Nightmare A1c results.

The long term stress of cancer and the diet going south would be obvious suspects in your recent A1c level changes; but you only get them checked once a year?

Depending on how well you can manage stress and diet, I would be hopeful of pushing those a1c numbers down, but discuss what can be done in the mean time at your appt. See what options are offered. I'd ask about getting a1c levels checked more frequently so you can track your progress, Are you testing bg levels?

Good luck at the appt. Hope it goes well for you.

They can only put you on meds if you agree to it!

You’ve had a hell of a year as you say so it’s hardly surprising that something gave way. I hope things are looking better now.

At your review you can discuss the reasons behind the rise and the fact that you want to restart the diet control. Perhaps agree a 3month review to see how that goes before committing to any meds. Many get that chance at diagnosis and I see no reason why this should be different unless there is some other medical urgency.

Do you test yourself? If so a record of improving results between now and then could be persuasive if you feel the need to convince her. Or examples of changes you are making - but any mention of keto or high fat might scare her silly if unaware of the benefits - perhaps talking about removing sugars, refined carbs and processed foods and increasing veg etc. Personally I’d just say “no, not yet, I’m trying diet again first”.

Edit to add : as tophat says you should really be on max of 6 monthly checks according to NICE and only if numbers are stable. Otherwise it should be 3 monthly.

I dont know how recent the chemo was and how much you had but it messes up everything including BG. Also having looked after someone going through chemo in the last year you are lucky if you can eat anything and keep it down. It may not have completely left your system yet so dont be too downhearted. Your oncologist might know about this. If you can now eat LC natural foods going forward I am sure your next HBA1c will improve. Hope your recovery goes well. Best wishes.

I am not surprised your blood sugars went haywire with all the stress and pressure of the cancer diagnosis, and especially the chemo. (Been there, done it, lost the hair in the process!), and this is aside from the poison they infuse in your blood stream and the steroids that go with it. My T2 diagnosis came 12 months after my cancer diagnosis whilst I was still on infusion treatment - and I know that apart from the treatment I was comfort eating and also eating to ward off chemo side effects, most of which is extremely unfriendly for diabetics. So no blame attached to you at all.

As the others have said, you should be on a minimum of 6 monthly reviews, but right now you need to be on 3 monthly, so this could be discussed with your nurse. She likely will want you to try the med route, but whether you accept them or not is entirely down to you.

I'm not sure what medication you will be offered or what you could combine with your other treatments, but it may be worth considering, even if it's in the short term, to give you a 'leg up'. Of course, it's up to you.

And also, their suggestions will be different for you, but for me, my BS was 103 when I was diagnosed. I was told 'no' to only diet and exercise, as I was thin with a BMI of 22. As much as I wanted to ignore this advice, I was worried about how high my BS was and the damage it would be causing, so I took the metformin (but not the insulin until a week ago), plus LCHF and plus exercise, and my BS was 46, 3 months later. I didn't want to take medication, I'm sure it didn't hurt me (and I'm loath to admit my life is easier since last week on insulin, I'm no longer in the ketone danger zones, and my BS now normalised.) It was told Metformin was an ISA - an insulin sensitising agent, to make what little insulin I had remaining with my extremely low c-peptide, more effective. Dr Bernstein: Diabetes Solution recommends the use of ISA's (Metformin) and insulin (for low c-peptide). Looking back, and hindsight is a wonderful thing, I should have followed their advice fully. But I got there eventually.

zaphod37 said:

Funny thing was about the chemo, I was told I would lose hair and lose weight, that there would be times when I coudnt face food and fatigue and tiredness would play a big part.

There are no words that can describe how bad the fatigue and tiredness were. My sickness was kept under control, I struck lucky and the first antisickness drug they tried, worked very well. I never lost weight which could have been because of the steroids, and my hair thinned but didnt fall out.

Click to expand...

I was never sick, and never even nauseous. The longer the chemo went on, the more fatigued I got to the extent that I could barely raise my arms high enough to take my coat off the peg, and had to sit down to clean my teeth. All those sort of things wear you out and must play havoc with blood sugars. I put weight on, and ate non stop.

Pleased to see you have passed your first year with a clear, and good luck for the rest of the 4 years and beyond. I am now 6 years down the road and still clear. Chemo is horrible, but it does work for the lucky ones!

I’m sorry to hear you’ve had such a dreadful year, but it’s great news you’ve got your first years’all clear’

My fist DN was horrible and wouldn’t listen to me at all. Told me that I’d never do it with diet alone she was awful In the end I took the script from her (but I never got it filled) they can give you a script they cannot stand over you every day making sure you take it. Your body, your health, your decision you’ve been through cancer and to a much higher degree you simply gave to trust them to know what they’re doing, but with T2 the information/training is SO POOR. SEe what they offer you but make your own mind up about what you want to do

Take care
C

zaphod37 said:

Take care folks and stay safe.

Click to expand...

And you!

zaphod37 said:

Hi Folks.
Just thought I would give you a quick update.
Despite the last week going ultra low carb, I couldnt get my blood sugars down very much. So I discussed my low carb diet and she actually listened to me and told me if it worked last time that it was worth another go. I did tell her i wasnt going to the extreme but to reduce my carbs to 50g per day for 3 months. She was ok with this.

We did however, decide to try Metaformin and to switch from Simvestatin to Atorvestatin. A decision was made to have a repeat A1c in 3 months and see how the plan is working.

I was very happy with the diabetic nurse and hopefully will have a good relationship with her.

Take care folks and stay safe.

Click to expand...

do be aware that statins can raise blood sugars.

Statins are also associated with a higher risk of developing type two diabetes - quite significantly higher, so you might want to consider just how much you need to take that sort of medication.

dawnmc said:

do be aware that statins can raise blood sugars.

Click to expand...

Really????? Well I never knew that. My cholesterol is right down, as was my hba1c on my 3 month check today and I'm on atorvastatin....

debsf1mad said:

Really????? Well I never knew that. My cholesterol is right down, as was my hba1c on my 3 month check today and I'm on atorvastatin....

Click to expand...

It has been shown in research that statins can cause non-diabetics to become diabetic (T2) by as many as 25% of the research participants. Even the manufacturers put a warning out about it.