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on tablets high recent hba1c don't want to go on insulin

Discussion in 'Type 2 Diabetes' started by cien, Dec 5, 2021.

  1. cien

    cien · Member

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    Anyone here brought their hba1c to manageable level without going on to insulin. My last reading a month ago was 12 (108).
     
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  2. Rachox

    Rachox Type 2 (in remission!) · Master

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    Hi @cien and welcome to the forum.
    Can you give us a little more information to help us to help you please? Can you tell us what medication you currently take and what you eat in a typical day? You may be able to avoid insulin by tweaking your diet.

    Edit to add, the actual answer to your question is ‘yes’, many members here control type 2 with diet alone or diet and oral medication. (Type 1s cannot avoid insulin)
     
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  3. lovinglife

    lovinglife Type 2 · Well-Known Member

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    There are lots of approaches before insulin for T2, I was almost as high as you with 11.something can’t remember but it’s in my signature, I started off on metformin and maximum gliclizide, reduced my carbs significantly down to about 130g a day, got down to the low 6s reduced my glic by half. Dropped my carbs again to about 90g a day and reduced my glic by half again. Got into the high 5s. Then went full keto about 15 - 20g carbs a day. Dropped my gliclizide completely now only on metformin for the past 3 years, I am in low to mid 6s now but happy with that.

    remember it’s not a race it’s a marathon and you will get there, maybe even quicker than me if you drop the carbs right down straight away. I took the slow and steady root because I have a lot of issues around food and felt it was the best way for me. It’s still really really hard some days but I stick with best I can. Have a good read around the forum and especially low carb area. Also a very good website for articles, info and recipes that a lot of us use is Diet Doctor - Google it and it will pop up.
     
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  4. cien

    cien · Member

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    Thank you for your response.
    My current medication is as follows
    Breakfast -1000mg glucophage, 25mg alogliptin. 40mg gliclazide
    Evening meal - 1000 glucophage ,40mg gliclazide

    For blood pressure 1.25mg Ramipril
    For Cholesterol 20mg Liipitor

    I am not overweight
    I have after the high hba1c reading become strict with my diet.
    Breakfast is 3 plain nairns oatcakes with benecol followed by either 2 eggs OR1/2 cup porridge with soy milk sprinkled with 1 tsp of cinnamon

    Since breakfast is quite late I tend to skip lunch but graze on a couple of rice cakes

    Dinner is salmon or chicken with vegetables

    I am waiting for a glucose monitor and strips to find out my reading

    I have been diabetic for a long time with my annual reading creeping up every year but lock down made me careless
     
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  5. lovinglife

    lovinglife Type 2 · Well-Known Member

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    Looking at your breakfast it’s quite carby with the oatcakes and porridge, try bacon and eggs, mushrooms- BUT be careful cutting carbs with the meds you are on, do you test before and after meals? This will give you a better idea how you react to certain foods rather than your Hba1c. Try reducing your oatcakes to 1 or 2 and test, skip the porridge if you have the oatcakes.

    if you do have lunch skip the rice cakes and have some cheese, eggs, meat, fish, again with the caveat of testing to make sure you aren’t going too low with the meds your on.

    dinner sounds fine with a protein and above ground veg, remember to add some natural fats like butter, cream, avocado, mayo, a few nuts (not peanuts) to keep you full. Take your time to learn what is good for you as a T2 - you’ll be surprised carbs bad, fats and protein good.

    E.T.A. *sorry just re read your last post and see you are waiting for a meter, that’s good once you get that you can begin to test and build up a good picture of which foods you can and can’t tolerate.
     
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  6. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Hi @cien I think it is great that you would like to do something positive. I tend to straight talk and assume that remission is your goal, so forgive the directness.

    It is likely with such as high A1c that you will need to make permanent change with no looking back. Currently some of your choices are in the looking back area. I will provide some potential alternatives:

    3 Plain Oatcakes - 3 Keto pancakes / chuffles (Reason - significantly less carbs). Eggs are great.

    Porridge with Soy milk - Coconut flakes (find 6 grams of carbs brands) with cows milk

    Soy Milk - Cows Milk (Reason - my opinion is that soy is milk is not as natural or as good as cow's milk, how difficult is is to squeeze soy to obtain juice etc)

    I would drop the benecol (Reason - a well formulated diet shown produce the correct gut bacteria compatible with our body, the absorption rate of benecol and similar is questionable)

    I would have snacks with meals not independently.

    Salmon and Chicken with Vegetables is great so long as the vegetables are non-starchy (this type of meal can also be a breakfast or lunch).

    Unless there is a religious reason, red meat is complimentary and most likely the absolute best single item bar none.

    Other Areas The Can Assist

    10 minute or more walk after each meal - proven to lower blood glucose levels.

    An exercise routine incorporating a little cardio, with a bias towards resistance exercise

    A focus on stress relief and quality sleep.
     
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  7. cien

    cien · Member

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    ok so I do tend to eat more oatcakes then are good for me. Shall reduce them to 2. Bencol is out and butter is in.
    I am alternating eggs one day and porridge the next . Mbaker your reading of 134 in Jan 2015 and the drop to 59 in March is impressive and I am looking to achieve that kind of dramatic improvement.
    I think the glucose meter will help a lot. Hope to get it next week.
    In terms of exercise I have started to do 100reps on my exercise bike and hope to increase that. I do go walking about once a week but not very much.
     
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  8. TriciaWs

    TriciaWs Type 2 (in remission!) · Well-Known Member

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    I don't like eggs for breakfast but replaced porridge with a low carb cereal of milled flaxseed, a little chia seeds and a couple of nuts (chopped), made with water and coconut milk, served with cinnamon and double cream.
     
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  9. bulkbiker

    bulkbiker Type 2 · Oracle

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    T2's have a problem coping with carbohydrate oatcakes and porridge are unfortunately both high carb foods.

    Have you though of avoiding them altogether and maybe even skipping breakfast totally?

    I replaced breakfast with a couple of mugs of coffee with double cream which seemed to help to drastically lower my blood glucose levels. I now don't eat until mid afternoon at the earliest.
     
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  10. cynetique

    cynetique Type 2 · Active Member

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    You are being given excellent advice. It is possible to make significant improvements: I went from 104 to 45 in 5 months.
    I nearly was prescribed insulin but the physician eventually prescribed Gliclazide instead, which I decided against taking and managed to reduce my glucose level with low carb diet, exercise and intermittent fasting, whilst taking metformin.
    One thing to bear in mind with going low card is the risk of hypos with Gliclazide which needs to be managed carefully.
     
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    #10 cynetique, Dec 5, 2021 at 5:48 PM
    Last edited: Dec 5, 2021
  11. cien

    cien · Member

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    Yes I am getting excellent advice and am very grateful, hopeful and positive.
    Thank you everyone please keep posting.
     
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  12. MrsA2

    MrsA2 Type 2 · Well-Known Member

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    @cien on the meds you are on it is dangerous to go straight to low carb quickly. Your sugars could drop too quickly and you could go into ketoacidosis which is life threatening. Its rare in type 2s so medics might miss it if you did.
    Better is to reduce carbs a little a time over a longer period of time. So example, reduce one oat cake for a week but don't change anything else. The next week reduce another oatcake, the next week reduce soemthing else.
    If you do it slowly, and watch to see as your bg drops whether your meds need reducing in alignment, then you should be OK
    Just don't rush it.

    Edited for typos
     
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  13. johnme

    johnme Type 2 · Well-Known Member

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    You may have to rethink your approach to carbs altogether. I had a shock in November when my hba1c had increased to 11.9, which is 107. It’s never been there before, usually rattling around 7, though I’d have imagined I hadn’t changed anything. I immediately went on a DietDoctor keto regime. Today the Freestyle Libre I’m experimenting with reports my GMI (more or less equivalent to hba1c) as 7.4 or 60 (depending on the system used). That’s in one month. But I’m barely eating carbs at all. Good luck with it.
     
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  14. EllieM

    EllieM Type 1 · Moderator
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    @cien if you are in the UK you should be entitled to NHS funded meter and strips, as you need to be able to tell whether you are hypo. (Happy to be corrected by UK forumites if I'm wrong).

    You really need to be able to tell what your bgs are doing with whatever regime you are on, so in my opinion a meter is a must.
     
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  15. Deediabetic

    Deediabetic · Active Member

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    I was diagnosed at the end of june with a hba1c of 13.3 so higher than yours. I ignored all the dietary advice for type 2 diabetics about eating 6 meals a day and the bulldust about low GI carbs at every meal. I went low carb but not keto. My second hba1c test was done 6 weeks after my first and came in at 7.6. My next hba1c was done 12 weeks after my first and came in at 5.6. I went to a clinic at my local hospital that gives diabetic counseling for women who want to conceive last week and they did an instant hba1c test whilst I was there and it again came back at 5.6%.

    I was prescribed 2 x 500mg tablets of metformin on diagnosis with the follow up of increasing my dose or looking towards stronger medications. I was never prescribed more medication because diet reduced my hba1c levels. I could have come off metformin completely but because I'm trying to conceive they said to just take one tablet a day as it may help a little in the first trimester of pregnancy and before hacing to swap to insulin in the second trimester. From your diet listed, you are eating far too many carbs and my guess that cutting your carbs significantly might help you reduce your hba1c and needs for more medication. I'd try that first for 3 months and see how you go. You be might surprised by how quickly low carb can put your diabetes into better and safer levels. The first few weeks of low carb were tough but now I'm loving it. Ive been able to find low carb bread substitutions in my local supermarket and I've loved eating low carb dips, cheese, ham, olives, celery, cucumber, nuts, pork crackle for snacks. Higher fat and protein has definately helped me feel full very quickly and doesn't have me craving carbs. Definitely try lower carb first but do it safely and under the care of your doctor because of the meds you are taking.
     
    #15 Deediabetic, Dec 6, 2021 at 7:25 AM
    Last edited: Dec 6, 2021
  16. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Thanks, but my drop to 59 was welcome but sub optimal, I still was eating home made soda bread and oats. I was able to get to get an A1c of 41/42 still on oat with 3 hours of cardio.

    By submitting to the removal of the grains mentioned, I was able to easily keep and maintain A1c's in the 30's. Oats are typically 60% sugar (as carbs are sugar molecules) Below is the nutritional values of the arguably best known oats brand:

    upload_2021-12-6_11-54-13.png

    For whatever amount you have you may want to divide the carbs by 4 to get an indication of sugar equivalent, so the above serving is 60 / 4 = 15 teaspoons of sugar. I cut down to 35 - 40 grams, circa 8 - 10 teaspoons. As there is some fibre this might mitigate the sugar hit.

    There is only 1 person I have seen on this site who has put diabetes into remission and eats a liberal amount of oats; in order to do this so much running and workouts, others have a minute amount (in my view not worth it, as it is not caviar). I would suggest you test with a glucose monitor what this grain is doing to you, if you want to reverse Type 2.
     
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  17. cien

    cien · Member

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    oh happy day I joined this forum! I am picking up so much useful information. Thank you
    I live in the Uk so I know I can get a glucose meter plus all the related bits on the NHS. I have asked my GP .
    Reducing carbs is not a HUGE task for me so having a go at that. Can't wait to see what my sugar reading is after 2 to 3 weeks of control.
    @Mbaker I don't think I could do your level of exercise especially as demonstrated by you profile photo! Am pretty fragile as it is.
    Exercise bike and walking is my limit. I don't need to lose weight. I notice the common thread here is loss of weight. The nurse was very pleased with my current weight.
    I think carbs is the culprit for me. Control and testing will tell.
     
  18. Mbaker

    Mbaker Type 2 (in remission!) · Well-Known Member

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    Yeah, I come from a sports background, so this is my go to. There is no requirement to exercise to where I am at, those who do less tend to have lower A1c's! This is due to the ramped up glucose produced by the liver to service the exercise, I except this side effect for the other health benefits. It is also possible to over do it and rely on exercise more than diet, when diet should be circa 90%.

    I would suggest the walking after each meal, as this is an easy win for lowering the A1c. For resistance, at your youthful stage, the same rules apply for anyone. Start slow, with progressive overload. This might look like sit to stand x 5 (either assisted or not). Increasing each week by 1 rep. When strong enough with this, going to body weight squats in the same manner. A structured plan you should be able to get via the NHS. The principal is to challenge the muscles regularly.
     
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  19. cien

    cien · Member

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    I am on the other side of the spectrum in terms of sports. I do gentle exercise.
    Now that I have aware of my carb. problem I am pushing ahead to resolve it - sensibly
     
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