Type 2 New to Forum -- some questions...

[tomatoman]

I've been T2 for apx 7 years. I took 500 mg of Metformin XR/ER once daily for that entire time. My doctor switched me to Jardiance 25 mg, and frankly I'm disappointed. Arguably, my A1c is no better than with the Metformin -- I'm just poorer! But here are my questions:

1. I'm in the U.S. and I'm not familiar with the Metric? expression of A1c. I'm just used to seeing numbers like 6.5, etc. What is the conversion to the numbers I see mostly on this site?

2. For me, Jardiance does great for about 12 hours, then has little effect, so high after-dinner readings are an issue. (Anyone else see this?)

3. My A1c has checked at 6.9 and 6.8 with Jardiance, even with getting high blood glucose reading at night and morning. My doctor (not an endocrinologist) says that is fine. Matters not that my blood glucose is high at night. A1c under 7.1 is the goal/bogey. It strikes me as "one foot in a bucket of ice water and one in hot water -- one the average I'm fine." Does your doc view A1c the same way?

4. Are there any blood/kidney tests that are routinely done with Jardiance yearly, etc. My doctor had my Magnesium checked when I started Jardiance, and that's all.

Thanks for any feedback!

 

[HSSS]

 

[HSSS]

Welcome @tomatoman .

I’m shocked you were put on jardiance with an hb1ac under 7%. Or was it higher on metformin alone?

The way most of us type 2 control it is with diet, specifically low carb. Are you familiar with this? The ADA have just approved this as a successful way of managing type 2.

lots of links below. Work your way through at your own pace and come back and ask questions.

Can I suggest you take a good look at LCHF ie low carb higher fat (than typically recommended) methods of eating (keto is just a version of this). It’s how an awful lot of us get our blood sugar levels under control and for some even eliminate medications and achieve remission and also reduce or improve complications. It is often the easiest and most sustainable form of weight loss for a type 2 if you need that. Other conditions often improve including but not limited to blood pressure, joint pain, inflammation, PCOS, and despite the dire warnings of the last few decades it improves cholesterol for most, yes improves cholesterol. Some jump right on it, others edge their toes in a bit at a time. Be aware the the USA count carbs differently so be aware if you look at their counting, recipes or products. They include fibre in their count we don’t. So if it’s USA stuff deduct the fibre to get our figures. (Fibre isn’t generally digested thus doesn’t get counted)


Try clicking these links for more detailed explanations that are well worth readings.


http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/


https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for info including low carb made simple


And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation


and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas


also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Excellent site and first port of call for many getting their head round low carb.


Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.


Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3, 6 or even 12 months and then have no idea what had what effect. It also helps keep an eye out that any meds are working appropriately not too much or too little. Getting a blood glucose meter is the only way to do this (no matter what contradictory advice you may have heard - it’s usually budget based rather than anything more scientific). Test before a meal and 2hrs later hoping for a rise of 2mmol or less. More and the carbs eaten were too many! Please ask if you want any guidance on this.


IMPORTANT FOR ANYONE ON DIABETIC MEDS (other than metformin): if you lower your carbs then any glucose lowering meds or insulin increasing meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc than your new carb intake requires. (This is not a concern for metformin on its own). Keep a very close eye on your numbers and do this with your dr’s knowledge. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around.