Newly Diagnosed - Doctor says Meds forever..

Granny_grump_

Well-Known Member
Messages
3,105
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Dishonesty lies and thieves and online Bullies!!!
Morning all.
Went to doctors last week as had underlying nausea since upping Metformin and wasn't happy with neck ache - my suspicions lie with statins there, and watching Dr Sultan's video last week convinced me even more.
I was due Hba1c in mid-dec, but Dr said get it done now and we can discuss meds after results.
Well, results are in;


Hba1c - Original was 92, my latest reading = 43!!

Puts me in "pre-diabetic category", but a very good result.

Cholesterol:
Total 3.5 (not worth much as a measurement, I know)

Triglycerides - Was 5.5, normal = .3 to 1.7, my latest = 1.3!

Cholesterol ratio - was 6/7, optimal = less than 3.5, my latest = 3.2!

HDL = 1.1, calculate LDL = 1.8

I've had lots more non-statin than statin days so I'm going to stay off those, and hopefully start discussions on reducing metformin.

Will carry on eating low-carb, with occasional treats, but overall happy with these results.

Finally, thanks for all your support. I do realise this is the beginning of a life-long disease management, but glad I found Dr Mosley and this forum.
Well done ObscureMH you've achieved great results keep,it up K
 
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bulkbiker

BANNED
Messages
19,576
Type of diabetes
Type 2
Treatment type
Diet only
Morning all.
Went to doctors last week as had underlying nausea since upping Metformin and wasn't happy with neck ache - my suspicions lie with statins there, and watching Dr Sultan's video last week convinced me even more.
I was due Hba1c in mid-dec, but Dr said get it done now and we can discuss meds after results.
Well, results are in;


Hba1c - Original was 92, my latest reading = 43!!

Puts me in "pre-diabetic category", but a very good result.

Cholesterol:
Total 3.5 (not worth much as a measurement, I know)

Triglycerides - Was 5.5, normal = .3 to 1.7, my latest = 1.3!

Cholesterol ratio - was 6/7, optimal = less than 3.5, my latest = 3.2!

HDL = 1.1, calculate LDL = 1.8

I've had lots more non-statin than statin days so I'm going to stay off those, and hopefully start discussions on reducing metformin.

Will carry on eating low-carb, with occasional treats, but overall happy with these results.

Finally, thanks for all your support. I do realise this is the beginning of a life-long disease management, but glad I found Dr Mosley and this forum.

Did your doc credit the pills with your reduction in HbA1c ? If he's anything like mine he should have been absolutely astounded with your results.
 

ringi

Well-Known Member
Messages
3,365
Type of diabetes
Type 2
If you can keep taking Metformin at a low dose so you don't get the side effects, its worth it, as it has been shown to reduce long term risk. (Tim Noakes convinced me of this.)
 

busydiabeticmum

Well-Known Member
Messages
441
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Hi all,


Male, aged 50, 1.79 metres tall, hovered around 80-82 kilos.

Last blood test about 2 and half years ago presented normal levels.


Had my “old man” NHS test this year, with result of raised levels, so sent for a full blood test.

Result from this (and pre-diagnosis) = Fasting Glucose of 16.8, which led to follow up.


Diagnosed 3 weeks ago.


Hba1c - 92

LDL - not available!

HDL - 1.2

Triglycerides - 5.5

(Ratio 6.5)


Cholesterol - 7.6


Mother is a diabetic


I didn't really take it all in, but didn't want to be on meds...

My wife had already found the Mosley Blood Sugar Diet following the glucose result, and we immediately went on the 800 calorie LCHF diet. Having read the book and various fora I thought that I'd try the diet route first, as I didn't (and still don't) want to be on meds forever.


Doctor prescribed:

Metformin, 500mg x 1, building to 500mg x 2 after 2 weeks.

Atorvastatin - 10mg x 1 at night


I stuck to 1 Metformin, with no side-effects, and didn't start the statin (was still confused on that one).


3 weeks on BSD started at 79.3kg, lost 3kg to go down to 76.4 today, taking me down to BMI of 24, and lost 5.5cm from belly. Loving full-fat greek yoghurt with berries for brekkie, salad, peppers, toms, and onion with tuna/chicken/turkey for lunch, and a new found appreciation of (some) veg, oh and eggs and bacon, cauliflower rice. Would say I’m currently on 50-75g carbs per day, mostly nearer 50-60. No bread, no beer, no potatoes, some red wine at the weekend – and one day off the wagon (company away day, where you need a few beers to survive, and beer = reduction in willpower, so ate mashed potatoes and a dessert!).


Was pleased with how things were going, but went back to Docs today and what I hadn’t really taken in first time was that as I wasn't particularly overweight and had no history of symptoms she feared/fears I may have a version of late-onset diabetes. She said that diet will of course help, but has asked me to build up to 4 x Metformin, by increasing by 1 each week, and to start the statins straight away. She also thinks that I’ll always be on Metformin or some equivalent.

They’re going to give me a monitor on Friday and teach me how to use it, and have another liver/Hba1c in 3 month’s time.


So, I agreed to follow medication directions, but feeling a bit down today as some outside hope of being able to control this thing with diet rather than meds doesn’t sound like an option for me.


Anyone else in the same situation as this?
Doctors only get paid if you are on meds to control diabetes... they prescribe it for everyone without seeing if you actually need it or not.

I was diagnosed type 2 with hba1c of 85 at the age of 30... 165cm tall and 85kg... I too didn't want to look at a life of medication especially as I am intolerant to metformin so would be put on insulin.
I went on the low carb diet (refused to take the metformin as they tried to put me on it even though I am intolerant) and within 4 months went to 65kg and hba1c 31.
This year it was 32... you can turn it around... don't let them get you down. Good luck.
 
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ObscureMH

Active Member
Messages
33
Type of diabetes
Type 2
Thanks everyone.
@bulkbiker I've not seen Dr yet, just got results from the admin people. Seeing doc next week.
@ringi To be honest if I can get off the Metformin I will, but I would need to be sure that I can control with diet. At minimum I will be aiming to reduce and get another hba1c in a few months. If I have to get the test privately I will. (I do feel sorry for those who can't afford that option).
As I said, this is just the start, not the end of disease management.
Mark
 

ringi

Well-Known Member
Messages
3,365
Type of diabetes
Type 2
If the does of drugs are being changed, a NHS GP should be happy to do a AC1 every 3 months, reducing to every 6 months (or year) once BG and drugs are stable. (NICE guildlines)
 

ringi

Well-Known Member
Messages
3,365
Type of diabetes
Type 2
Doctors only get paid if you are on meds to control diabetes... they prescribe it for everyone without seeing if you actually need it or not.

Not true, the only drug they get paid for "offering" people with Type2 is satins, if you refuce to take satins, they can record that on the system and still get the payment. Otherwise the payment is based on AC1 results, prooving they done regular views of medication, foot checks, etc.

But they do get the same payment for “good” AC1 results regardless of how many drugs they use (and the drugs are not paid for by the GP), so the system does not give them a intensive for “minimal drug care”. Add in all the free lunches etc they get from the drug companies reps, along with the drug companies sponsoring most conferences etc and it is not the best system…….
 

busydiabeticmum

Well-Known Member
Messages
441
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Not true, the only drug they get paid for "offering" people with Type2 is satins, if you refuce to take satins, they can record that on the system and still get the payment. Otherwise the payment is based on AC1 results, prooving they done regular views of medication, foot checks, etc.

But they do get the same payment for “good” AC1 results regardless of how many drugs they use (and the drugs are not paid for by the GP), so the system does not give them a intensive for “minimal drug care”. Add in all the free lunches etc they get from the drug companies reps, along with the drug companies sponsoring most conferences etc and it is not the best system…….
http://www.dailymail.co.uk/health/a...-million-diabetes-sufferers-misdiagnosed.html

"The Government promised GPs cash incentives for diagnosing greater numbers of serious conditions such as diabetes. The QOF also sets stringent guidelines about effective treatment and doctors are further rewarded when more than half their diabetic patients score blood-sugar levels below seven – incentivising early drug treatment.

Dr Sharp adds: ‘GPs now screen for diabetes at an earlier stage. By fishing in shallower waters, testing seemingly healthy patients, more borderline results are likely to be turned up and some may be wrongly prescribed Metformin [the standard drug treatment] by an over-cautious or ill-informed GP. ’"

It does go on but this is what I am speaking about.
 

ringi

Well-Known Member
Messages
3,365
Type of diabetes
Type 2
"The QOF also sets stringent guidelines about effective treatment and doctors are further rewarded when more than half their diabetic patients score blood-sugar levels below seven"

As I said the payment is not for prescribing drugs, GPs can make more money by telling people about Low Carb, as it gets more of their patients with a low enough AC1. I don't know why the daily mail is using US units but in our units its an AC1 of 53 they get the reward for getting us below, given we all wish to get way lower than that, I don't see it as an issue.

Once again the payments (unlike statins) are not linked to prescribing drugs, they are linked to results.

And most of us would be better off if our GPs had done AC1 tests on us a lot early.
 

busydiabeticmum

Well-Known Member
Messages
441
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
"The QOF also sets stringent guidelines about effective treatment and doctors are further rewarded when more than half their diabetic patients score blood-sugar levels below seven"

As I said the payment is not for prescribing drugs, GPs can make more money by telling people about Low Carb, as it gets more of their patients with a low enough AC1. I don't know why the daily mail is using US units but in our units its an AC1 of 53 they get the reward for getting us below, given we all wish to get way lower than that, I don't see it as an issue.

Once again the payments (unlike statins) are not linked to prescribing drugs, they are linked to results.

And most of us would be better off if our GPs had done AC1 tests on us a lot early.
I agree with that, however the reason why they prescribe metformin and not low carb is the "ill informed" and out dated mindset.

They have also admitted that the reason why they don't go straight to the diet is because they don't "think" the patient would be able to do it ... but obviously this removes the choice for said patient (hence op predicament). I can't find the link for that at the moment but it was on BBC news a few months ago.
As you may know a lot of people on here (including me) are being told NOT to do the low carb diet... that this is an extreme and that we are self harming etc. It was only recently that doctors are starting to cotton on because it has become "fashionable" and was on telly, the problem is that some doctors are still anti low carb... metformin is still being handed out like sweets (excuse the metaphor).
 

ObscureMH

Active Member
Messages
33
Type of diabetes
Type 2
Thanks all. Appreciate the feedback.
Saw doctor today and she relented and said I can come off statins. She said they're given as a precautionary for diabetes patients, but she relented.Fair play to her. She told me her reasons for keeping statins but listened to my concerns. Tick.
She then said I can reduce Metformin to 1 tablet twice a day, and we'll run another hba1c in 3 months, and see if we can remove it altogether - her words, but knowing that is my wish. Tick.
She was astounded by my readings, and said she'd not seen such a significant change in 3 months. I said low-carb diet was the key, however, her question was "what was your diet like before to be that high?". I didn't think it was that bad, but guess it was.
So, off to Australia for Christmas, where I may lapse a bit, but after that will maintain low carbs forever (with occasional off days).
Fingers crossed for next hba1c.
Mark
P.s. do you think I should post something in Success Stories forum?