Newsly diagnosed, with a monstrous Hba1c

[Tristan77]

So, 3 weeks ago, i was admitted to hospital with an excrutiating pain in my kidney - for the third time i had kidneystones. By fluke, on one of the random urine tests they noticed glucose in my urine. So out comes the blood sugar monitor - 17.2. Over the next 7 days they monitored it 4 times a day it it consistently held between 11 and 17. Finally, they had my Hba1c results back, and they clocked in at 116.

They had constantly been asking the standard questions abour warning signs, and nothing had flagged, predominantly because it was masked. ‘Do you feel tired’ - well yes, but i get up for work at 6 and have a 1 year old and a 3 year old. ‘Have you had unexplained weightloss’ - well ive lost a stone this year but thats because ive been going to the gym every day and have been actively trying to lose weight. You get the picture.

So, long and short, ive got a bit of an issue there (understatement). When i was told i weighed 103 kilos - big yes, but not crazy for a 6’2 40 year old. I’m fairly active, but have paid very little attention, stupidly, to my diet. Of course i didnt realise how stupidly until i started monitoring everything i eat and realised theres 7 grams of sugar in a **** carrot.

Gp consultation on the 10th october, confirmed all of the above and he talked about this 800 calorie trial. Urgh. Diabetic nurse appointment later that day and she gave me the parameters to a low calorie, 1165 (very precise!!!) diet with exact levels of nutrients to match. Target is to lose 20 kilos in 3 months. That sounded a better way of doing it to me - rather than a prescribed set of sachets of soups and shakes, you have to research all your food as you shop and fit within the parameters yourself. So it teaches you about the nutrients etc.

So, all rather tough. On top of kidneystones, and my father passing away, its been rather difficult to stop from moping. But yesterday, my motivation got that extra boost

You see, in the 10 days since i started, my weight has been steadily dropping - i mean 1165 calories a day, how could it not - ive lost 5 kilos in 10 days. But my blood sugar for the first 6 days was still double figures. Every time. I mean sure, it was 10s and 11s instead of 15s, but still too high considering im down to 55 grams of carb intake a day.

But then day 7, i got an 8.9, then an 8.2. Day 8 got an 8.6 and a post meal 8.8. Day 9 got a 7.9 and an 8.2. And this morning. This glorious, wonderful morning, i got a 7.0.

Still loads to do. 15 more kilos to lose. But without being on meds, i’m in the range.

 

[Rachox]

Very well done! Keep at it, you’ll get there. As is often said this is a marathon not a sprint

 

[bulkbiker]

So, 3 weeks ago, i was admitted to hospital with an excrutiating pain in my kidney - for the third time i had kidneystones. By fluke, on one of the random urine tests they noticed glucose in my urine. So out comes the blood sugar monitor - 17.2. Over the next 7 days they monitored it 4 times a day it it consistently held between 11 and 17. Finally, they had my Hba1c results back, and they clocked in at 116.

They had constantly been asking the standard questions abour warning signs, and nothing had flagged, predominantly because it was masked. ‘Do you feel tired’ - well yes, but i get up for work at 6 and have a 1 year old and a 3 year old. ‘Have you had unexplained weightloss’ - well ive lost a stone this year but thats because ive been going to the gym every day and have been actively trying to lose weight. You get the picture.

So, long and short, ive got a bit of an issue there (understatement). When i was told i weighed 103 kilos - big yes, but not crazy for a 6’2 40 year old. I’m fairly active, but have paid very little attention, stupidly, to my diet. Of course i didnt realise how stupidly until i started monitoring everything i eat and realised theres 7 grams of sugar in a **** carrot.

Gp consultation on the 10th october, confirmed all of the above and he talked about this 800 calorie trial. Urgh. Diabetic nurse appointment later that day and she gave me the parameters to a low calorie, 1165 (very precise!!!) diet with exact levels of nutrients to match. Target is to lose 20 kilos in 3 months. That sounded a better way of doing it to me - rather than a prescribed set of sachets of soups and shakes, you have to research all your food as you shop and fit within the parameters yourself. So it teaches you about the nutrients etc.

So, all rather tough. On top of kidneystones, and my father passing away, its been rather difficult to stop from moping. But yesterday, my motivation got that extra boost

You see, in the 10 days since i started, my weight has been steadily dropping - i mean 1165 calories a day, how could it not - ive lost 5 kilos in 10 days. But my blood sugar for the first 6 days was still double figures. Every time. I mean sure, it was 10s and 11s instead of 15s, but still too high considering im down to 55 grams of carb intake a day.

But then day 7, i got an 8.9, then an 8.2. Day 8 got an 8.6 and a post meal 8.8. Day 9 got a 7.9 and an 8.2. And this morning. This glorious, wonderful morning, i got a 7.0.

Still loads to do. 15 more kilos to lose. But without being on meds, i’m in the range.

Just a slight word of warning.. have you thought about what you're going to go onto once you have got down to your 83? kilo target? I guess you know that eating 1165 calories isn't really sustainable long term (check out the biggest loser study) so it could be worth checking around and seeing what other ways of eating there are.
If you look at my signature than you'll get what I would recommend.. but if eggs and bacon and steaks with butter aren't your thing then ....

Edit to add sorry I should also of course have said a great start and well done for taking control! Only on my first coffee so not quite awake yet..

 

[Tristan77]

Just a slight word of warning.. have you thought about what you're going to go onto once you have got down to your 83? kilo target? I guess you know that eating 1165 calories isn't really sustainable long term (check out the biggest loser study) so it could be worth checking around and seeing what other ways of eating there are.
If you look at my signature than you'll get what I would recommend.. but if eggs and bacon and steaks with butter aren't your thing then ....

Edit to add sorry I should also of course have said a great start and well done for taking control! Only on my first coffee so not quite awake yet..

Yeah theres a long term plan being evolved - i have reviews and tests every 18 (wierd figure but hey) days, where they will tweak the intake and mix of nutrients, my first one is thursday next week. The diet is pretty protein heavy which is a godsend - im having to cut everything i enjoy pretty much, except meat. Im allergic to eggs which causes problems.
Obviously the recent bouts of kidneystones have also complicated things a little

 

[bulkbiker]

Yeah theres a long term plan being evolved - i have reviews and tests every 18 (wierd figure but hey) days, where they will tweak the intake and mix of nutrients, my first one is thursday next week. The diet is pretty protein heavy which is a godsend - im having to cut everything i enjoy pretty much, except meat. Im allergic to eggs which causes problems.
Obviously the recent bouts of kidneystones have also complicated things a little

Interesting.. that's a pretty involved procedure.. Most of us just get the odd appt with a "Diabetes Nurse"... well done for getting someone to pay attention. I'd be quite interested in their ongoing changes to the program if you are happy to share. I'm assuming you have dieticians etc involved but they seem to be keeping you fairly low carb? Which is a great thing. Just watch out if they start suggesting "whole grains" but as you are testing you'll see what they do to you!

 

[Tristan77]

Interesting.. that's a pretty involved procedure.. Most of us just get the odd appt with a "Diabetes Nurse"... well done for getting someone to pay attention. I'd be quite interested in their ongoing changes to the program if you are happy to share. I'm assuming you have dieticians etc involved but they seem to be keeping you fairly low carb? Which is a great thing. Just watch out if they start suggesting "whole grains" but as you are testing you'll see what they do to you!

Absolutely happy to share. At the moment my carb intake is limited to 25% or 55 grams per day max - cant go over either figure although to be honest im struggling to get to 55 grams on a 1165 cal diet that limits carbs to 25% anyway!
Of those sugar cant be more than 25 grams. I have limits on cholesterol and sodium too, but these are more aligned to the usual rda’s albeit a little lower. Fat is 33% and protein whatevers left. Theres some macro nutrient stuff underneath too. Water intake, sleep(!!) output calories are all monitored closely too.

I think theyre paying close attention to my case in particular because my recent kidneystone caused damage to my kidney on the way out, and some of my underlying markers (despite having no ketones in my blood at all) were concerning, plus this 116 has come from nowhere - again, by chance i’d had an Hba1c done a year ago as part of a health MOT and it wasnt remotely high.

Im lucky in many ways as im an absolute stat nerd so this kind of precise goal setting is right up my street. Ive even set up excel graphs and charts to track the progress. Utter geek, me

 

[bulkbiker]

Im lucky in many ways as im an absolute stat nerd so this kind of precise goal setting is right up my street. Ive even set up excel graphs and charts to track the progress. Utter geek, me

A kindred spirit!
Wonder why they are worrying about cholesterol? Do you have any figures for that? Especially as dietary cholesterol has little if any impact on blood cholesterol.
Also do you know what your previous HbA1c was? I had one about a year before diagnosis which was pre-diabetic but I pretty soon deteriorated to "full blown" type 2 by changing nothing because I really didn't know what to do.
I hope the stones problem doesn't recur. I have never had them myself but a good friend did and he said it was the most painful thing he had ever experienced.

 

[Pinkorchid]

Yeah theres a long term plan being evolved - i have reviews and tests every 18 (wierd figure but hey) days, where they will tweak the intake and mix of nutrients, my first one is thursday next week. The diet is pretty protein heavy which is a godsend - im having to cut everything i enjoy pretty much, except meat. Im allergic to eggs which causes problems.
Obviously the recent bouts of kidneystones have also complicated things a little

Well done to you so carry on doing what you are doing now as it is working for you and that is what we all have to do to find the way that works for us personally which may not be what works for others

 

[Tristan77]

A kindred spirit!
Wonder why they are worrying about cholesterol? Do you have any figures for that? Especially as dietary cholesterol has little if any impact on blood cholesterol.
Also do you know what your previous HbA1c was? I had one about a year before diagnosis which was pre-diabetic but I pretty soon deteriorated to "full blown" type 2 by changing nothing because I really didn't know what to do.
I hope the stones problem doesn't recur. I have never had them myself but a good friend did and he said it was the most painful thing he had ever experienced.

Yeah kidneystones suck. Ive had them three times. Apparently if you had them before you were 25 youre more susceptible for recurrence. In typical Tristan style i got them at 24 years and 10 months!

My cholesterol is ‘borderline’ hence the added focus. They did say this diet and weight loss will take care of that, but want to monitor it in the meantime.

My previous test was 38, i think. Certainly high 30s and certainly not even in pre diabetic range - it didnt raise any kind of flag.

Ive been told if things hadnt improved by this check in next week theyd start me on metformin but am hoping with 4 successive days of single figure, including this latest 7.0 that i can stay off that

 

[DCUKMod]

@Tristan77 - I'm not going to interfere with your very productive conversation with @bulkbiker, but just wanted to add that one of the very important things in all of this is ensuring you keep your fluid intake up. You'd probably be astonished how grotty becoming a bit dehydrated can feel, but it is incredibly common when so much focus, understandably, goes onto what we are eating in these early days.

You've made a great start. I'll be interested to hear of your progress along the way.

 

[rhubarb73]

Hello and well done so far.
Even with an Hba1c that high you can still get it down quite quickly and with those daily BG scores you are already on the way. The life of a blood cell is 2-3 months so if you are kind to the new ones then they will give you a score to be happy about in due course.
I agree you need a long term plan but great to have a supportive doctor.
I am 6’ 1” and got from 101.5 to 83.5 in 5 months. Hba1c from 66 to 40 in 3 months.
If you find the very low calorie approach becomes difficult there are other methods to try. I was on about 2000 kcal a day (and now a bit more).
Do what works for you and keep sharing your success.

 

[bulkbiker]

Yeah kidneystones suck. Ive had them three times. Apparently if you had them before you were 25 youre more susceptible for recurrence. In typical Tristan style i got them at 24 years and 10 months!

My cholesterol is ‘borderline’ hence the added focus. They did say this diet and weight loss will take care of that, but want to monitor it in the meantime.

My previous test was 38, i think. Certainly high 30s and certainly not even in pre diabetic range - it didnt raise any kind of flag.

Ive been told if things hadnt improved by this check in next week theyd start me on metformin but am hoping with 4 successive days of single figure, including this latest 7.0 that i can stay off that

Good luck!. I reckon with you taking charge you'll be fine.. as for cholesterol it may go up as you lose weight but I wouldn't be concerned in the short term (well in fact I wouldn't be concerned in the slightest). It would appear to be possible to "hack" your readings to make your levels move up and down almost at will and its more about certain ratios.. but for the time being I would just concentrate on reducing blood sugar levels which will be best achieved by cutting carbs as low as possible. We can go into the whole cholesterol thing another time!

 

[Daibell]

Hi. I wouldn't panic about the high HBa1C; mine was 12.5% when first diagnosed. The GP/nurse are right to check that your kidney remains in good condition but note that I had a small calcium oxalate stone many years ago that eventually (!) passed thru and left no damage. Your stones may be much more of a problem of course. Reducing calories will certainly help but as you read posts on these forums you will find that it's the carbs you need to focus on as they make both BS and weight increase. Fats and proteins have far less effect so as long as it doesn't conflict with other aspects of your condition think carbs rather than calories. As another poster has said, the fats you eat have very little effect on the cholesterol your liver produces (I read recently it was only 15%). Any blood cholesterol tests you have should be fasting ones including Trigs; you may well find the results change little with fats you eat. Our genes probably have the biggest effect.

 

[Tristan77]

@Tristan77 - I'm not going to interfere with your very productive conversation with @bulkbiker, but just wanted to add that one of the very important things in all of this is ensuring you keep your fluid intake up. You'd probably be astonished how grotty becoming a bit dehydrated can feel, but it is incredibly common when so much focus, understandably, goes onto what we are eating in these early days.

You've made a great start. I'll be interested to hear of your progress along the way.

Yes, in amongst the nutrition and excercise goal is a minimum 104 ounce per day water target - i’m averaging about 110 at the moment - plus plenty of black coffee!

The other thing was sleep - my sleep patterns were really poor before - maybe 4/5 hours a night maximum. Ive been told to up it to a minimum of 6 whenever possible

 

[SaskiaKC]

I agree completely with the advice to stay hydrated -- on the right kind of liquids. Water is great.

I know nothing about kidney stones and I'm not a doctor, but doesn't drinking lots of water help with those?

 

[Dr Snoddy]

Congratulations on your progress so far. Do you know the composition of your kidney stones as this may impact on your diet in the long term?

 

[Tristan77]

Congratulations on your progress so far. Do you know the composition of your kidney stones as this may impact on your diet in the long term?

Predominance of calcium all three times which is odd as ive never had a diet that was calcium heavy. First time i had them i was a 24 year old, slim (78 kgs) with a very active lifestyle - things have changed since then of course, but there seems to be little consistency with circumstance or lifestyle when ive had them. They dont *think* theyre particularly to do with diet.

First time i had more, and bigger, and bad painwise - but this one - a 6ml stone - has done by far the most damage. Im still on 400mg of tramadol a day and they passed 2 weeks ago, which doesnt make it the easiest to excercise, especially on less than 1200 calories a day.

Sorry went off on a tangent there!!

 

[Johnkennedy]

Very well done! Keep at it, you’ll get there. As is often said this is a marathon not a sprint

I am Obi.
I was diagnosed with T2, Last week (there about). My fasting bsl was 13.03, after 3 pack of Normal Saline, it came down to 10.2. Dr. Placed me on glucophage 2 x500mg per day. Took it for 1day &half, rather than decreasing, it increased to 12.5. I consulted another Dr. Who conducted a Random test, which produced an 8.6 bsl. Next day without drug, but with exercise and diet, I got 10 Fbsl. Day 2: Fbsl 9. Day 3 today: 9.3 (an increase). Am I on the right track? Is there anything I can do to normalize my bsl? Very sorry, I forgot to mention that I was diagnosed of Malaria and Typhoid fever (I'm from Nigeria) and still has blurred vision. Forgive too, for filling your space with this lengthy post. Your assistance and advice will be appreciated. Obi - a new member.

 

[paulmh]

Hi bud I was diagnosed September 17 with an HbA1c of 123 and glucose of 17. No symptoms, picked up in a blood test for something else.

Four months ago I came off Metformin with an HbA1c of 42.

This week I had an HbA1c of 37, free of drugs. I train every day and keep carbs about 100g. BMI of 25.5, I’ve lost maybe two stone, so like you I was overweight but not technically obese. But Lord, I was sedentary. I’m struggling to shift that last stone but it’s a nice problem to have. I understand that some T2s make all the right actions and still have the diabetes, some of us are lucky enough to be able to get in remission through our own actions. I wanted to find out which category I was in by shifting the weight and getting fit, and now I know. I would have accepted the outcome either way. Getting leaner and fit again is a winner either way. I think we all know it’s like anything in life - we have to show up and keep showing up, one day at a time. All the very best in your journey!

 

[Tristan77]

So a quick pre-chrimbo update. Im now down to 85 kilos, so have dropped 3 stone in 9 weeks. I havent had an out of range blood sugar reading in about 4 weeks - although its never gone lower than 6.2

Doctors are really happy with the progress, now its just a case of keeping going, and waiting for ny next HbA1c which is scheduled for 12th january.

Fingers crossed!