low bmi type 2 - doctor wants me to half my medication - I'm very worried about this

[ianf0ster]

Yeah I eat 6 times per day.

Most Type 2's (initially at least) have constantly high insulin since the high BG drives the beta cells in the pancreas to work extra hard making insulin until eventually they start to fail.

I suppose that you realise that your BG will likely be higher by eating more often. Longer gaps between eating helps reduce the insulin resistance since it means there are longer periods between the insulin spike that accompanies each meal, giving your body a rest from it. High insulin constantly tends to makes insulin resistance worse.

That's why many Type 2's either eat snacks that have zero carbs, or eat only one or two meals per day.

 

[jn81]

What sort of cardio are you doing if your running then this will be counter productive if trying to bulk up with food and weights as you will be burning more calories running.

Also I think you need to try and find out what your calories maintenance is for your height and weight because even if your consuming 2500 you are most likely burning more and being in a calorie deficit.

Yeah I am careful with exercise not to do too much to burn too many calories.
I do short bursts. I find if they are intense and done 10-15 minutes after lunch my sugars drop instantly and stay down after.
I may do a 20 minute fast cycle or a 20 minute really brisk walk at lunch to lower mid day sugars. I do this every day. I may do it twice a day sometimes.
I play golf if I get a chance, just 9 holes. Bit it's just relaxing more than anything.
Often in the week I'll walk into town also and back but more casually. About 30 mins return
Then weights 3 times a week.

 

[jn81]

Most Type 2's (initially at least) have constantly high insulin since the high BG drives the beta cells in the pancreas to work extra hard making insulin until eventually they start to fail.

I suppose that you realise that your BG will likely be higher by eating more often. Longer gaps between eating helps reduce the insulin resistance since it means there are longer periods between the insulin spike that accompanies each meal, giving your body a rest from it. High insulin constantly tends to makes insulin resistance worse.

That's why many Type 2's either eat snacks that have zero carbs, or eat only one or two meals per day.

3 meals a day doesn't really work for low BMI high calorie diet.

My last 'meal' is usually very low net carb. 30g pistachios plus 2 squares 85% dark chocolate.

Two other 'meals' are more snack like also.

 

[AndBreathe]

Yeah I eat 6 times per day.

Gosh. How do you find the time? (laughing)

That said, I have never snacked. We do 3 meals and that’s it, although my OH isn’t particularly low carb, so he’ll sometimes have a biccie, mid morning.

 

[AndBreathe]

3 meals a day doesn't really work for low BMI high calorie diet.

My last 'meal' is usually very low net carb. 30g pistachios plus 2 squares 85% dark chocolate.

Two other 'meals' are more snack like also.

I’ve responded elsewhere that I eat 3 meals a day. No snacks, but I have never smacked.

Looking at your descriptions of your ways of eating, exercising and so on, whilst we eat roughly similar caloric amounts, I have larger meals, with longer gaps, but then, I will often be working I; the garden from breakfast until lunch, or lunch until dinner, so my activity phases are also longer.

I tend to be happy to have fewer eating episodes, because my blood glucose has a decent chance to come down and settle after eating, rather than topping up in between meals.

it all goes to show how different we can all be.

 

[HSSS]

3 meals a day doesn't really work for low BMI high calorie diet.

But it can. You just need to add those “snacks” to the end of a meal and prolong the gaps between eating. It’s not about eating less overall but about condensing the feeding times into fewer events and eating the most nutrient (and calorie) dense food you can. Giving your insulin a rest to reduce insulin resistance is, in my opinion, even more important for your long term health than gaining an extra pound.

 

[Mrs HJG]

Hi @jn81 - take a look at my signature figures - I am classified as T1-LADA as I am positive for all antibodies, but by going low carb, upping my exercise, (nothing extreme, 20 mins fast walking per day either after breakfast - preferable, or after lunch when working), my HbA1c has remained in non-diabetic range for the last 18 months and I do not take insulin (yet) - but I do see big spikes if I eat something of 'unknown origin', like Holiday Inn sausages, so I know it's not in my mind, or I've got better.

I was on 1000mg Metformin twice a day (2x2 tablets), and reduced to 2 x 500mg (1 tablet twice a day) about 4 months after diagnosis and it made absolutely no negative difference to my HbA1c, which I was really worried about too.

I went from c.80kg with lockdown boredom (previously 70kg and wanting to lose weight) and dropped to 60kg in 6 months before diagnosis, despite filling my face with all the worst foods, I am steadily 53kg now but was 48kg last summer, which was a bit too low. I eat c.100g carbs/day, but don't really check anymore - salad and 'meat' or crisp breads and peanut butter, blueberries and greek yogurt and variations of the same, boring but I know where I am without obsessing. 3 meals and a couple of little snacks a day.

Check out Jessie Inchauspé/Glucose Goddess - her explanations of the science and her hacks are my go-to.

Nuts, cheese and greek yogurt are your friend, and will keep the calories up but carbs down, and 90% Lindt chocolate, indulge, they are my go to snacks.

I am 53 now and was 51 at diagnosis for what it's worth.

I saw my consultant this week, and he still considers me one of his 'specials'; it appears that my T1 was triggered at the same time as my first covid jab, and it is, according to him, something that is becoming well documented - did your symptoms, with hindsight, start shortly after a jab, or another ailment? LADA is often 'virus' triggered, so I don't think the link with covid antibodies is too big a jump in how your body can react.

You can be T1 without antibodies, (or T2 with), it's not as nice and tidy as most would think.

I have been tested again for GAD and other antibodies this week, (as they had dropped a lot 12 months from my levels at diagnosis), and my c-peptide was re-tested for the first time too, (that's via a urine, not blood, test) - results will be a few weeks yet; but I am itching to know the results and any implications for my short/long-term future; my diabetes team can only suggest I keep doing what I'm doing until it doesn't work any more.

I'm sorry if this brain dump is a bit disjointed, I just wanted to show you are not alone in similar presentation and treatment options, and happy to share more of my experience if it helps.

 

[ATB123]

Hi everyone, I was diagnosed with an hba1c of 127 in February 2023.

I had lost some weight and was going to the bathroom more often, so went to docker and A&E and got diagnosed.
Two years before this my hba1c was 41 in a blood test - not even pre diabetes as determined in ireland, so something unusual happened to me that caused this extremely fast progression to a 127 hba1c. I wasn't living a life with a great diet and exercise, but I certainly wasn't terrible either.
Looking back ay symptoms that I didn't really recognise at the time, I was probably in the diabetes range for 6-9 months before diagnosis.

I was prescribed 1000mg of metafornin twice daily.
Straight away I worked hard on a strict healthy diet and exercise.
Being low BMI(~19 bmi) it is a challenge to maintain my weight on metafornin and with regular exercise - I am on a high calorie diet (mostly good fats, fibre , protein, ~200g carbs per day)..
In late May I got a hba1c of 43 on a strict diet and good exercise.
In early September I got a hba1c of 38.
I got close to these hba1c values mostly because of the medication dosage - my diabetes was obviously very strong.
At diagnosis my morning spike before medication was going up as high as 23mmol/L.
When I went on the metafornin I saw a huge improvement in blood sugars.
I monitor regularly.

I got the 38 hba1c in a period of ideal family life ( my fiancée covered many tasks for me while I exercised ) ,
I was working from home 5 days a week and could cook and exercise there, ( now only 2 days at home )
and was in perfect health all summer (no colds, flus, covid ).
I wont bore with the details but you cannot imagine how hard I worked on every aspect to get down from 43 to 38 hba1c.

I have a 2 year old daughter and all that matters to me is being around long enough and being healthy enough to look after her and my fiancée
and this is what motivated me for my extreme work in lowering my hba1c.

My reward for this extreme hard work is the hospital now want to half my medication now after seeing the 38 hba1c.
I ( and my fiancée ) are devastated with this as we know how extremely hard I worked to do this.
So it feels like I am now trapped in that I will always be stuck having to work to these extreme measures to get even a 45 hba1c now with half the medication.
It feel like this will not only affect my blood sugars, but my mental health, my partner, my concentration at work and my weight.
As I am low BMI and not far above the minimum healthy level. So on half the meds I won't be able to eat as much as I do now and will possibly lose more weight.

Also I have covid at the moment and as a result my sugars are much higher, but I don't even know how my sugars will be in the long term after covid.
Will they be the same as before covid? Should the hospital be making a change until my blood sugars settle after covid again etc...
Thankfully my covid symptoms are mild luckily enough.

I was just getting used of my routine and managing my diabetes and keeping blood sugars very healthy.
It was finally getting easier for me.

Now it seems I am stuck in a bad place and feel like being on half the meds will affect my mental health, my partner, my work, my child , my low BMI as I feel like I will have to always work to extremes.
It feels almost like it's almost a punishment for working so hard on getting excellent hba1c numbers and that my life would have been better off if I had ate ice cream and casually exercised and coming in with a higher hba1c. Then I could stay on same meds and live an easier life.

I measure my carbs in every meal, and for breakfast for example I almost always eat 40g oats, 60g walnuts, 2 large spoons greek yoghurt, soy/almond milk, a couple of strawberries. I know on current meds this will usually peak around 10mmol/L and drop to about 7mmol/L after 2 hours.
I feel like on half my meds I won't even be able to eat this breakfast as it will peaking higher , at maybe 12 or 13mmol/L.

Let me know if anybody has any advice or has had similar experiences?

Thanks

Covid knackered my blood sugars. I had a1c of 66 in late July, straightaway my blood sugars, which weren't doing great before that despite low carb eating, rocketed to up in the 20s all the time. Was taken off meds and put on insulin which seems to be working great atm. I'm convinced it's Covid that tipped me over the edge.

 

[jn81]

Covid knackered my blood sugars. I had a1c of 66 in late July, straightaway my blood sugars, which weren't doing great before that despite low carb eating, rocketed to up in the 20s all the time. Was taken off meds and put on insulin which seems to be working great atm. I'm convinced it's Covid that tipped me over the edge.

yeah it certainly has an effect on some, and seems to be worse with others and sometimes more long term.
great that the insulin working well.

 

[jn81]

Hi @jn81 - take a look at my signature figures - I am classified as T1-LADA as I am positive for all antibodies, but by going low carb, upping my exercise, (nothing extreme, 20 mins fast walking per day either after breakfast - preferable, or after lunch when working), my HbA1c has remained in non-diabetic range for the last 18 months and I do not take insulin (yet) - but I do see big spikes if I eat something of 'unknown origin', like Holiday Inn sausages, so I know it's not in my mind, or I've got better.

I was on 1000mg Metformin twice a day (2x2 tablets), and reduced to 2 x 500mg (1 tablet twice a day) about 4 months after diagnosis and it made absolutely no negative difference to my HbA1c, which I was really worried about too.

I went from c.80kg with lockdown boredom (previously 70kg and wanting to lose weight) and dropped to 60kg in 6 months before diagnosis, despite filling my face with all the worst foods, I am steadily 53kg now but was 48kg last summer, which was a bit too low. I eat c.100g carbs/day, but don't really check anymore - salad and 'meat' or crisp breads and peanut butter, blueberries and greek yogurt and variations of the same, boring but I know where I am without obsessing. 3 meals and a couple of little snacks a day.

Check out Jessie Inchauspé/Glucose Goddess - her explanations of the science and her hacks are my go-to.

Nuts, cheese and greek yogurt are your friend, and will keep the calories up but carbs down, and 90% Lindt chocolate, indulge, they are my go to snacks.

I am 53 now and was 51 at diagnosis for what it's worth.

I saw my consultant this week, and he still considers me one of his 'specials'; it appears that my T1 was triggered at the same time as my first covid jab, and it is, according to him, something that is becoming well documented - did your symptoms, with hindsight, start shortly after a jab, or another ailment? LADA is often 'virus' triggered, so I don't think the link with covid antibodies is too big a jump in how your body can react.

You can be T1 without antibodies, (or T2 with), it's not as nice and tidy as most would think.

I have been tested again for GAD and other antibodies this week, (as they had dropped a lot 12 months from my levels at diagnosis), and my c-peptide was re-tested for the first time too, (that's via a urine, not blood, test) - results will be a few weeks yet; but I am itching to know the results and any implications for my short/long-term future; my diabetes team can only suggest I keep doing what I'm doing until it doesn't work any more.

I'm sorry if this brain dump is a bit disjointed, I just wanted to show you are not alone in similar presentation and treatment options, and happy to share more of my experience if it helps.

thanks for your detailed message .
it's great to see that halfing your meds didn't make difference for you.
I'll lookup Jessie Inchauspé/Glucose Goddes also thanks

 

[jn81]

thanks for your detailed message .
it's great to see that halfing your meds didn't make difference for you.
I'll lookup Jessie Inchauspé/Glucose Goddes also thanks

@Mrs HJG - on a quick review of her book's chapters/detail, she seems to put a big impact of vinegar.
I'd noticed that myself with meals and I believe it works.
I also find that adding a good bit olive oil to carbs like bread(sour dough/potatoes) in my case makes a big difference also.
The Mediterranean diet certainly has major advantages

 

[Mrs HJG]

@Mrs HJG - on a quick review of her book's chapters/detail, she seems to put a big impact of vinegar.
I'd noticed that myself with meals and I believe it works.
I also find that adding a good bit olive oil to carbs like bread(sour dough/potatoes) in my case makes a big difference also.
The Mediterranean diet certainly has major advantages

Ironically that's the one thing I don't do; I don't eat bread or potatoes so maybe if I did... I ate low carb bread for a while, and if it helps, it does pile on the pounds as its quite calorific. LivLife is nice but the slices are so small it looks like a baby's sandwich which psychologically I find worse than not having it at all. I may go back to it over winter though, as tiny cheese on toast is quite nice when it's cold rather than more salad.

 

[MrsA2]

as tiny cheese on toast is quite nice when it's cold rather

That's the only thing I use low carb bread for , and the occasional sardines on toast

 

[LionChild]

Hi everyone, I was diagnosed with an hba1c of 127 in February 2023.

I had lost some weight and was going to the bathroom more often, so went to docker and A&E and got diagnosed.
Two years before this my hba1c was 41 in a blood test - not even pre diabetes as determined in ireland, so something unusual happened to me that caused this extremely fast progression to a 127 hba1c. I wasn't living a life with a great diet and exercise, but I certainly wasn't terrible either.
Looking back ay symptoms that I didn't really recognise at the time, I was probably in the diabetes range for 6-9 months before diagnosis.

I was prescribed 1000mg of metafornin twice daily.
Straight away I worked hard on a strict healthy diet and exercise.
Being low BMI(~19 bmi) it is a challenge to maintain my weight on metafornin and with regular exercise - I am on a high calorie diet (mostly good fats, fibre , protein, ~200g carbs per day)..
In late May I got a hba1c of 43 on a strict diet and good exercise.
In early September I got a hba1c of 38.
I got close to these hba1c values mostly because of the medication dosage - my diabetes was obviously very strong.
At diagnosis my morning spike before medication was going up as high as 23mmol/L.
When I went on the metafornin I saw a huge improvement in blood sugars.
I monitor regularly.

I got the 38 hba1c in a period of ideal family life ( my fiancée covered many tasks for me while I exercised ) ,
I was working from home 5 days a week and could cook and exercise there, ( now only 2 days at home )
and was in perfect health all summer (no colds, flus, covid ).
I wont bore with the details but you cannot imagine how hard I worked on every aspect to get down from 43 to 38 hba1c.

I have a 2 year old daughter and all that matters to me is being around long enough and being healthy enough to look after her and my fiancée
and this is what motivated me for my extreme work in lowering my hba1c.

My reward for this extreme hard work is the hospital now want to half my medication now after seeing the 38 hba1c.
I ( and my fiancée ) are devastated with this as we know how extremely hard I worked to do this.
So it feels like I am now trapped in that I will always be stuck having to work to these extreme measures to get even a 45 hba1c now with half the medication.
It feel like this will not only affect my blood sugars, but my mental health, my partner, my concentration at work and my weight.
As I am low BMI and not far above the minimum healthy level. So on half the meds I won't be able to eat as much as I do now and will possibly lose more weight.

Also I have covid at the moment and as a result my sugars are much higher, but I don't even know how my sugars will be in the long term after covid.
Will they be the same as before covid? Should the hospital be making a change until my blood sugars settle after covid again etc...
Thankfully my covid symptoms are mild luckily enough.

I was just getting used of my routine and managing my diabetes and keeping blood sugars very healthy.
It was finally getting easier for me.

Now it seems I am stuck in a bad place and feel like being on half the meds will affect my mental health, my partner, my work, my child , my low BMI as I feel like I will have to always work to extremes.
It feels almost like it's almost a punishment for working so hard on getting excellent hba1c numbers and that my life would have been better off if I had ate ice cream and casually exercised and coming in with a higher hba1c. Then I could stay on same meds and live an easier life.

I measure my carbs in every meal, and for breakfast for example I almost always eat 40g oats, 60g walnuts, 2 large spoons greek yoghurt, soy/almond milk, a couple of strawberries. I know on current meds this will usually peak around 10mmol/L and drop to about 7mmol/L after 2 hours.
I feel like on half my meds I won't even be able to eat this breakfast as it will peaking higher , at maybe 12 or 13mmol/L.

Let me know if anybody has any advice or has had similar experiences?

Thanks

I would be asking for another Type 1 check?

 

[Junius]

Hi everyone, I was diagnosed with an hba1c of 127 in February 2023.

I had lost some weight and was going to the bathroom more often, so went to docker and A&E and got diagnosed.
Two years before this my hba1c was 41 in a blood test - not even pre diabetes as determined in ireland, so something unusual happened to me that caused this extremely fast progression to a 127 hba1c. I wasn't living a life with a great diet and exercise, but I certainly wasn't terrible either.
Looking back ay symptoms that I didn't really recognise at the time, I was probably in the diabetes range for 6-9 months before diagnosis.

I was prescribed 1000mg of metafornin twice daily.
Straight away I worked hard on a strict healthy diet and exercise.
Being low BMI(~19 bmi) it is a challenge to maintain my weight on metafornin and with regular exercise - I am on a high calorie diet (mostly good fats, fibre , protein, ~200g carbs per day)..
In late May I got a hba1c of 43 on a strict diet and good exercise.
In early September I got a hba1c of 38.
I got close to these hba1c values mostly because of the medication dosage - my diabetes was obviously very strong.
At diagnosis my morning spike before medication was going up as high as 23mmol/L.
When I went on the metafornin I saw a huge improvement in blood sugars.
I monitor regularly.

I got the 38 hba1c in a period of ideal family life ( my fiancée covered many tasks for me while I exercised ) ,
I was working from home 5 days a week and could cook and exercise there, ( now only 2 days at home )
and was in perfect health all summer (no colds, flus, covid ).
I wont bore with the details but you cannot imagine how hard I worked on every aspect to get down from 43 to 38 hba1c.

I have a 2 year old daughter and all that matters to me is being around long enough and being healthy enough to look after her and my fiancée
and this is what motivated me for my extreme work in lowering my hba1c.

My reward for this extreme hard work is the hospital now want to half my medication now after seeing the 38 hba1c.
I ( and my fiancée ) are devastated with this as we know how extremely hard I worked to do this.
So it feels like I am now trapped in that I will always be stuck having to work to these extreme measures to get even a 45 hba1c now with half the medication.
It feel like this will not only affect my blood sugars, but my mental health, my partner, my concentration at work and my weight.
As I am low BMI and not far above the minimum healthy level. So on half the meds I won't be able to eat as much as I do now and will possibly lose more weight.

Also I have covid at the moment and as a result my sugars are much higher, but I don't even know how my sugars will be in the long term after covid.
Will they be the same as before covid? Should the hospital be making a change until my blood sugars settle after covid again etc...
Thankfully my covid symptoms are mild luckily enough.

I was just getting used of my routine and managing my diabetes and keeping blood sugars very healthy.
It was finally getting easier for me.

Now it seems I am stuck in a bad place and feel like being on half the meds will affect my mental health, my partner, my work, my child , my low BMI as I feel like I will have to always work to extremes.
It feels almost like it's almost a punishment for working so hard on getting excellent hba1c numbers and that my life would have been better off if I had ate ice cream and casually exercised and coming in with a higher hba1c. Then I could stay on same meds and live an easier life.

I measure my carbs in every meal, and for breakfast for example I almost always eat 40g oats, 60g walnuts, 2 large spoons greek yoghurt, soy/almond milk, a couple of strawberries. I know on current meds this will usually peak around 10mmol/L and drop to about 7mmol/L after 2 hours.
I feel like on half my meds I won't even be able to eat this breakfast as it will peaking higher , at maybe 12 or 13mmol/L.

Let me know if anybody has any advice or has had similar experiences?

Thanks

Are you sure that 127 wasn't a blip, something wrong with the reading? I have lost four stone (and I wasn't wildly obese) to bring my hba1c down to 41 as I refused to treble the moderately low dose of Metformin the doc started me on. I hate taking any medication that much that I stopped taking Metformin completely for several months back last Spring and summer. With my reading saying 49 I put myself back on my one pill a day. Now my hba1c is 41. I am delighted. This thing is definitely food related. Your breakfast sounds like mine except that I mix 1 egg, big dollop of no fat natural yogurt (lowest sugar I can find), linseeds & other seeds & nuts, oatmeal, a sliced banana and some cut up fresh fruit (blueberries, strawberries, apple etc...) in a dish, divide the mixture into little "cakes" and cook them in my air fryer for 12 mins. A breakfast I can't wait to cook & eat every morning! (also works fantastic substituting low fat cottage cheese for the yogurt and chives & onions instead of the fruit). Still take the Metformin, I'd give it up in a shot if I could. Taking drugs to stay normal is never a good idea!

 

[BorisP]

Hi everyone, I was diagnosed with an hba1c of 127 in February 2023.

I had lost some weight and was going to the bathroom more often, so went to docker and A&E and got diagnosed.
Two years before this my hba1c was 41 in a blood test - not even pre diabetes as determined in ireland, so something unusual happened to me that caused this extremely fast progression to a 127 hba1c. I wasn't living a life with a great diet and exercise, but I certainly wasn't terrible either.
Looking back ay symptoms that I didn't really recognise at the time, I was probably in the diabetes range for 6-9 months before diagnosis.

I was prescribed 1000mg of metafornin twice daily.
Straight away I worked hard on a strict healthy diet and exercise.
Being low BMI(~19 bmi) it is a challenge to maintain my weight on metafornin and with regular exercise - I am on a high calorie diet (mostly good fats, fibre , protein, ~200g carbs per day)..
In late May I got a hba1c of 43 on a strict diet and good exercise.
In early September I got a hba1c of 38.
I got close to these hba1c values mostly because of the medication dosage - my diabetes was obviously very strong.
At diagnosis my morning spike before medication was going up as high as 23mmol/L.
When I went on the metafornin I saw a huge improvement in blood sugars.
I monitor regularly.

I got the 38 hba1c in a period of ideal family life ( my fiancée covered many tasks for me while I exercised ) ,
I was working from home 5 days a week and could cook and exercise there, ( now only 2 days at home )
and was in perfect health all summer (no colds, flus, covid ).
I wont bore with the details but you cannot imagine how hard I worked on every aspect to get down from 43 to 38 hba1c.

I have a 2 year old daughter and all that matters to me is being around long enough and being healthy enough to look after her and my fiancée
and this is what motivated me for my extreme work in lowering my hba1c.

My reward for this extreme hard work is the hospital now want to half my medication now after seeing the 38 hba1c.
I ( and my fiancée ) are devastated with this as we know how extremely hard I worked to do this.
So it feels like I am now trapped in that I will always be stuck having to work to these extreme measures to get even a 45 hba1c now with half the medication.
It feel like this will not only affect my blood sugars, but my mental health, my partner, my concentration at work and my weight.
As I am low BMI and not far above the minimum healthy level. So on half the meds I won't be able to eat as much as I do now and will possibly lose more weight.

Also I have covid at the moment and as a result my sugars are much higher, but I don't even know how my sugars will be in the long term after covid.
Will they be the same as before covid? Should the hospital be making a change until my blood sugars settle after covid again etc...
Thankfully my covid symptoms are mild luckily enough.

I was just getting used of my routine and managing my diabetes and keeping blood sugars very healthy.
It was finally getting easier for me.

Now it seems I am stuck in a bad place and feel like being on half the meds will affect my mental health, my partner, my work, my child , my low BMI as I feel like I will have to always work to extremes.
It feels almost like it's almost a punishment for working so hard on getting excellent hba1c numbers and that my life would have been better off if I had ate ice cream and casually exercised and coming in with a higher hba1c. Then I could stay on same meds and live an easier life.

I measure my carbs in every meal, and for breakfast for example I almost always eat 40g oats, 60g walnuts, 2 large spoons greek yoghurt, soy/almond milk, a couple of strawberries. I know on current meds this will usually peak around 10mmol/L and drop to about 7mmol/L after 2 hours.
I feel like on half my meds I won't even be able to eat this breakfast as it will peaking higher , at maybe 12 or 13mmol/L.

Let me know if anybody has any advice or has had similar experiences?

Congrats on your massive success in regulating your T2DM dysfunction. 200g carbs per day is way too much (for me at least) and we have no idea how you get to that number? do you eat a lot of bread/ rice / pasta or cake? Also, you didn’t report any side effects from your Metformin dosage? That’s a good thing. I was on the same dosage for 6 months with much less carbs per day and it worked but the side effects we just unbareable. Basicaly all I would say is don’t be afraid to half your dosage. If you can maintain your HbA1c on 2x500 XR’s you are doing really realy great. If you are successfully implementing exercise and diet control your reward is reduced meds. many people here would suggest you lower your carb intake to less than 50g a day but I am not one of them. a small dosage of Metformin goes a long way. good luck and keep doing what you are doing!

 

[zulu7]

Hi everyone, I was diagnosed with an hba1c of 127 in February 2023.

I had lost some weight and was going to the bathroom more often, so went to docker and A&E and got diagnosed.
Two years before this my hba1c was 41 in a blood test - not even pre diabetes as determined in ireland, so something unusual happened to me that caused this extremely fast progression to a 127 hba1c. I wasn't living a life with a great diet and exercise, but I certainly wasn't terrible either.
Looking back ay symptoms that I didn't really recognise at the time, I was probably in the diabetes range for 6-9 months before diagnosis.

I was prescribed 1000mg of metafornin twice daily.
Straight away I worked hard on a strict healthy diet and exercise.
Being low BMI(~19 bmi) it is a challenge to maintain my weight on metafornin and with regular exercise - I am on a high calorie diet (mostly good fats, fibre , protein, ~200g carbs per day)..
In late May I got a hba1c of 43 on a strict diet and good exercise.
In early September I got a hba1c of 38.
I got close to these hba1c values mostly because of the medication dosage - my diabetes was obviously very strong.
At diagnosis my morning spike before medication was going up as high as 23mmol/L.
When I went on the metafornin I saw a huge improvement in blood sugars.
I monitor regularly.

I got the 38 hba1c in a period of ideal family life ( my fiancée covered many tasks for me while I exercised ) ,
I was working from home 5 days a week and could cook and exercise there, ( now only 2 days at home )
and was in perfect health all summer (no colds, flus, covid ).
I wont bore with the details but you cannot imagine how hard I worked on every aspect to get down from 43 to 38 hba1c.

I have a 2 year old daughter and all that matters to me is being around long enough and being healthy enough to look after her and my fiancée
and this is what motivated me for my extreme work in lowering my hba1c.

My reward for this extreme hard work is the hospital now want to half my medication now after seeing the 38 hba1c.
I ( and my fiancée ) are devastated with this as we know how extremely hard I worked to do this.
So it feels like I am now trapped in that I will always be stuck having to work to these extreme measures to get even a 45 hba1c now with half the medication.
It feel like this will not only affect my blood sugars, but my mental health, my partner, my concentration at work and my weight.
As I am low BMI and not far above the minimum healthy level. So on half the meds I won't be able to eat as much as I do now and will possibly lose more weight.

Also I have covid at the moment and as a result my sugars are much higher, but I don't even know how my sugars will be in the long term after covid.
Will they be the same as before covid? Should the hospital be making a change until my blood sugars settle after covid again etc...
Thankfully my covid symptoms are mild luckily enough.

I was just getting used of my routine and managing my diabetes and keeping blood sugars very healthy.
It was finally getting easier for me.

Now it seems I am stuck in a bad place and feel like being on half the meds will affect my mental health, my partner, my work, my child , my low BMI as I feel like I will have to always work to extremes.
It feels almost like it's almost a punishment for working so hard on getting excellent hba1c numbers and that my life would have been better off if I had ate ice cream and casually exercised and coming in with a higher hba1c. Then I could stay on same meds and live an easier life.

I measure my carbs in every meal, and for breakfast for example I almost always eat 40g oats, 60g walnuts, 2 large spoons greek yoghurt, soy/almond milk, a couple of strawberries. I know on current meds this will usually peak around 10mmol/L and drop to about 7mmol/L after 2 hours.
I feel like on half my meds I won't even be able to eat this breakfast as it will peaking higher , at maybe 12 or 13mmol/L.

Let me know if anybody has any advice or has had similar experiences?

Thanks

You have carbs in the oats and strawberries, I was advised to separate the two and have the fruit a couple of hours later, that way one should not spike so much.

 

[jn81]

just an update on this, thankfully my consultant agreed to keep me on the same medication. she said she was more than happy to do this.
I would prefer to keep the same meds and keep my hba1c low for as long as I can.

I had tests done for MODY and I have none of the 45 associated genes.

I also do not have the GAD antibodies (or any LADA associated antibodies), and this fact coupled with my well controlled blood sugars on metafornin alone makes them think I do not have LADA either.
they reviewed c-peptide tests also, and I am making insulin just not the quantities of a non diabetic.
they say LADA can be ruled out if I do not need insulin within 3 years of diagnosis, and at this point in time they say my case does not point towards LADA, but can be reviewed at the 3 year mark etc..