Newly diagnosed - Trying to observe whilst on medication

[enzosb]

Hi. I’m looking for a bit of guidance or advice please

I’m about to be newly diagnosed following very high readings (18 on the finger prick and HbA1C of 115). Don’t think I’ve officially been diagnosed yet but as good as pending a second blood test which is also to check kidney function etc. as they would like to prescribe me Metformin

My plan before finding out about the Metformin was to self fund a CGM, at least in the early days and start the scientific process of making lifestyle changes, food swaps, reduce carbs etc to try and identify what it is my body is unable to tolerate.

I would consider my diet fairly typical for somebody who is not actively following any particular plan. There are definitely changes I can make to switch some choices out for healthier options but also wouldn’t consider it that bad to cause such high readings over what appears to have been a length of time. There are a couple of food/drink types I suspect in particular and it would kind of make most sense (to my mind at least) if there were specific things I’m eating that are causing it rather than just general “unhealthiness” (as I am otherwise healthy)

I guess you could say I was interested in finding out the reasons and causes behind it so that hopefully I can longer term learn how to keep it under control and make permanent changes where necessary. Like many people, if I can get the feedback loop and real evidence of knowing every time I eat x then something bad happens then I think I’d have a lot more motivation to make that permanent than if I was just guessing

I understand the priority right now will be to get my levels down and that’s why I am being prescribed Metformin. But would the medication make it pointless me trying to be more proactive with the observation and food experimentation too at the same time? I.e. would the medication make observation less obvious in terms of spikes etc? Or would I still be able to see reactions to food despite the medication?

I tried to ask the nurse who did my second blood test but she seemed to downplay any idea of monitoring myself, mentioned that the medication could make it more difficult to see and also mentioned about the periodic appointments where they’d measure me every number of weeks. I just don’t necessarily like the idea of waiting between each appointment to see how things are going and then even if levels have come down not really knowing what may have contributed to that. And if I can get things under control longer term, not really being wise to what the triggers and problems are

Am I trying to run before I can walk? Should I just be focussing on getting the levels down for now in the early days and then worry about causes later? Or could I realistically be more proactive and try to understand things better right from the off by monitoring myself alongside the more passive NHS approach?

Sorry if this sounds like nonsense based on your experiences or even delusional. Its early days and I’m still learning. I think I was ready to be more proactive than it sounds like I’m supposed to be

Thanks for any advice

 

[Rachox]

Hi @enzosb and welcome to the forum. I love your approach to your diagnosis, wanting to understand what your body is doing. Testing is good it’ll start your journey to understanding and then putting things right. Metformin is a mild drug, it doesn’t lower your blood sugar levels directly, it just stops your liver chucking out sugar that as a type 2 diabetic isn’t very helpful. I’ll stop babbling now and just post a link to information one of our members wrote. It covers all the basics, have a read and come back with any questions you have.

The Nutritional Thingy

There’s a few things you should know. 1. Practically all carbs turn to glucose once ingested , so not just straight sugars, but starches...

josekalsbeek.blogspot.com

 

[enzosb]

Thank you for the response @Rachox and for the link. I like how direct it is with the information. I've been reading a lot recently (but obviously feel like I still have so yet much to learn) and am keeping links such as this to be able to refer back to

 

[Melgar]

Welcome to the forum @enzosb . This is a great forum for help and advice. @Rachox has given you a great link on diet.

Many members here have had the “you don‘t need to monitor your blood sugars” talk. My suggestion is to smile and thank them for the advice, but ignore it and monitor your own blood sugars. Getting a glucose monitor is definitely a good idea. Glucose monitors are your go to as they read your blood glucose directly From your blood. You mentioned a CGM. A CGM will give you a continuous blood sugar reading enabling you to see what your blood sugars are doing. Unlike glucose monitors ( finger prick tests ) which measure the glucose in your blood, CGM’s measure interstitial fluid CGM’s are great to see how your body deals with the food you are consuming. You can see what foods sends your blood sugars up and what foods your body can handle.

As for Type 2 diabetes, one of the main drivers of TD2 is Insulin Resistance. Insulin resistance is where the body becomes insensitive to insulin. It is not fully understood why some people develop insulin resistance. Most people who have Type 2 are insulin resistant. Insulin is the key that allows glucose to leave the blood and enter the cells of the body to use for energy. Your body likely started to become insulin resistance many years before your diabetic diagnosis.

Even though your pancreas is producing a lot of insulin, because of the IR, it is unable to produce enough to keep your blood sugars in the normal range especially when you add food in to the mix, especially carbohydrates. So cutting down on your carbs is the way to go.

 

[Outlier]

You'll appreciate that we can't tell you whether or not to take any meds, but what we CAN say is that lots of us have brought our readings into non-diabetic levels purely by diet change. I applaud your attitude, and there is every chance you can do the same, whether you take the meds straight away then phase them out as your readings improve, or opt for diet change to see what happens and then decide. There is a LOT of incorrect information out there (including, sadly, from the NHS) so I would strongly recommend you check out the link (sounds as if you already have) and do ask us anything you are not sure about. Sugar and carbs are added in surprising ways to foods we buy (e.g. starch added to sliced meat!!!) so we need to be aware of this.

 

[enzosb]

Hi @Melgar and @Outlier

Thank you for taking the time to reply. I do appreciate it. And thanks for the reassurance regarding the fact that monitoring would not be a bad idea, the extra detail regarding insulin resistance, and also confirmation that the professional advice can sometimes we imperfect (which I think I knew anyway but good to hear real experiences). As you can probably tell I am keen to try and understand this, understand the science behind it and be able to influence it myself rather than just doing nothing and leaving it to medication

Regarding the medication, I'm somebody who would rather not if at all possible so my hope would definitely be to phase them out over time if I could manage that rather than intend to be on them forever

In some ways I kind of wish I had started some observation and diet/lifestyle changes before triggering the NHS process and been able to have a period of time to see if I could impact it myself without meds.

I presume there would be nothing to stop me from asking to do that but one thing I'm not clear on is how foolish that may be or how much the NHS may baulk at such an idea. Basically, I know my levels are very high and if they were lower then there would be more scope for taking things slowly. And therefore I'm wondering if they are so high that only an idiot would not just suck it up and take the meds in the short term

I'm expecting a call tomorrow with the results of my second test, formal confirmation and Metformin prescription so I can discuss it with them then. I'll also order a CGM

Many thanks again

 

[Melgar]

@enzosb , meds are not a bad thing. I know many of us would prefer not to be on meds of course, but they do work in most instances. I’m on meds.I also watch my carb intake. As @Outlier says, we can’t say whether to take them or not, but you can take things slowly with the diet. It doesn’t have to be one or the other ( I know you know this). Gradually reducing your carb intake, and importantly, monitoring your blood sugar levels so you know what’s going on with your blood sugars has merits. There are many TD2s who have had very high blood sugars and have gone low carb, even very low carb, are now in remission. How comfortable you are in changing your diet is a personal choice.
Exercise too, in my opinion, is a good thing. You are probably producing a lot of insulin right now to counter your IR. Excessive amounts of insulin, unfortunately, adds to your IR. Exercise, however, helps to lower your IR. Reducing carbs and therefore reducing the amount of insulin you need also helps lower your IR.

I am currently reading an informative book called ‘ Why We Get Sick’ , by Benjamin Bikman. It was recommended to me by another member. It’s an informative read about the part insulin resistance plays in chronic diseases. When I was diagnosed I had never heard of IR. Now I have become informed. Like you I wanted to find out more about diabetes.