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Rise in HbA1c Level

M

Mickeymoos

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Hi Everyone
Hope someone can give me some advice. I was diagnosed T2 in March 2008 and am currently taking 2 x 850mg Metformin and 40g Simivastatin. Hb1Ac this time last year was 5.7, when I saw diabetic nurse for annual check up today, my latest reading was 6.9. She told me that the latest protocol is that I require additional medication to Metformin, but didn't elaborate further, just told me to make an appointment with my GP. She then added that my control was moderate to good.
Does anyone know what the "protocol" is, does it now mean I need additional medication, or will the Metformin dosage be increased?
I thought I was going along quite happily, blood readings rarely go above 7 or 8, although I did have a period of a couple of weeks in August where they went haywire - for example - I had a post meal reading of 13 (never been in double figures before, so was in shock!!), then three hours later reading dropped to 4.6. Doctor was a bit concerned about the big difference, but didn't offer any explanation.
Thank you in anticipation of any help you can give.
 
Those are not acceptable levels, but they could be a lot worse.

"They" say so much and don't explain themselves. It makes my blood boil. And I know this is not exclusive to diabetes.

They are not going to give you a lot of useful inforamtion that will help you to stay in control of your blood sugar. You need to inform yourself.

When I was struggling to deal with my diagnosis earlier this year I found my way to http://www.bloodsugar101.com and the information I found there gave me hope that I cuold deal with it myself and minimise the medication I needed to take. The support I have had here and at http://www.lowcarbdiabetes.comhas helped me to normalise my blood sugar most of the time. My HbA1c has fallen from 7.8% at diagnosis to 6% last month on diet alone.

Tell us about your diet and we might be able to offer you advice on what you can do to reduce your numbers without more medication.

Also, do you test your blood sugar - if you don't you need to start, because that will help you to monitor how you are doing. All will be explained at Blood Sugar 101!
 
Hi Spiral

Thanks for your reply. When I was first diagnosed I was advised to follow a "healthy diet" rather than a low carb diet. For breakfast I have two shredded wheat with semi skimmed mik, for lunch a sandwich, normally cheese or chicken, dinner varies - sometimes fish, other times meat and veg. I am not a great lover of potatoes, so don't really eat those. I do eat quite a lot of fruit and I normally have nuts and an occasional bag of crisps as snacks. I don't have any added sugar, don't drink alcohol, but do drink sugar free soft drinks and tea.
I wasn't doing much exercise in the past, but have starting walking everwhere the past two or three weeks, I probably walk about 3 miles every other day on average.
I do test my blood (buy my own test strips as Doctor won't prescribe them), when I said my readings don't normally go above 7 or 8, that was a general statement. Normally my levels in the morning before breakfast are around 5 - 5.5, 7 or 8 is the highest readings I have had (besides my glitch a few weeks back). I am afraid my diet is rather "boring", I like to stick to foods I am safe with, if I eat anything new or different I will test afterwards to see how it effects me.
 
Your diet is why your blood sugar is high. You are eating a lot of starchy carbohydrate - starchy carbohydrate turns to glucose as your body digests it :shock:

Whatever diet you eventually adopt, you need to reduce the amount of starchy carbohydrate you eat. You need a diet you can stic to. I'd recommend you visit Blood Sugar 101, it is very informative and it may give you ideas of how you can adapt your diet. Take a look in the diet forums, especially at the sucess stories and see how others have done it.

Succesful diabetics - those with good control - reduce the amount of carbohydrate they eat. I stopped eating obvious carbs in May when I cut out bread, pasta, rice and potato and that has had a massive impact on my blood sugar. I don't like to go above 6.5 after a meal and my blood sugars are much improved - hope to be in the 5% club next HbA1c in January.
 
Sorry to sound a bit dim, but what part of my diet is the worst starchy carbohydrate? I don't eat potatoes or rice etc, and only have two slices of bread a day.
I'll have a look at the recommended website and see what I can learn from there.

Thanks again.
 
I will highlight the carbs

Mickeymoos said:
Hi Spiral

Thanks for your reply. When I was first diagnosed I was advised to follow a "healthy diet" rather than a low carb diet. For breakfast I have two shredded wheat with semi skimmed mik, for lunch a sandwich, normally cheese or chicken, dinner varies - sometimes fish, other times meat and veg. I am not a great lover of potatoes, so don't really eat those. I do eat quite a lot of fruit and I normally have nuts and an occasional bag of crisps as snacks. I don't have any added sugar, don't drink alcohol, but do drink sugar free soft drinks and tea.
Click to expand...

Do you read food labels? I usually look at the carb content and generally don't buy things with greater than 10g carb per 100g. There are carbs hidden in all kinds of things :shock: it isn't just obvious sugar :? Go read Blood Sugar 101 :D
 
Hi again
Yes I do read labels, I was given a leaflet from the Diabetic Nurse when first diagnosed that the following were okay to eat:
(Per 100g)
3g of fat or less
1.5g saturated fat or less
5g sugars or less
0.3g of salt or less
0.1g sodium or less
0.5g fibre or less

so I try to buy foods which fall in this criteria, obviously there is no mention of carbohydrates in the list, I'll add that now!

Just to confirm, by the way, is a HbA1c of 6.9 really that bad - the nurse told me this was moderate to good! Doctor tells me that as long as BG levels are in single figures, he is happy!
 
The doctor isn't the one living in your body, with diabetes, and the prospect of future damage showing up! Mine diagnosed at 8.2 fasting... so not all doctors think single figures are okay.

Others are more expert in food stuff, but following what they advised I have cut my bg levels to under 6s all the time. Expecting a decent a1c when next tested. I think I understand that if you are not getting your energy from carbs you will need to be eating some fat etc to fuel your body. Someone will explain!

Good luck anyway - you can probably do it yourself without extra meds if you are brave enough to defy your doc! It's your diabetes, not his. Resist!!

DG
 
Why not make a start by having one shredded wheat - and add some protein, eg cheese or ham if you don't want to cook first thing.

Crisps for snacks is not the best choice - a few unsalted nuts would be better.

How about an open sandwich *- that way you use half the bread.

Just by making these small changes you would make quite a difference to the amount of carbs you eat without your daily routine being changed very much.

* or if this is part of a packed lunch, you could make a sandwich with one slice, and take some extra filling separately.
 
Sorry - meant to add that it is best to spread the fruit out over the day - only one piece at a time - and try to increase the ratio of veg:fruit in your 5+ per day - eg 3 veg to 2 fruit rather than the other way round.
 
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