Metformin or not?

I would continue with your diet for a while. Have you cut out the carbs? And have you got yourself a meter?

When I was first diagnosed I controlled my sugar with diet for quite a few years before I needed help. I only went on meds in 2005 and was diagnosed in 1998... 5 years of oral meds and then put on insulin. I think 3 weeks is too soon to be putting you on any oral medications. If I had my time again I would have preferred to be put on insulin rather than oral medications. My reason for that is that most oral meds put pressure on your pancreas to pump more insulin and in the long run you wind up with beta cell damage that I now have, so I don't hardly produce any of my own insulin anymore. Metformin works on the liver and not the pancreas but I found metformin is not that great at getting your sugar under control quickly. It took some time for me to see any results at all and when I did the results were minimal so by that stage my docs started introducing more oral meds into the mix. See if you can hold off meds if you can and control with diet and exercise. If you have to get help, then discuss all the options first. Docs are so quick at putting diabetics straight on to metformin. I didn't tolerate that drug too well at all either. I've also been quite sick ever since I've being on that drug and I now have several chronic conditions... I question what long term effects it does have on people to be honest. I'm not convinced it is a wonder drug myself. That's just my opinion though... I'm just sharing from my own experience here. If you do have to go on metformin my advice would be don't put up with what I did which was 5 years of hell because docs insisted I needed to be on the drug because I was type 2. I wound up with a good couple of years with not good control and then I insisted that they do the diagnostic tests on me again... I'm glad I did and wished I had done it sooner (lesson learnt). That's also my number 1 advice I give to any other type 2.... if things don't work, try something different... if you've tried a few options and it still doesn't work... get the GAD test and c-peptide test done to check if you are in fact type 2 still and whether or not you are still producing insulin. Ok, hopefully I haven't confused you here.... but wishing you the best in your diabetes management.

@Mr tosh Like you I was diagnosed T2 a few weeks back. My bloods where 79 on the initial HbA1c. I asked for another set of tests straight away, I was in denial. The doctor said the test gives a picture of the sugar in your blood perhaps stretching back 6-8 weeks. They said there is no point in doing it again for a couple of months. In fact our local hospital labs would refuse to do the tests. So it may be a few more weeks before your change in diet truly reflect in the HbA1c. Personally I didn't take the metformin that was offered. When the doctor saw I had dropped 4kgs, significantly increased my exercise and was monitoring my blood sugar, he was supportive. The consultant I saw afterwards (on a separate but related matter) was also supportive.

Personally (note my complete lack of experience and expertise) I would not take the drugs just now. Keep working on reducing your weight. Note the excellent advice on low carb diet on the forum. It is certainly working for me. I am sure your diabetic nurse is very competent but at the end of the day he or she is not a doctor, ask your Doctor's advice. As dawnmc says above it is perhaps worth getting yourself a meter and avoid carbs.

Good luck and welcome to the forum

Mr tosh said:

Have tried to reduce them by doing things like swapping from brown bread to whole grain and reducing things like potatoes but still finding it a bit confusing as to what's good and what's not at the moment. I've not been offered a meter as yet but have been booked onto the education course and it was hinted that I needed to do that first

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No bread, no spuds, no statins. 1st / 2nd / 3rd thing I learnt. 4th was getting a meter. There are huge debates here about statins. Some people, no issues. Others? Massive.

Get rid of the bread, pasta, rice, potato, pies etc. Code free meters are cheap and its the strips that can cost, I got mine for £5.99 for 50. You wont get a meter from the doc. Their are loads of good recipes on here and the net for low carb diets. And don't fear the fat, it fills us up and doesn't muck about with blood sugars. Have bacon and eggs for brekkie, avocado, nuts like walnuts, macadamia and almonds.
Read the forum too.

Oh and slather butter on your green veg too.

Nobody here can advise you as to whether you should or should not take medication @Mr tosh, we do not have the expertise.

You need to discuss why Metformin and statins are being offered and then make an informed decision. Three weeks is hardly enough time to see if diet and exercise are going to be the solution and three months is a more practical time.

I will tag @daisy1 to give you some basic information that will help you with your eating plan. If you are provided with a meter then you will have a better idea of what you can eat. If not then people will provide you with a link to a cheap meter and strips.
Good luck and keep asking questions.

Hi @Mr tosh If you ever do go on metformin, please bear in mind that people are more likely to post about a bad reaction to meds than an ok one so you are more likely to read horror stories

@Mr tosh

Hello Mr tosh and welcome to the forum Here is the information we give to new members and I hope you will find it useful. It gives a lot of advice on carbs which you need to reduce to get better levels. You have some good advice from other members above. Ask as many questions as you like and someone will be able to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 150,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

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 bloodglucose 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.

Hi and welcome. Yes, do keep anything with carb in it down to a sensible level and a meter, which is essential, will help guide you. Metformin is a good safe drug but never has that much effect on blood sugar and is of most use if you are overweight. Althouhg some peoeple have bowel issues with it for the first few weeks it usually sorts itself out but the SR (Slow Release) version is much kinder if you can twist the nurses arm for that. Arguments on statins continue and there is a lot of info for and against on the web. Be aware that total cholesterol is not the issue rather than the HDL/LDL ratio and trigs so do ask the nurse what these readings are and discuss from that information.

Hi . I was diagnosed with type -2 about 3 months ago . I was given metformin and gliclazide . I have got my levels down from a high of 27 and my levels are now 4.5 to 5.5 . Iv had no bad reaction from the medication and my DN has dropped my gliclazide down from 120mg to 40mg I do think it helped me get my levels down . But now iv changed my diet I'm hopping to come of them altogether . So. If you do get put on medication you can always come of them as your experience with your diet improves . I changed the type of carbs I eat and have kept them below 200 . It has worked for me . It did take a while to find the right thing for me to eat . I have a meter on prescription which I could not have done without . It does take some time to Change your diet. .i just changed one think at a time . All the best . And don't forget to keep us posted

Clive

Mr tosh said:

Hi, I was diagnosed with type 2 3 weeks ago with my initial bloods coming back at 84! with cutting out sugar and changing my diet the second lot have come back yesterday at 72 and cholesterol at 5.2. The nurse is wanting to put me on metformin MR (4 x 500 a day) and statins. After reading up on it I'm not sure I want to go down this route as most people seem to have a rough time with it! Is my drop in BG enough to continue the diet only approach?

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What the nurse probably doesn't realise is that it's ok to try diet only for 3 months before trying meds like metformin. Similarly, not everyone needs to go on statins. Personally, I wouldn't go on them unless my LDL/Trigs were sky high, and even then I'd think long and hard about it, because the side effects can be really bad.

If you follow the suggestions made here about low carbing, it should be possible to see a big reduction in your levels within 3 months, and they will probably in the normal range within 6 months. Good luck and keep us posted

Hi. Your HBa1C doesn't directly relate to your average meter reading although there are some rules of thumb. Aim for less than 8.5mmol on your meter 2 hours after a meal and aim for an HBa1C of 45mmol or less at the next blood test

Mr tosh said:

Hi, I was diagnosed with type 2 3 weeks ago with my initial bloods coming back at 84! with cutting out sugar and changing my diet the second lot have come back yesterday at 72 and cholesterol at 5.2. The nurse is wanting to put me on metformin MR (4 x 500 a day) and statins. After reading up on it I'm not sure I want to go down this route as most people seem to have a rough time with it! Is my drop in BG enough to continue the diet only approach?

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Metformin does not seem to affect me at all at (4 x 500 a day). I was on gliclazide but they stopped that when I started injecting Victoza. This has reduced the weight for me but is not for everyone. When first used it has horrible side effects such as diarrhoea and sickness, but if you stick with it, it does work. I have lost a stone and a half since last November.

Mr tosh said:

Thanks all for the Mine of information, have got myself a meter and have just done my first one which comes back as 9.0 mmol/L pre food. My question is how does this relate to my results of 84 then 72 on my HBA1c tests. Confused

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Hi and welcome.
Look at this as a possible conversion
http://www.diabetes.co.uk/hba1c-to-blood-sugar-level-converter.html

I was given 3 months and managed by diet, weight loss and exercise to reduce my HbA1c from 95 to 50 in those 3 months so it is worth trying if that is what you want. I did a lot of testing and finding what I could/could not eat. Do ask questions and there should be people who can help you.