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HbA1c levels

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Type of diabetes
Type 2
Hi Everyone, I am new to all this and I have loads of questions. I was recently diagnose as type 2 Diabetic in May 2017 and put onto metformin. I have recently had HbA1c 90 mmol/mol. Please can anyone advise how I can bring this level down to a normal reading. I have been prescribed Farxiga to help reduce the glucose levels. I do not understand all these terms and numbers.

Any help would be brilliant.

Mandy
 
Hi and welcome. Can you tell us what meals you have in a typical day? That’ll help us advise you. I’ll also tag in @daisy1 who post loads if useful info for you.
 
Hi and welcome,

The HbA1c is a test that measures your average glucose over the previous 2 to 3 months. Anything 48mmol/mol and above is diabetic. Under 42mmol/mol is non-diabetic. Between 42 and 47 is pre-diabetic. The initial number to aim for is 48.

Diet is the key to bringing your numbers down, and reducing carbohydrate is a very wise plan. (Bread, pasta, rice, potatoes, breakfast cereals, fruit and fruit juices are the main culprits in raising blood sugar levels)

I do advise you to ask for a print out of all your blood test results. You need to know what they all are, and not just the glucose levels but also cholesterol, lipids, kidney & liver functions and full blood counts. All these are important when you have diabetes. If you don't understand what they all mean, we can help you. If you are in England, you can also ask if your surgery puts test results on line as they are supposed to do, and how to register for this.

Also, it will be of great benefit to you to buy your own blood glucose meter and start testing out your meals and how your body reacts to the food. Testing before you eat and again 2 hours later shows you at a glance what that food did to your BS levels. This gives you the chance to eliminate some items or reduce the carb portion sizes. Keeping a food diary and recording your levels alongside will help enormously.
 
For any newly diagnosed diabetic there is loads of information to take in and you might feel a little bit overwhelmed by it all. This is a perfectly natural reaction. The trick is just to take things slowly and methodically. Very soon I thin k you may be really surprised about how much you start to understand about your own condition and how different things affect you. You say you have loads of questions? This is also completely natural. There are a lot of diabetics in this Forum with many, many years experience of the condition. Just ask away and someone here will be more than willing to assist you. There really is no such thing as a daft question.
 
Hi @mandy_fielding .. and welcome
I was diagnosed T2 in early Feb and, like you and many others, I was a bit shell-shocked with little information and no real idea of what was happening to me. That said, you have certainly made a good move coming here .. since joining this forum, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. So ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

The key point to take on board now is that managing and controlling your diabetes through exercise, diet and testing your blood glucose seems to be the best way forward for many people. For me, committing to an LCHF (Low Carb High Fat) lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I see that @Rachox has already tagged @ daisy1 for you and I suggest that you read up on the valuable information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. together with the following Diet Doctor websites, which will give you all the info that you need on what and what not to eat ...
Low Carb Intro and Information and Low Carbs in 60 Seconds

Unless you are given one by your Doc or Nurse (unlikely), it is a top priority that you get yourself a test meter and, for this, the following websites might help:
https://homehealth-uk.com/product-category/blood-glucose/
for the SD Codefree meter, which costs £12.98 or:
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
who distribute the TEE 2 meter, which is free.
I have both which I alternate for comparative purposes and I have never found any significant difference between them.

The costs of testing comes down to the ongoing charges for test strips and lancets. Make sure that you tick the appropriate box on the on-line order form and you won't pay VAT on your meter or strips.
For the SD Codefree, the strips are £7.69 for a pack of 50 and there are discount codes available for bulk purchases:
5 packs x 50 use code: 264086 .. cost is £29.49
10 packs x 50 use code: 975833 .. cost is £58.98
For the TEE 2, the strips are £7.75 for a pack of 50 .. but there are no discount codes currently available

I'm testing 3-5 times a day which works out at around £10 to £12 per month for either of the two packages above but, more importantly, I now know what my BG levels are .. and I can now manage them

Hope this helps
 
@mandy_fielding

Hello Mandy 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 want 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 well over 250,000 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 free 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. They're all 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.
 
Hi @mandy_fielding of course this is not a club you would want to join, but the upside is that Type 2 diabetes (and others) can be extremely well managed.

There is not enough information on you so this is general advice, that the me two and three quarter years ago would have liked, so is my opinion:

The priority is to get blood sugars down.

Suggested Drinks:
Black Coffee (I do filter), any Teas, Water

Suggested starter breakfasts
:
Bacon, Eggs, Mushrooms, Tomatoes

Variety of berries, currants, full fat unsweetened natural yogurt (I do Greek) with some nuts (minimal cashews)

Suggested Lunch / Dinner:

Any meat or fish, lots of above ground vegetables (use these as the filler and source of carbs), salads without the dressings

Additions:
Apple cider vinegar, cinnamon, ginger, Indian / Italian spices (any in general). Flax, pumpkin seeds

Suggested Desserts:
Cheeses, Berries a little Oppo ice cream.

This is just a suggested set of foods to get you going. It seems quite small but in the vegetables section alone there are loads in supermarkets, and if you eat meat and fish a stack again of choices. Once you begin to fix your system, there are loads of foods to add.

Eating Out:
If you eat burgers, you can remove the bun. If you eat say ribs and you can't get dry, scrape off the sauce.

Try to eat twice a day with intermittent fasting. E.g. breakfast at say 11.00 with dinner 17.00. This gives your body time to heal. Try reduce / eliminate snacks.

Try to walk after meals. And where possible undertake resistance exercise. Sleep circa 7 hours.

I would say at least 75% of the above is generically compatible with most Type 2's and would have a positive impact on your blood sugars. Again just the advice I would have given myself.

Expectations:
It is possible to get normal range blood sugars. It is possible to get "reversal" / "remission". It is hard but at the same time easy to halve or better your HbA1c within 6 months, many do this - some get into the normal range wirh dedication. You may get contradictory information from official sources; it is your choice to decide if those "living" with the condition with countless examples are better to follow, for example your HbA1c was 90 and you were prescribed 2 drugs, mine was 134, I was prescribed just metformin and told to take a statin and blood pressure tablets - I now have numbers without the tablets that are in the required ranges.

Here are some topics you might want to research on this site, the web and youtube:
  • LCHF
  • Newcastle Diet
  • Insulin Resistance
You will need to measure your blood sugars as this type of regime will either require a reduction in your medications if not complete removal.
 
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