I don’t know what to do

[gilllsmaad]

I have just recently had HbA1c which is 50 think it was 49 a year ago . Also told my cholesterol is high serum 6.93 hdl 5.7 ldl 5.06 and also high blood pressure, which was done Friday. Have just been tested positive for COVID today.
The nurse wants me on metaformin which apparently will help with weight loss and to also take statins. I’ve said no but I really don’t have a clue what I’m about or what I should do for the best. I started (again) low carb intermittent fasting on the 4th January this year have lost about 6-7lbs. Last year I started really well then lockdown happened my husband who is autistic has to work from home has very few friends so his well being has been on me. I also suffer with depression and have fibromyalgia as well as under active thyroid degenerative disc in lower back( exercise is difficult)

It is a shock to know in just a year my percentage for risk of heart attack stroke , I think this is what the nurse referred to, is 24%.
If I continue with low carb intermittent fasting with weight loss is this enough to help with the cholesterol and blood pressure. I don’t wish to die, I’m 55 and don't as yet have any grandchildren and still have plenty of things I wish to achieve.
I apologise if my writing is long

 

[Ronancastled]

Firstly, deep breath, calm.
Good news, you've only barely crossed the diagnostic threshold for diabetes, 48 being the cutoff.
Some small lifestyle changes & modifications ought to see you back inside the non-diabetic zone.
Metformin should improve your insulin sensitivity so don't see it as a failure, it's a very safe drug.
There are many here who would be envious of your HbA1c.

I can't comment on the Statins but many here feel strongly against them.

 

[gilllsmaad]

Firstly, deep breath, calm.
Good news, you've only barely crossed the diagnostic threshold for diabetes, 48 being the cutoff.
Some small lifestyle changes & modifications ought to see you back inside the non-diabetic zone.
Metformin should improve your insulin sensitivity so don't see it as a failure, it's a very safe drug.
There are many here who would be envious of your HbA1c.

I can't comment on the Statins but many here feel strongly against them.

Thank you for your reply, it is hard when the brain isn’t wanting to focus in the right direction

 

[ziggy_w]

Hugs for your worries and for your Covid diagnosis, @gilllsmaad. I really can empathize how upsetting this is.

As @Ronancastled has mentioned, the good news is that your HbA1c is still really good especially considering the stress of lockdown and feeling responsible for the wellbeing of your husband -- you might also want to consider that based on research (unfortunately I can't find the research article right now), blood sugars are a more important risk factor in heart disease risk than cholesterol.

Do you have a printout of your blood lipids? Somehow the numbers don't seem to add up. The formula for calculating cholesterol according the Friedewald equation (which most labs use) is HDL + LDL + trigs/2.2 = total cholesterol. Based on the formula above HDL and LDL combined already exceed 10 mmol (rather than the 6.93 mmol you report), so something doesn't really add up.

Imo, changing your diet and getting back to low-carb can really make a huge difference. So, it might be worthwhile to see what the results will be. Personally at diagnosis, my 10-year risk of developing heart disease was about 20 percent based on various risk calculators. However, after adopting a low-carb diet this dropped to about 2 percent currently. So, possibly it might be a good idea to see how diet changes work for you and then reconsider? Please also remember that weight loss might temporarily elevate cholesterol.

As to medication -- Metformin doesn't only help with blood sugars but it also has a pretty good record with respect to lowering heart disease risk. So, if you can tolerate it, it might be worth considering -- at least for a while.

 

[gilllsmaad]

Hugs for your worries and for your Covid diagnosis, @gilllsmaad. I really can empathize how upsetting this is.

As @Ronancastled has mentioned, the good news is that your HbA1c is still really good especially considering the stress of lockdown and feeling responsible for the wellbeing of your husband -- you might also want to consider that based on research (unfortunately I can't find the research article right now), blood sugars are a more important risk factor in heart disease risk than cholesterol.

Do you have a printout of your blood lipids? Somehow the numbers don't seem to add up. The formula for calculating cholesterol according the Friedewald equation (which most labs use) is HDL + LDL + trigs/2.2 = total cholesterol. Based on the formula above HDL and LDL combined already exceed 10 mmol (rather than the 6.93 mmol you report), so something doesn't really add up.

Imo, changing your diet and getting back to low-carb can really make a huge difference. So, it might be worthwhile to see what the results will be. Personally at diagnosis, my 10-year risk of developing heart disease was about 20 percent based on various risk calculators. However, after adopting a low-carb diet this dropped to about 2 percent currently. So, possibly it might be a good idea to see how diet changes work for you and then reconsider? Please also remember that weight loss might temporarily elevate cholesterol.

As to medication -- Metformin doesn't only help with blood sugars but it also has a pretty good record with respect to lowering heart disease risk. So, if you can tolerate it, it might be worth considering -- at least for a while.

Hi Ziggy
Do you know if the person taking met for in would know when they can come off it? As I’m on so many meds at present and having to remember them all in order as well as a large family (6 kids not all at home but always on the phone asking +1 hubby) . I think I would then give it a go. It’s just I’m scared to and scared not to and that in itself is frustrating!

 

[ziggy_w]

Hi Ziggy
Do you know if the person taking met for in would know when they can come off it? As I’m on so many meds at present and having to remember them all in order as well as a large family (6 kids not all at home but always on the phone asking +1 hubby) . I think I would then give it a go. It’s just I’m scared to and scared not to and that in itself is frustrating!

Hi @gilllsmaad,

In my case, the GP put me on the maximum dose of metformin initially (but admittedly my HbA1c was very high at the time), halved the dose half a year and two normal HbA1c later, and then took me off metformin altogether after one year. So, it doesn't really have to be for a long time if your numbers get better.

Also remember in the end, it is pretty much up to you if and when to start medication and when to come of it -- the nurse (or any other HCP) can only recommend/advise.

P.S. Keeping my fingers crossed you'll get over Covid soon with a minimum of symptoms.