New, panicking, and asking for advice please!

[SheilaCanning]

Hello. About 2 ½ years ago I was told my HbA1c was high enough twice for me to have a diagnosis of diabetes. After that, I went on a strict diet and exercise regime and when I was retested 3 months later I was down to pre-diabetic levels. Things have gone haywire for me over the last year and my dr thought I was having perimenopausal issues or other problems. It was only last month when I asked to have my bloods done that they diagnosed me as diabetic with HbA1c of 7.7.
I've just come off the phone from a chat with a diabetic nurse. I thought she might say lets retest in 3 months as I am back on the diet/exercise regime, or maybe prescribe Metformin. But instead, she has suggested I go on either once a week injections, Ozempic or a tablet, Dapagliflozin. This has thrown me a little! It suddenly all feels very serious and overwhelming. She suggested I take some time to read up on them and pick which one to go with. She will call on Monday to find out which I want to start.

I'd be so very grateful for any advice & thoughts on this.

Background - my father had multiple cardiac issues and died of heart failure, he was also diabetic. My maternal gran was diabetic. My aunts are diabetic. I am very overweight (15 stone and very short.)

 

[Resurgam]

Hello and welcome to the forum.
Assuming that you are a type two what is your carbohydrate consumption like?
We can diet and exercise all we like, but our basic problem is an inability to cope with carbs, so most successful controllers start with totting up their intake.

 

[bulkbiker]

Hello. About 2 ½ years ago I was told my HbA1c was high enough twice for me to have a diagnosis of diabetes. After that, I went on a strict diet and exercise regime and when I was retested 3 months later I was down to pre-diabetic levels. Things have gone haywire for me over the last year and my dr thought I was having perimenopausal issues or other problems. It was only last month when I asked to have my bloods done that they diagnosed me as diabetic with HbA1c of 7.7.
I've just come off the phone from a chat with a diabetic nurse. I thought she might say lets retest in 3 months as I am back on the diet/exercise regime, or maybe prescribe Metformin. But instead, she has suggested I go on either once a week injections, Ozempic or a tablet, Dapagliflozin. This has thrown me a little! It suddenly all feels very serious and overwhelming. She suggested I take some time to read up on them and pick which one to go with. She will call on Monday to find out which I want to start.

I'd be so very grateful for any advice & thoughts on this.

Background - my father had multiple cardiac issues and died of heart failure, he was also diabetic. My maternal gran was diabetic. My aunts are diabetic. I am very overweight (15 stone and very short.)

Hi and welcome
Your results (and the rather antiquated way your nurse reported them) are explained slightly here.

60.7 mmol/m isn't amazingly high (mine on diagnosis was 87) so I'm very surprised your DN has suggested such strong medication.

The best thing to try in order to bring your numbers down is reduce carbohydrate intake.

This will also help with weight loss as many of us can attest.

I'd suggest trying that and maybe taking metformin to appease your HCP's for at least 3 months before moving onto stronger meds (assuming that you haven't made any improvements in the interim).

 

[LaoDan]

Hello. About 2 ½ years ago I was told my HbA1c was high enough twice for me to have a diagnosis of diabetes. After that, I went on a strict diet and exercise regime and when I was retested 3 months later I was down to pre-diabetic levels. Things have gone haywire for me over the last year and my dr thought I was having perimenopausal issues or other problems. It was only last month when I asked to have my bloods done that they diagnosed me as diabetic with HbA1c of 7.7.
I've just come off the phone from a chat with a diabetic nurse. I thought she might say lets retest in 3 months as I am back on the diet/exercise regime, or maybe prescribe Metformin. But instead, she has suggested I go on either once a week injections, Ozempic or a tablet, Dapagliflozin. This has thrown me a little! It suddenly all feels very serious and overwhelming. She suggested I take some time to read up on them and pick which one to go with. She will call on Monday to find out which I want to start.

I'd be so very grateful for any advice & thoughts on this.

Background - my father had multiple cardiac issues and died of heart failure, he was also diabetic. My maternal gran was diabetic. My aunts are diabetic. I am very overweight (15 stone and very short.)

I’d get on a diet plan and if that doesn’t work, then try the medication route. Do you have a meter? If not get one and start testing before and after your meals. Cut out the foods that cause you to spike, most likely carbs.

 

[Daibell]

Hi. I suspect your diet regime wasn't a low-carb one? Set yourself a daily limit for carbs - perhaps 150gm or even a bit less? Hopefully you can gradually get the weight down and then you should find your HBA1C comes near to or below diabetic levels. I would delay the meds until the weight comes down but it's your choice.

 

[SheilaCanning]

Hello and welcome to the forum.
Assuming that you are a type two what is your carbohydrate consumption like?
We can diet and exercise all we like, but our basic problem is an inability to cope with carbs, so most successful controllers start with totting up their intake.

Thanks so much for replying!
Sorry, yes, type 2. I do like my carbs but when I originally went on my diet 2 ½ years ago I switched all white carbs to wholewheat - brown rice, wholegrain bread, pasta etc. I am on MyFitnessPal and keep an eye on carbs (not super strict) and don't eat biscuits, cakes and so on. Looking over the last week or so 129g carbs Tuesday, 165g Monday, 126g Sunday, 190g Saturday, 125g Friday etc).

 

[SheilaCanning]

Hi and welcome
Your results (and the rather antiquated way your nurse reported them) are explained slightly here.

View attachment 47248

60.7 mmol/m isn't amazingly high (mine on diagnosis was 87) so I'm very surprised your DN has suggested such strong medication.

The best thing to try in order to bring your numbers down is reduce carbohydrate intake.

This will also help with weight loss as many of us can attest.

I'd suggest trying that and maybe taking metformin to appease your HCP's for at least 3 months before moving onto stronger meds (assuming that you haven't made any improvements in the interim).

Thank you for your response. I'm surprised too!
She said that metformin is fairly neutral in terms of weight reduction whereas her suggestions are much better at reducing weight alongside diet and exercise. I also have high cholesterol and family history of diabetes and heart disease. She suggested a statin but I asked if we could wait and see if my cholesterol reduces with the diet and she agreed I am very wary of side effects.

I also have hideous stomach bloating that has been going on for a year now and my GP was concerned metformin would add to that.

 

[SheilaCanning]

Hi. I suspect your diet regime wasn't a low-carb one? Set yourself a daily limit for carbs - perhaps 150gm or even a bit less? Hopefully you can gradually get the weight down and then you should find your HBA1C comes near to or below diabetic levels. I would delay the meds until the weight comes down but it's your choice.

Thank you. I could be more careful with carbs for sure (see above).
When I asked if I could wait and diet and exercise the nurse said no.

I should add that I have been off sick since just before Christmas with aches, fatigue/exhaustion, and insomnia. I was put on HRT patches a month ago. I feel like such a wreck and honestly quite despairing.

 

[bulkbiker]

I also have hideous stomach bloating that has been going on for a year now and my GP was concerned metformin would add to that.

That's true.. metformin can be quite nasty on the tum that's why I stopped taking it and simply cut way down on the carbs and frequency of eating.
Still put the T2 into remission without any medication.

Metformin is not really designed to assist in weight loss.. what you eat does that far more effectively but the met can lower blood sugar levels. As I said I lasted for 3 weeks with it then just used diet alone. I had a far higher HbA1c than yours when I started.

As for cholesterol.. well that's for another day firstly lets get your blood sugars lower through diet (but well done on declining the statins anyway!).

 

[HSSS]

When I asked if I could wait and diet and exercise the nurse said no.

Your body your choice, not hers.

Many have gone the lifestyle route with figures much much higher than yours. These nurses just doubt anyone will actually follow through or find an effective method. She’s likely never heard of low carb or doesn’t under how effective it is for blood glucose, weight, blood pressure, generally feel better, cholesterol particularly triglycerides etc.

 

[SheilaCanning]

I feel so **** confused.

 

[HSSS]

I feel so **** confused.

With what part of this specifically? We can probably direct you to resources to help.

Sadly an ill informed nurse doesn’t help much for clarity. And most of us in here have had to take a leap of faith and trust others that have walked in our shoes before us and go against nurses like this. A few were lucky enough to get more enlightened medical advice. There are mainstream medical nhs doctors that fully support our methods (google dr David unwin) and the nhs even prescribe a low carb program in some areas.

 

[HSSS]

60mmol hb1ac isn’t horribly high and most of us in here started with just diet or metformin at this level. I was 55 at diagnosis, 44 just 3 months later without any medication and 2 stone lighter too. Others have even bigger changes.

Your symptoms since Christmas could be related to these levels and improve as they reduce too.

 

[bulkbiker]

I feel so **** confused.

Your nurse is simply doing her job (poorly but that's her job)

You have your diabetes just as we did the nurse doesn't.

Who has the greater interest in you getting better control ...you or the nurse?

 

[Resurgam]

Thanks so much for replying!
Sorry, yes, type 2. I do like my carbs but when I originally went on my diet 2 ½ years ago I switched all white carbs to wholewheat - brown rice, wholegrain bread, pasta etc. I am on MyFitnessPal and keep an eye on carbs (not super strict) and don't eat biscuits, cakes and so on. Looking over the last week or so 129g carbs Tuesday, 165g Monday, 126g Sunday, 190g Saturday, 125g Friday etc).

Oh dear - did someone tell you that brown carbs were the good ones? I'm afraid that they are carbs, just the same.
To keep my numbers in the normal range I eat no more than 40 gm a day, but I am really sensitive to carbs. I checked my levels after eating in order to keep things under control.
I really do advise avoiding those high carb foods, maybe start to test after meals so you can see what foods cause you to spike, as that ought to help a lot in the long run, getting normal Hba1c and helping with weightloss.

 

[MrsA2]

Sadly, after meeting my first ever diabetic nurse onlu 2 days ago, I am even more convinced that they follow a mathematical script with no allowance for individuals or family history.
Mine was very much " if you hba1 c is over 60 then is meds of certain level, if its over 42 if a retest in 3-6 months, if its under 41 then maybe an annual test". It was all formulaic with no time for anything else.

Most of us on here have come to understand and take charge of our own health based on results and research, and that was is low carb with healthy fats

It is such a shame the NHS is so blinkered and short sighted. I am sure they will change in time, but I am not going to let my health deteriorate while we wait for them to catch up

Please @SheilaCanning down despair, theresa lot to learn but there's also a lot of support here. Don't be shy and ask away. We are all in similar boats

 

[Estragon]

Most of us on here have come to understand and take charge of our own health based on results and research, and that was is low carb with healthy fats

Yes, yes, yes,....

 

[Mrs T 123]

I was higher than you when I was diagnosed (HbA1c86) and like you it was suggested that I take metaformin etc. This gave me a big fright and I decided to take control of my health. I am not one for taking tablets so I asked/told my DN I wanted to try diet & exercise first (after reading up online about this) to which she reluctantly agreed. 3 months later I was in the 40s and since then around 3 years ago now, I have been in control/remission with non diabetic numbers. I did this by going lower carb and getting more active and the bonus was I lost around 3 stone (3 dress sizes - yay) and now I am not overweight at all. Have a look at my journey on my signature. You know what you have to do - good luck!

 

[SheilaCanning]

Thank you so much for your advice. It all feels very overwhelming right now and it doesn't help that I feel so unwell anyway. My mind is reeling. I will try and screw the courage up to ask the nurse for 3 months to try and sort myself out with diet and exercise. I have loads of questions though. So sorry to be such a nuisance but:

I signed up to MyDesmond - did anyone else use it?
is there a good low carb for diabetes book you'd recommend?
Is there a blood glucose monitor you'd recommend?
I'm on MyFitness Pal and switched to low carb instead of calories - should this be ok?
It's a lot to get my head round. I so appreciate your generous sharing of knowledge.

 

[bulkbiker]

is there a good low carb for diabetes book you'd recommend?

https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

That and www.dietdctor.com are probably all you need.

There is a low carb cookbook from the Caldesi's with a foreword by Dr Unwin (one of the low carb superheroes)

https://www.lowcarbtogether.com

https://www.caldesi.com/category/low-carb/

Is there a blood glucose monitor you'd recommend?

I use the Tee2+ from here
https://shop.spirit-health.co.uk/collections/tee2
If you phone and order a few pots of strips they'll often throw in the meter for free.
Don't forget to tell them you have been diagnosed T2 to avoid paying VAT.

.

Asking questions is great its what we all come here for to help others so ask away.