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Managing Type 2 With Or Without Metformin

Discussion in 'Metformin/Biguanides' started by azad1983, Jun 6, 2018.

  1. azad1983

    azad1983 Type 2 · Member

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    When I was diagnosed, I started a very strict diet and after 3 months my HBA1C came to 56 from 104. I didn't take Metformin at all.
    However, for the next 3 months test I have been taking Metformin but we're eating more than before and I got HBA1C level 42 only.
    I'm puzzled, despite eating more Metformin kept my glucose level very low!
     
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  2. briped

    briped Type 2 · Well-Known Member

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    Hi Azad, and welcome. I see this is your first post here. @daisy1 has a very informative welcome post for you to read, I'm sure. Anyway, in my opinion and experience your BG levels depend more on what you eat than the amounts you eat. If you eat food with a very low carb content, then you're fine, but "a very strict diet" can mean so many different things. Carbs are basically the same as sugar. There are lots of carbs in pasta, rice, potatoes, root veggies and bread, for example. Which diet have you been following?
    I'm sure lots of experts will be along shortly :)
     
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  3. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Hi azad and welcome to the Forum and well done on your excellent results. As this is your first post I’ll tag in @daisy1 for her useful welcome info post.
    Your question is too vague to answer. Can you give more info about your diet. If you kept your carbohydrates low but increased your intake of other foods, yes your HbA1c would still stay low. Metformin will help a little but your diet probably has more bearing on your results.
     
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  4. Freema

    Freema Type 2 · Expert

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    My experience is that metformin lowers my HbA1c with around 1 mmol in average, that is actually also a lot remembering that it keeps numbers lower also the hours where we don't eat at all

    note only the green is the truely non-diabetic level
    50shades - Copy.png
     
  5. 4ratbags

    4ratbags Type 2 · Well-Known Member

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    The lower result is most probably due to what you are eating rather than the Metformin. Within a year of being diagnosed my HbA1c went from 100 down to 34 and while I'm sure Metformin helped I credit it more to the changes in my food choices. If you can give us some indication of what you generally eat on an average day it would be more useful.
     
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  6. daisy1

    daisy1 Type 2 · Legend
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    @azad1983

    Hello Azad and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it helpful. Ask as many questions as you need to and someone will help.


    BASIC INFORMATION FOR NEW MEMBERS

    Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

    A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

    On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

    The role of carbohydrate

    Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

    If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

    The bad news

    Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

    The good news

    People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

    Controlling your carbs

    The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

    There are two approaches to controlling your carbs:
    • Reduce your carbohydrate intake
    • Choose ‘better’ carbohydrates
    Reduce your carbohydrates

    A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

    The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

    Choosing better carbohydrates

    The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

    Read more on carbohydrates and diabetes.

    Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

    Eating what works for you

    Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

    To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

    The blood sugar ranges recommended by NICE are as follows:

    Blood glucose ranges for type 2 diabetes
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 8.5 mmol/l
    Blood glucose ranges for type 1 diabetes (adults)
    • Before meals: 4 to 7 mmol/l
    • 2 hours after meals: under 9 mmol/l
    Blood glucose ranges for type 1 diabetes (children)
    • Before meals: 4 to 8 mmol/l
    • 2 hours after meals: under 10 mmol/l
    However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

    Access to blood glucose test strips

    The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
    • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
    • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

    Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

    You may also be interested to read questions to ask at a diabetic clinic.

    Note: This post has been edited from Sue/Ken's post to include up to date information.
    Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

    • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

    • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
     
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  7. azad1983

    azad1983 Type 2 · Member

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    Thanks, strict meant low carb food.
     
  8. azad1983

    azad1983 Type 2 · Member

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    Hi,
    My strict diet was as follows:
    Breakfast: 1 slice of wholemeal bread with just one tbsp peanut butter with a cup of black tea without sugar.
    Lunch: 1 piece of salmon or cod fillet with mixed veg.
    Afternoon snack: a banana
    Last meal: lots of mixed veg, 1 piece of chicken drum stick and 100g or less brown rice.

    Following this diet I lost 9 kg in a month.
     
  9. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    You are really lucky to be able to eat bread, banana and rice - and lose weight too. Your metabolism must be in better shape than mine.
     
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  10. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Wow, you’ve done well to achieve your HbA1c of 42 if this is a typical day’s food. A lot of us Type 2 would find normal wholemeal bread, bananas and brown rice would raise our blood sugars, but if it works for you that’s brilliant.
     
  11. azad1983

    azad1983 Type 2 · Member

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    I also do lots of cycling so that's also help.
     
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  12. Jenny15

    Jenny15 Type 2 · Well-Known Member

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    I've been reading the HbA1c changes over time that people have in their signatures and it seems like Metformin does lower A1cs a little bit in addition to low-enough low carbing. It's completely unscientific, finger in the wind stuff, of course. I would love to see a study or two on it, if anyone's aware of one.

    Metformin + LCHF allowed me to be in the low 30s and my hunch is that LCHF alone would have allowed me to be in the high 30s, (both examples were when my BMI was lower.)

    The OP stated the reduction to 42 was while taking Metformin so I'm not totally surprised by it. I have gotten out of the habit of routinely eating bread, bananas and rice and I don't miss them. Now that my overall health is worse and I've had to start a trial of insulin, I definitely cannot tolerate those foods and I am strictly avoiding them so as to lighten the load on my pancreas and keep the insulin doses as low as I can.

    @azad93 it may be possible to keep your A1cs below 48 for some time while taking Metformin and eating moderate carbs but I think in the long term you may find out you need to reduce carbs a bit further to stay under 48.

    Increasing the Metformin dose gave me "Metformin diarrhoea" for the first time, and I missed seeing it as that for many months because I assumed that >8 years on the drug without that side effect meant it agreed with me. I now know that only 1000mg/day agrees with me and 1500mg/day does not.

    Since I did not want to reduce my total daily carbs to less than say 80g, let alone 50g or 20g, my mind was open to other drugs than metformin. Then one of my doctors suggested insulin because (in my case due to non-diabetes issues) my A1c of 74 and being very symptomatic was placing my health at risk of infections that could become life threatening and complications that are probably not reversible. Due to a series of medical errors this high BG state had already gone on too long to wait longer. Insulin was the sensible option for me and I will aim to get off it when I can, subject to medical needs at the time.

    Just saying all this so you're aware early on that low carbing from the start can save you from a lot of heartache down the track. Your A1c is very good at the moment and I see no reason why you would need more than Metformin at this time (and could probably discuss with your nurse or doctor stopping it *if* you low carbed enough).

    I hope others can learn from my mistakes so they can avoid pitfalls.
     
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