Meds Or Diet??

Hello and welcome to the forum. Tagging @daisy1 for the info pack offered to all newcomers.

Yes, a diet lower in carbs is the best way to tackle your numbers and improve your health. Metformin is considered a mild, safe drug though many people have gastric upset when first taking it. If this proves to be a problem for you for more than a couple of weeks then ask your medics for the slow release version which is said to be kinder on the system.

My HbA1c was similar to yours on diagnosis and I made great strides in lowering it with Metformin and dietary changes, it can be done.

Have a wander around the forum and ask as many questions as you like.

Many people reverse situations like yours by changing their diet/lifestyle. An increasing number of doctors are becoming aware of this, but unfortunately you seem to have one of the less up to date ones. Metformin is the drug they start everyone off on, but it doesn't do much to reduce blood sugar levels, so, sooner or later, you end up on something stronger and so it progresses. For health, vitality and weight loss, without or with the minimum of drugs, you need to change what you eat and the food that is making you ill/ diabetic/ fat are the sugars and starches. Cut out most of these and life will get better.
I'm now going to tag @daisy1 who will post a very useful information sheet on this thread and I also suggest that you have a look at this site, https://www.dietdoctor.com/
By the way, welcome to the forum and keep asking as many questions as you need to .
Sally

Hi and welcome to the forum.

It doesn't have to be an either/or choice. You can do both. Metformin can be very helpful, especially in the early stages of trying to get your BG under control as it helps to control the release of extra glucose created by the liver.

CF said:

diet has caused my condition and I’d rather reverse meds free.

Click to expand...

I agree, it doesn't have to be an either/or choice.

No medication on it's own will reverse the condition, it can only be done by lifestyle and diet changes, but some medications can assist with the process.

Metformin is a drug that can help, especially in the early days. It does not directly reduce blood glucose levels in the blood, but works by affecting the way your Liver becomes involved in the processes. It is a safe and well understood drug.

The only reason I can think of for not taking metformin alongside lifestyle and dietary changes, would be if you are one of the few people who suffer bad side effects from taking it.

I was diagnosed in March with hba1c of 95 weight 16st ,started on metformin and stopped eating starchy high carbs like bread,rice pasta cereal etc and started to lose weight. Next hba1c was June and was 44 I then decided my own choice to stop metformin and statin(Cholesterol high) to see how the weight loss and some exercise and some fasting done my last hba1c was August weight 12st 10 and was 33 and my cholesterol ratio had improved I also have had some high carb foods between tests but have finger tested my bloods a lot to see where I am costing me a bit in strips but great guide to what works.I was confident in what I was doing would control my bloods hence why I made the decision to stop meds.

Metformin is known to help protect the heart, and for some of us has the added bonus of reducing appetite. It can have unfortunate effects on the gut, but introducing it slowly and being persistent will often settle things down. It is a long standing and well understood drug and does not clobber your pancreas the way that some diabetic drugs do.

Reference:
Nesti L, Natali A. (2017)
Metformin effects on the heart and the cardiovascular system: A review of experimental and clinical data.

Nutr Metab Cardiovasc Dis. 2017 Aug;27(8):657-669. doi: 10.1016/j.numecd.2017.04.009. Epub 2017 May 10.

For anyone who hasn't read this, Jenny Ruhl's article on metformin is an excellent overview:

https://www.bloodsugar101.com/metformin

Hi. Metformin is a very safe drug which I still take after 15 years. It never has much effect but helps. Ask for the Slow Release version if you have bowel issues. Keep going with the low carb but have enough proteins and fats to keep you feeling full. Your weight should continue to reduce and so should you BS.

CF said:

Hi - don’t know what best to do- docs prescribed metformin 500mg to start up to 2000mg over a month but diet has caused my condition and I’d rather reverse meds free. But is this wise? I got little advice re diet and testing and everything else other than a clinic would be in touch re this. But that doesn’t help me now! I was 22st 2 back in Oct last ye and lost to 17 9 in March this and then halted as it was hard work and work paid work was reallly stupid busy high levels stress etc. I was up to 18 3 after a lazy summer so not too bad. However blood pressure blood test routine showed 11.7 fasting and then a hba1c of 104. Which is crazy high. I don’t get it. Lost weight a large amount - through dieting - I can and will lose and carb down to do so but what do I do. Are my readings so high I need tablets. Doc just said chronic progressive disease take these tablets for three months you may have bad guts- clinic will be in touch!

Click to expand...

Like others said, it's not an either/or thing, per se. I reacted badly to metformin, and I didn't care much for gliclazide. (Nor the statins). So I figured out a diet that worked for me, and was med-free, in this respect anyway, in 3 months. That's how I wanted to do it; stop diabetes in its tracks. It might not be your choice though, and that's what is before you; a choice. If you rely on meds 100%, then diabetes is certainly a progressive disease. Throw diet in the mix and the odds of regression and no complications get a whole lot better. It's up to you. (Check dietdoctor.com for ideas!)
Good luck!

CF said:

I eat fish so as long as I can cut out the sweets, pastries, pizzas and bread ( the nice stuff) I’ll be back in the swing of things with the weight loss

Click to expand...

Don't forget to add some fats for satiety otherwise you'll be hungry and fall off the horse.
Avocado , olives and eggs if you don't eat meat I guess and butter and cream of course.

I'd far rather have the option of going out of the house whenever I like whilst sticking to a low carb diet than any 'help' from Metformin which made me feel just dreadful.
My Hba1c was 91 at diagnosis - but the doctor did not seem bothered, phoned and made an appointment for two weeks later, but then, he hasn't bothered to see me since, so maybe its him, not me.
Luckily I went low carb and was back to normal in 6 months - but having experienced 5 weeks of Metformin means that I can defy all temptations simply by thinking of the pressure to take it again if my Hba1c was to rise.

Fellow members.

I don't think that it is responsible to imply to newly diagnosed who have been prescribed Metformin that there are likely to be terrible side effects.

The vast majority of people who take Metformin do not suffer any side effects, and as has been shown taking the drug has many potential benefits.

Metformin helps keep my bowels regular, especially when fasting and or on a LCHF diet.

@CF

Hello CF and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will be able to 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.
  

Yes I agree. As due to lack of experience a newee may get some loose movements whilst med is settling in but that improves in many.
It is rare but does cause some a problem. Like any side affect noted on tablets.

E.g I was told horror stories about painkiller Tramadol.
I got none of its side affects. In fact it was the best drug for scatica I've come across.

I'm trying to tolerate metformin again but I have to slowly introduce it otherwise it makes by IBS look like a *****.
I didnt have to the first or second time of introducing metformin. I have to be so careful now though.

CF said:

Hi - don’t know what best to do- docs prescribed metformin 500mg to start up to 2000mg over a month but diet has caused my condition and I’d rather reverse meds free. But is this wise? I got little advice re diet and testing and everything else other than a clinic would be in touch re this. But that doesn’t help me now! I was 22st 2 back in Oct last ye and lost to 17 9 in March this and then halted as it was hard work and work paid work was reallly stupid busy high levels stress etc. I was up to 18 3 after a lazy summer so not too bad. However blood pressure blood test routine showed 11.7 fasting and then a hba1c of 104. Which is crazy high. I don’t get it. Lost weight a large amount - through dieting - I can and will lose and carb down to do so but what do I do. Are my readings so high I need tablets. Doc just said chronic progressive disease take these tablets for three months you may have bad guts- clinic will be in touch!

Click to expand...

Oh dear, regards contents of mail, and re chronic progressive disease stated by your Doc, if any consolation my own doc said similar words, along with take metformin,/convince yourself your diabetic dont drink coffee and still eat your rice paella Sundays! The chronic progressive disease or words similar are also noted on the ADA and Australian Websites, how welcoming it would be, if those websites, and others who state these words including Doctors, could add to give some positive incentive stating, "having said that, with lifestyle change, diet, more exercise, intermittent fasting as and when one is able, one can control their situation, with or without medications". to make the initial diagnosis softer This rarely if ever happens sadly.

What did I do with my Doc of 30 years, obviously, his words advices regards diabetes indicated he was no longer the right Doctor for myself, took charge fo this, in the best interests of my body health, sacked him, found a new Doctor whose approach is 100% different and prefers to offer lifestyle changes first and foremost, its a case seek and one will find, there are few out there who, thankfully are coming around to the reality. good luck whatever you decide which way to go.

I would say if I could choose I would do both low carb and take metformin... but my GP took the metformin away when I got down in the normal level-- which has made it more difficult for me to stay under 6 mmol in morning blood glucose and also does force me to eat much lower level of carbs on a daily basis..
If I could choose I would also take metformin like 2 x 850 mg daily

but many can not cope with metformin.... I never had great problems with it though, the only anoying sideeffect was that I had to get up to pee up till 4 times every night, which I awoyded by taking the whole metformin dose in the mornings