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Saw doctor for first care plan after diagnosis

P

perth

Member
Messages
11
Type of diabetes
Treatment type
Diet only
Hi all, first diagnosed 6 weeks ago now, doctor delayed my first treatment until the new year but I didn't want to wait that long so I started treating myself with the information I had here.

I went LCHF got my official first fasting at 13.0 mmol/L (spiking up to 21.8) and over the course of five weeks, am now getting fasting levels in the 7 range, just by diet change. I have found the change very easy, my vision has improved dramatically, I have lost 8kg (20kg since mid last year) and I feel so so much better. I'm 43 years old and 6'7" tall.

So I went to see my doctor after having my first HbA1c (a few days ago, so not truly accurate as a baseline as I had already made changes) - this came in at 8.4%.

Doctor said I haven't done enough, that I need to go on Metformin. He said it not only lowers blood sugar, but also helps in other ways to reduce mortality. I don't have an issue taking medication (I'm not anti med in anyway)... To be honest I was a bit sad because I had put everything into trying to improve, I had even provided a visual graph of all my readings (and I tested very often, sometimes to excess for a T2, but I was learning what was having effect - as a side note I found Maltitol would spike me unacceptably, it was bad as sugar, so I had to watch what sweetners were used in foods)

So I've started taking Metformin, but to be honest it's has has No effect. My dose is 2x500mg after dinner. I woke up later in the night with stomach cramps and rhe runs, but I'm wondering if it's going to take longer to work or if I need something else, or If I just persist with diet alone. I am about to start exercise. I told my doctor I cut out all sugars where I could and am on low carb (less than 50g daily) but he said I'm too strict and I will fall off the bandwagon, so I should have some cheat days. But I don't want to. I won't cheat as I have already adjusted to this way of eating and to be honest I find it's very healthy for me, I've never felt better.

So I'm very confused right now. My levels before I started taking meds were about 7.3 - 8.5 during the day, I was finding them slowly falling but I have yet to get under 7. Doctor says I need to be at 6. Do I really need to take Metformin? Should I give it longer? What are the other benefits to taking it that he mentions (he said lower mortality rate but isn't that just because of lower blood sugar levels?) he's telling me to have fruit, all i eat are berries but he says have grapes or apples. I showed him what happens when I did that on my graph (spikes by 3-4 points) and he said that's ok and Metformin will help.

Aargh. Appreciate any advice and sorry to rant on here, I'm sure it's a common story but this is my life were dealing with here and I dont want to screw it up any more than I already have.
 
Hi , you might want to ask for the slow release metformin ...helps with the bathroom problems ...lots of people here have had that problem ...not saying it will work but worth a try ..
For me I would not eat grapes , but I am fine with an apple ....and sometimes with a banana , but we are all very different and at different stages with our eating plans ...
All Drs have different ideas about levels ....it really is about what is right for you and what keeps you well ...
I do feel a certain amount of gladness that my GP knows about this awful disease ...if I had a GP that did not understand , I would ask to go to a clinic to see someone who does know ...

Just a thought do you keep a food diary or see a dietitien ...these are things I have done in the past ...

I wish you well...kat
 
Hi Kat, looks like I'm already on the extended release Metformin. The doctor prides himself on his DB knowledge in fact he spent 45 minutes with me which was a first. He's been my family doctor for over 20 years, not that he's a great doctor, just close and cheap, and just been the doctor I've always seen.

Did the Metformin work immediately for you? My mother who takes it also (so does my Dad) say it is noticeable fairly quickly. Don't think a dietitian would help me at this stage though, I believe most of them don't agree with the LCHF way of eating.
 
Stick with it you are doing fine.
The drs just trotting out the standard advice they give you will get better advice on here.
Metformin won't lower your sugars by much but I believe it helps your pancreas function better.
With regards the Metformin did the Dr say to take two tablets at once ? I'm on the same dose but I take one tablet in the morning and one at tea time that may help with the cramps and runs
 
Hi Sancho, doctor asked what my biggest meal was, I said dinner. he said to take two after I eat. But sometimes my lunch has more carbs than dinner (I have a barley wrap for example 9g carb) but dinner might just be steak and some vegies, or just pan fried chicken breasts.

I was wondering if I try one at lunch and at dinner maybe?

If it helps other functions I will keep taking it, the cramps are bearable, nothing over the top, i could probably get used to them by spacing them out.
 
I would give it a go Perth it may help, I hardly had any problems with Metformin when I first started and what problems I had cleared up after a few days but unfortunately some do have problems,
 
Hi, welcome to the forum.

Most people who do LC tend to have researched it and worked out how their unique body reacts to low carbing, and particularly to individual foods.

Doctors have almost never done that. And their knowledge of nutrition is informed by NHS guidelines with (usually) very little personal interest. Hence all the default referrals to dieticians!

I think you are to be congratulated. On finding a diet that works for you, on sticking to it, on losing the weight, on your BG drop and on being here on this forum. :D:D:D

You asked about metformin.
It is a drug that takes several weeks to build up in your system, so it won't have a sudden effect. It also works in the background, lowering your overall numbers by 1 or 2 mmol/l. So it won't stop spikes after food. As such, it should affect your HbA1c, but you won't necessarily see it working in your after food readings. It definitely won't flatten out spikes of 3 or 4 from eating fruit

The stomach cramps are a side effect that should wear off after a few weeks. If they don't, please go back to the doc. If you search the forum you will find many threads showing people suffering varying side effects. The consensus is to start slowly, on one tab a day for a week or so, then add another, then another, if nec. Easing your way in, as it were.

You asked about fruit.
Eat to your meter.
If you want to eat apples, then you can. But test before and after. If your BG rises by more than 2 mmol/l, then eat a smaller portion next time.
That applies to everything.

Have a look at the bloodsugar101 link in my sig for the BG targets that I personally live by. The site gives the thinking behind this, which I find convincing. They are lower targets than the NHS use.

I used to feel that same unsettling confusion every time I saw my doc. The things he was telling me just didn't add up. Since reading the books listed in my sig, and spending time on this forum, I am absolutely certain that I know more about diabetes that my doc and nurse combined!

I no longer feel confused, just saddened and irritated. And I don't follow their advice until I have verified it in a separate source.
 
I used to take 1500mg metformin , spaced out ...
Now I take one tablet of metformin 1000mg slow release ...
I believe it works over the 24 hour period .... I take it about the same time every evening with my main meal ....

It is really good to have a GP you feel comfortable with ...
I saw a dietitian who really helped with my veggie diet ....which incorporated other health needs ...

I don't do the diet you describe ...sounds like you are getting into your diet, and as @Brunneria says research is important for the diet ..for me , I am finding new information out all the time ...its a mind field ...

Hope you notice the metformin working soon, I think from memory I noticed the difference after a few months ...

When I changed to slow release we gave a 3 month change over time ...
 
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as I understand it the Hba1c test covers approx the previous 12 weeks, so if you've only been making changes for 6 weeks, then it probably is a bit higher than you hoped. I'm not sure if I've worded that very well, could someone with a less foggy brain please clarify!
 
Hi,

Metformin isn't a miracle cure. It reduces insulin resistance, the production of glucose from the liver, and appetite. All to a limited extent. It is mainly an appetite suppressant. Diet is the key to control, not Metformin. You may find it helps eventually with your morning fasting readings as it will help stop the liver from dumping glucose when you get up, but certainly not with your after meal spikes. If your doctor were a diabetes expert, he would know this.

Your HbA1c after 6 weeks from diagnosis will include possibly the 6 weeks prior to that, before you were eating low carb, so don't put too much reliance on it. It is a sort of average of the previous 2 to 3 months.

I say well done on being proactive and starting this new eating plan. Stick with it and when your next HbA1c is well down you can tell your doctor just how you did it, and it won't have been by eating grapes. ;)
 
Thanks guys very reassuring comments, I now understand how Metformin works a lot better now, my doctor and chemist gave me the impression it lowered spikes after eating so that's what got me worried. It doesn't seem to be very useful really as my levels have been slowly dropping over time and when I graph my meters results you can see a downward trend line, without meds.

I hope to aim for a normal range HbA1c on my next 3 month test, so I'm going to keep doing LCHF and am determined to surprise the doctor next time I see him.

I don't know what I'd do without this forum!
 
It's too late and I'm too tired to write a long post out, but really you are doing fine Perth stick with us And we will stick with you and hopefully you and your Dr will be amazed
 
@perth here is some information about the beneficial effect on mortality that metformin has, which is really quite surprising:

http://www.diabetes.co.uk/news/2014...ld-help-extend-lifespan-for-all-92959331.html

Essentailly a large scale study involving 180,000 patients found that while diabetes is generally thought to reduce life expectancy by 8 years, for those taking metformin life expectancy is actually 3 years longer than the non-diabetics in the study, truly remarkable!

I intend to continue taking it for as long as I can, despite my currently very well controlled BG readings

Maxwell
 
Silver Hammer said:
@perth here is some information about the beneficial effect on mortality that metformin has, which is really quite surprising:

http://www.diabetes.co.uk/news/2014...ld-help-extend-lifespan-for-all-92959331.html

Essentailly a large scale study involving 180,000 patients found that while diabetes is generally thought to reduce life expectancy by 8 years, for those taking metformin life expectancy is actually 3 years longer than the non-diabetics in the study, truly remarkable!

I intend to continue taking it for as long as I can, despite my currently very well controlled BG readings

Maxwell
Click to expand...

That's an interesting news article.

But the fact it says this (my bold):

"Patients treated with metformin had a small but statistically significant improvement in survival compared with the cohort of non-diabetics, whereas those treated with sulphonylureas had a consistently reduced survival compared with non-diabetic patients. This was true even without any clever statistical manipulation."

I find this rather disturbing. It implies that manipulating statistics is standard. Of course, such manipulation probably IS standard, but it hardly encourages me to trust the 'findings'.
 
Sancho panza said:
Stick with it you are doing fine.
The drs just trotting out the standard advice they give you will get better advice on here.
Metformin won't lower your sugars by much but I believe it helps your pancreas function better.
With regards the Metformin did the Dr say to take two tablets at once ? I'm on the same dose but I take one tablet in the morning and one at tea time that may help with the cramps and runs
Click to expand...
Same here. Hi Perth, I am on Metformin 500 twice a day, one in the morning and one before tea. I also had the runs at the beginning but about 6 weeks down the line the runs stopped and I feel fine now. So I would say, stick with them but like Sancho says, ask your GP if you could split the dose to 2 x daily. Good luck
 
Silver Hammer said:
@perth here is some information about the beneficial effect on mortality that metformin has, which is really quite surprising:

http://www.diabetes.co.uk/news/2014...ld-help-extend-lifespan-for-all-92959331.html

Essentailly a large scale study involving 180,000 patients found that while diabetes is generally thought to reduce life expectancy by 8 years, for those taking metformin life expectancy is actually 3 years longer than the non-diabetics in the study, truly remarkable!

I intend to continue taking it for as long as I can, despite my currently very well controlled BG readings

Maxwell
Click to expand...

Hi Maxwell, that is very surprising information. Firstly I was not aware the life expectancy was reduced by 8 years, but this must be what my doctor was referring to when he said it helps not only lower blood sugars but general mortality. Very interesting article.
 
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