend trying.

Thanks for the info @KennyA, it’s very encouraging that you have managed your diabetes by diet alone. That is what I am aiming for, I guess I just need some patience to see any results .

 

[LivingLightly]

Evening @Tybee and @vivien1962.

I was diagnosed with Type 2 in 2003 whilst in hospital undergoing treatment for something else, but I remember the conversation as though it were yesterday. A physician performed a finger prick test and recorded >18 mmol/L. Later, I was told my HbA1c was 110 mmols/mol and issued with a glucometer, test strips and medication.

In 2003, this wonderful forum did not exist, but by testing systematically with my meter and keeping a food diary, I realised that foods made with cereals like bread, cake, pastry and porridge were my undoing. Also, against advice from my GP's practice nurse, I cut out the spuds. That left plenty of delicious foods to enjoy. If you replace the carbs with foods that are predominantly protein and fats, you'll never feel hungry. My most recent HbA1c was mid 30s mmol/mol.

 

[Grant_Vicat]

Hi @Chris24Main Thanks for the welcome, you are right, it’s definitely very confusing!! I’m glad you managed to get the info you needed eventually. How are you getting on now?
My HbA1c was 55 hence the diagnosis, I haven’t had any info from the doctors yet so have been finger pricking to try to understand what’s going on, although not sure how useful that is when I’m not sure what I’m aiming for. I know a lot of patients aren’t required to test, and I assume I may be one of those but I thought it would give me some insight. Thanks for your help.

A friend of mine is a Type 2 and has been told that testing is not necessary. I wonder how she is supposed to notice any patterns in relation to foods that help and those that don't! I hope you are successful in your treatment.

 

[VashtiB]

Hi @Chris24Main Thanks for the welcome, you are right, it’s definitely very confusing!! I’m glad you managed to get the info you needed eventually. How are you getting on now?
My HbA1c was 55 hence the diagnosis, I haven’t had any info from the doctors yet so have been finger pricking to try to understand what’s going on, although not sure how useful that is when I’m not sure what I’m aiming for. I know a lot of patients aren’t required to test, and I assume I may be one of those but I thought it would give me some insight. Thanks for your help.

I tested regularly for at least 3 years. I now self fund a CGM from time to time to 'keep me honest'. I'm a carb addict and it is very easy for me to carb creep. I was also told no need to test but I disagree- how can I make good choices without that information.

Rigorous exercise can temporarily raise your levels but they do come down. Some people find they go lower and stay lower longer but I didn't find that. I now do less rigorous exercise (which has nothing at all to do with my hatred of vigorous exercise )

We are all different- the thing is to experiment to find out what works for you physically mentally and for your life.