Medical opinion

Hi @Laconic,

On diagnosis in May 2015, my HbA1c was with 100 mmol only slightly lower than yours. As in your case, my GP also believed that diet would not work and that insulin was the only option, but was put on metformin initially. Embarked on a low carb diet and three months later my HbA1c was at normal levels with 34 mmol. After one year was taken off all metformin and have maintained normal levels since-

So, don't give up hope. It can be done and many on this forum have done so, even with levels higher than yours. Surprise your GP and nurse. Keeping my fingers crossed for you.

Edited to add: It might be a good idea to get a glucose meter and start monitoring your blood sugar levels. Gliclazide pushes your pancreas to produce more insulin. Combined with the effect of low carbing, this can easily push your blood sugars too low -- causing hypoglycemia. So, you need to be a bit careful. Maybe even talk to your GP, tell him that you will try to control by diet and ask him if you can start Glic in three months' time if your next blood glucose test isn't a lot better.

Laconic said:

Having just been diagnosed as a type 2, I went to see the diabetic nurse who, checked my feet, blood pressure and weight.
I asked if I would be on medication long as my HbA1c was 110 mmol, she replied that I would be on some form of medication indefinitely, the doctor also said the same. Currently am on Gliclazide and Metformin, they agreed to test my HbA1c again in 3 months instead of 6 which was said to me at first.
My sisters boyfriend who was 53 mmol was given the option of changing his diet instead of meds and he has now reversed this diabetes.
I have been told my HbA1c is so high I need to be on medication and can’t bring it down with diet alone, I’m hoping that when I’m tested in 3 months I will be below 50 mmol and diet changes would be enough.
I don’t mind taking meds if I need to, but never thought I’d have to forever, when my diabetes is better controlled.

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Hi yes you can significantly lower it by the way you eat. On diagnosis I was 97 and currently 29 I’m on no meds diet only - it is possible.
Why not ask if you could have a short time to try out a low carb way of eating say for three months and say you’ll consider meds if it hasn’t come down significantly? You should be given opportunity to try this out.
If you use a blood glucose meter regularly too you should be able to see the change very quickly yourself and if no impact you could see that too. Testing two hours after low carb meals should help you to learn what works for you and how many and which carbs your body can deal with. Worth a discussion with your HCPs lots of us on here have seen dramatic reductions just by going LCHF even from very high numbers.
Good luck on your journey as @ziggy_w said surprise your Durand nurse you can do it

shelley262 said:

Hi yes you can significantly lower it by the way you eat. On diagnosis I was 97 and currently 29 I’m on no meds diet only - it is possible.
Why not ask if you could have a short time to try out a low carb way of eating say for three months and say you’ll consider meds if it hasn’t come down significantly? You should be given opportunity to try this out.
If you use a blood glucose meter regularly too you should be able to see the change very quickly yourself and if no impact you could see that too. Testing two hours after low carb meals should help you to learn what works for you and how many and which carbs your body can deal with. Worth a discussion with your HCPs lots of us on here have seen dramatic reductions just by going LCHF even from very high numbers.
Good luck on your journey as @ziggy_w said surprise your Durand nurse you can do it

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Absolutely agree, @shelley262. Was just amending my post when you posted your advice.

122 to 35 in 4 months.

Put it this way. I was told that I would be on ever-increasing doses of medication for the rest of my life. My diabetes would continue to get worse and I would eventually die of a complication. Instead, I'm now on no medication, my diabetes has gone, and I've never been healthier. The secret of my success? Do the exact opposite of everything every doctor or nurse ever told me.

That's not to say that we will all be as fortunate, but there's certainly a very good chance of turning things around. The majority of doctors don't understand the concept of beating type 2 diabetes because they have spent an entire career making it worse. Best of luck with everything. You are certainly in the right place to get proper help and support

@Laconic Some really good advice here from @shelley262 and @ziggy_w .

Would just like to say that I also had a high hba1c when diagnosed. In 2012 I had an hba1c of 125 and was put straight on insulin. Was on it for four years. Started LCHF in 2016. Went down to 20g carbs at the end of 2016 and came off the insulin. Not on any other meds either. The information on this forum has been invaluable.

I think I will probably will have to stay with the 20g carbs for life. I don't mind this because I found injecting insulin really hard to get right. I was either injecting too much or too little.

@Jim Lahey very well said.

Laconic said:

I might ask if they can meet me half way and just take metformin, because if I’m low carbing Gliclazide might be counter productive

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Yes, I agree. Metformin usually doesn't cause hypos when low carbing. It probably the safest diabetes medications for T2s on low-carb.

Laconic said:

Having just been diagnosed as a type 2, I went to see the diabetic nurse who, checked my feet, blood pressure and weight.
I asked if I would be on medication long as my HbA1c was 110 mmol, she replied that I would be on some form of medication indefinitely, the doctor also said the same. Currently am on Gliclazide and Metformin, they agreed to test my HbA1c again in 3 months instead of 6 which was said to me at first.
My sisters boyfriend who was 53 mmol was given the option of changing his diet instead of meds and he has now reversed this diabetes.
I have been told my HbA1c is so high I need to be on medication and can’t bring it down with diet alone, I’m hoping that when I’m tested in 3 months I will be below 50 mmol and diet changes would be enough.
I don’t mind taking meds if I need to, but never thought I’d have to forever, when my diabetes is better controlled.

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Of course everyone is different, but please dont take your DN’s word as the only way. My Hba1c was 112 and with very strict (but satisfying and enjoyable) LC had Hba1c of 36 only three months later. (My Hba1c dropped to 97 a week later after initial diagnosis - second test as they didn’t believe I could have diabetes!). I was put on metformin fir two weeks but taken off it as my BG home tests were so good and it didn’t agree with me ( probably because the dose was upped too quickly)

Anyway. Your fate may not be sealed. Follow your instincts and the amazing help, advice and support from the very knowledgeable people here.

If you are taking Gliclazide then you should be provided with a meter and test strips as you can get hypos with it - particularly dangerous if you intend to eat a low carb diet.
Eating low carb is very effective - why your HCPs think that you would not be able to lower your blood glucose to normal I do not know - I was back to normal levels in 6 months without really trying.

Hi. Can you let us know a bit more about your weight and typical diet?

Hi @Laconic

I agree with the above advice/information and it's great that you could see that you'd been given poor advice from your HCPs (Health Care Professionals)

I'm prescribed Glipizide, which is a similiar type of medication to Gliclazide but I didn't tolerate it well)

With very careful monitoring (I am fortunate enough to be able to self-fund Freestyle Libre) and finger pricking, I am able to see what my glucose levels do after different foods (am on LCHF) and can also see general patterns, ie morning spike (Dawn Phenomenon / 'Feet on Floor') AND how the Glipizide/Gliclazide affects your levels, timing etc.

Using this information, and that the Glipizide/Gliclazide tabs are not coated, I cut them into 1/2, and then 1/4 etc, and have been able to determine, myself, what level I require on each day. Personally, I found, when prescribed only 1 tablet daily, to be taken in the morning, I will go 'hypo' at around 4 hours after taking it, then having to correct the levels by eating some glucose (Jelly babies, in my case). So, I found splitting the dose, morning and before evening meal, this evened out much better, keeping a much more stable glucose level.

I have to admit the HCPs, particularly the nurse, wasn't happy about this but one of my GPs 'gets it' and is happy for me to do this, probably because she has seen I do monitor carefully and that I've been pretty successful. I must also add that I'm a retired nurse so perhaps I've been given a bit of credit for that too

As you are to be re-tested in 3 months, I would agree with above suggestions and change what you eat to lower carbs. There's a good chance you'll get down to a really good level and, hopefully, reverse your diabetes. Shock your HCPs into realising they're too out of date

Also, if you are able, Jason Fung's book 'The Diabetic Code' is definitely worth a read. Also now available on YouTube. His explanations are brilliant and relatively easy to understand

Good luck

How has the change in diet altered your blood glucose levels?
Are you still taking Gliclazide?

Do be careful - you could hypo, check often.

Laconic said:

Still taking Gliclazide blood glucose level 5.0 mmol 2 hours after eating

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Sorry if I missed it, but is your doctor aware you are low carbing?

Low carbing and gliclazide can be a tricky combo. The drug makes your pancreas produce more insulin, if you go low carb you can end up hypo. If you are insulin resistant (I'd imagine you are to some degree) then making the pancreas produce even more seems very counter productive and can worsen insulin resistance.

If you are at 5 after a meal, then you may be walking a fine line in between meals because of the gliclazide and a lower carb diet. I'd be sure to have some sort of hypo treatment within finger tip reach in case you do become hypo. Jelly babies or some sort of glucose that is absorbed quickly. So testing more frequently becomes needed also. I like to have a back up meter, sometimes they can just stop working. Not a situation you want to encounter at the worst possible moment. I know that sounds a bit much, but I like to have all my bases covered.