Is it worth going on meds?

[Howski]

Hi,

Being diagnosed about 2 weeks ago I have been on a pretty steep learning curve over the last couple of weeks. My doctor has recomended trying just diet/weight loss first off. I have been testing my BG and generally speaking my before meal levels are high 5 to mid 6 and 90 mins after a meal low to mid 7mmol/l. Although there have been spikes (my fault - testing foods).

With readings like that - I'm thinking its worth starting now on meds. If I loose a lot of weight and start getting lots of lows then I can always come off later if need be...... what are people's thoughs?

From what I read meds don't shorten the life of your beta cells so I would have thought getting those numbers down first off and then sorting the rest out later?

Opinions?

Thanks in advance
-Howard.

 

[sugarless sue]

Opinion.....
5's to 6's are not high pre-meal numbers. Why are you testing at 90 minutes ? The optimum is usually two hours, three or four if it is a meal heavy in fat or complex carbs.

If you are reducing carbs and portion sizes then you will probably maintain your weight loss and blood sugar control without going on to medication.

However, this is your choice and one that you should discuss with your GP/DSN.

 

[Howski]

While it is my choice - I'd like to make an informed one and hearing other peoples opinions based on experiance is always the way to go of you ask me!

I read somewhere that 90mins is a good time - but I can and will adjust.

 

[cugila]

Another opinion then........

As Sue says those numbers are not high. The testing regime recommended by HCP's and also by us on this site is as Sue stated usually 2 hrs with 3 and 4 hrs when required.

As for experience I would also recommend the same as Sue stated, why go on meds if you can control Bg levels without. Surely that has to be the best way forward. Sue has been controlling her Diabetes for over 3 years on diet only as have many other members on the forum. If I was able to I wouldn't want to take any meds.....unfortunately I dont have that luxury of choice.

Ken

 

[Howski]

Well on other places I have read that they are on the high end. I know this site says 8-10 after 2 hours but the majority of other sites say 6-8 which puts me close to the high end and I'd like to make my levels as normal as possible. Maybr this is an over reaction but I was thinking that if I can knock a bit of my bg without harming my beta cells - then this will help in the long run.

 

[slummymummyof3]

If you can sensibly control your blood sugar with diet andexercise, why would you want to start meds with their side effects?

 

[Cliff2]

Howski - those are very similar to the readings I had for the first few months after diagnosis. At that time I was in the 5 to 8 range. Some dietary tweaks and I now run in the 4 to 6 range which is far more comfortable. In fact, these days, only my fasting levels hit the 6s (dawn phenomenon?)and my pre and post prandials are in the 4s and 5s. I am completely diet/exercise controlled and my last HbA1c was 5.6%. My meter readings suggest a lower figure next time. It really is worth giving diet/exercise a chance before going on to meds.

I don't know what your lipids are like - mine were very high with cholesterol at 7 and trigs at 6. I was told diet/exercise would never reduce them by more than 30% and so I must take statins. I declined. My cholesterol is now 4.1 and my trigs 1.2 which works out at 41% and 80% reductions respectively, without meds. Done mainly by chopping out the starchy carbs like bread, potatoes, rice and pasta.

 

[slummymummyof3]

Cliff - what do you do to counteract the dawn phenomenem? Do you take a snack if your blood sugars are below a certain level?

 

[Cliff2]

The snacking option didn't work for me although I understand it works for others (except for red wine the night before - that does work for me but I shouldn't encourage anyone to increase their alcohol intake).

When diagnosed I had a fasting level of 9mmol/L. I got that down to the low 7s quite quickly by cutting out the obvious nasties.

I got my post-prandial levels down to acceptable levels by controlling my carbs - reduced carb but not low carb by some standards - but I choose my carbs very carefully.

For a few months I had problems getting my fasting level down - it varied from about 6.5 to 7.2, more often than not above 7. My fasting level appears unaffected by what I eat the day before. But it has definitely reduced over the last few months and I'm now between 5.5 and 6.2 generally. For me it seems to be linked to insulin resistance. I was 17st 6lb in October and and am now 13st 10lb. I think the weight loss has helped.

 

[Howski]

I'm self fast testing myself over night to see what I get. I know my HbA1c was over 10 when tested but I can't remember what the other vitals were. Mind you I was under a really bad cold when that happened.

As far as the why - like I said - say I loose 10% of my body mass and that drops everything to the low end - I'd be really happy. However say that takes 6 months - well thats 6 months worth of harmfull BG levels that my beta cells would struggle with.

I'm not saying I will/won't - more I was considering asking for it. By the looks of things its pretty much a unanimous no though!

 

[Cliff2]

Howski - it has to be your call and no-one else's. What are your fasting readings? Do you have much weight to lose? Diet and exercise are really powerful tools in your armoury. You do have the option of metformin plus diet and exercise and, if you gain great control, reducing or eliminating the meds with the support of your health care team.

 

[Howski]

Thanks Cliff

I can't remember what the BG levels were on diagnosis...... however its something I will be getting. I'm fasting overnight tonight so I'll let you know how I get on. Currently I am at 6.1 after having a pre meal of 4.8 and a 2 hour of 6.3.

I was not planning on giving up exercise/diet - as the less I use things the longer they will last! I do have a lot of excess that I could stand to use and even pre-diagnosis I was slowly loosing. Again I was mainly thinking a little pain short term (with the meds) could reap the benifits long term.

While I realise it my body, so my science experiment - I was and still am intrested in people's opinion. While I know peoples reactions my very there must be generals I can use to get started and then talyor to my own reactions.

Anyway like I said - its not like it was a definate "I Will go on meds" more like a "What if" or "Is it a good idea"

 

[Cliff2]

Howski - I'd be very interested to hear about your fasting levels. Your pre and post prandials appear pretty good and are not far away from my own, and I have a pretty decent HbA1c. You might be pleasantly suprised at your next test.

 

[Howski]

Well everything crossed...... Had a good day today. Only a little carbs and went for a walk along the thames for a good few hours.

 

[hanadr]

Howski
If considering medication, don't forget to investigate possible side effects.
I think I understand your thoughts on numbers.
i personally try to keep in the non diabetic range all the time. I mostly do. Some people think I'm obsessive.
Hana

 

[cugila]

Well on other places I have read that they are on the high end. I know this site says 8-10 after 2 hours but the majority of other sites say 6-8 which puts me close to the high end and I'd like to make my levels as normal as possible. Maybr this is an over reaction but I was thinking that if I can knock a bit of my bg without harming my beta cells - then this will help in the long run.

This forum does not consider those levels high end at all.

I have no idea where you get the idea that this forum recommends post prandial levels as high as 8 - 10 mmol/l

2hrs post prandial .......???? We recommend the NICE guidelines which for a T2 are as follows:
Fasting(waking)............between 4 - 7 mmol/l.
2 hrs after meals..........no more than 8.5 mmol/l. (A T1......no more than 9 mmol/l)

Obviously if you can keep the post prandial numbers lower so much the better. They are just guidelines. Not rules.

Ken

 

[Howski]

Well my fasting test gave me 4.2 ........... thats really low. I suppose I should but that score down to the vast amount of exercise yesterday???

 

[OregonDog]

My wife had blood-sugar readings in the mid-300's ( 16.6 mmol/l) and her doctor put her on metformin and insulin injections. The problem was that the medications made her feel horrible and her blood sugars were still wildly fluctuating. She then went on a combination of diet and supplement plans as reccomended by Rosedale, Mercola, and Sally Fallon. They are not all exactly the same, but they do have similarities. We also went and purchased about $500 dollars of supplements that Rosedale had reccomended. The guy at the checkout counter had a bewildered look and smiled, "Well, thanks alot". Well, it was an initial miracle as she lost her excess weight and her blood-sugars have since been in the normal range. I'm not reccomending this to anyone, but she stopped taking the medicines without the doctor's permission when she started the diet and supplements. Since she already had a record of stable blood sugars at this point, however, the doctor grudgingly agreed to let her stay off them. (He was kind of upset).

After that initial miracle, it is still a slow learning curve as the supplements ran out and she fine-tunes her diet. If she eats things out of order or adds the wrong things, she can gain weight at a rate of a pound a day. Her weight did increase by about 15 pounds and holds steady there. She is planning to look at re-starting some of the supplements and hoping to add soaked grains and other things back into her diet. We are trying to figure out more information about why her blood sugars are rising on an empty stomach and what foods types (fats, carbohydrates, proteins) she should be eating (and when) to address this situation without going into a weight gain cycle. It seems obvious that some of us get into a situation where our bodies think we are starving, and are prone to rapid weight gain.

 

[Howski]

From the site not the froum:

A normal pre-prandial (before meal) blood glucose level will be between 4 and 7 mmol/l. After eating (post-prandial) levels should be less than 10 mmol/l

I want below 6 ideally

But yea I'm now on meds 2x 500mg of met per day. While its what I wanted anyway I do have to question my GP.

He wanted me to go on meds as well but he reasoning worried me. He said my A1C was too high indicating that I had "poor" control of my diabetes. Yes I agree it was high(10.1%) in the blood test over a week ago what really surprised me as the AC1 was what he used to access my control. I can't understand this reasoning as I have been only diag for just over a month. I thought that the A1C test shows the "average" blood sugar for the last 30-100 days, so if Its been just over a month any changes would have not had much if any effect on the cells or am I missing something???

Thanks
-Howard

 

[cugila]

From the site not the froum:

A normal pre-prandial (before meal) blood glucose level will be between 4 and 7 mmol/l. After eating (post-prandial) levels should be less than 10 mmol/l

-Howard

Howard.
Not having seen those figures before and knowing that they are not what the NICE 2010 guidelines state we have taken this up with the Administrator. Hopefully we can get those figures corrected as it is incorrect. So is the 90 min figure as it is always given as 2 hrs by UK medical authorities, and this forum.

The correct guideline figures are as follows:
Fasting (waking)...................between 4 - 7 mmol/l. Type 1 and Type 2.
2 hrs after meals..................no more than 8.5 mmol/l. Type 2
2 hrs after meals..................no more than 9 mmol/l. Type 1

Nobody here or in the NICE guidelines advocates 10 mmol/l.
NICE do not advocate testing after 90 minutes........it is 2 hrs which is the recognised timing.

I should also point out that the Forum is totally separate from the Community pages. So we quite often differ from some of the Community page information.

Ken.