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Seeking Medication Advice

Discussion in 'Type 2 Diabetes' started by Johosephat, Oct 6, 2021.

  1. Johosephat

    Johosephat · Active Member

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    I hoping forum users will be able to kindly offer me some advice.

    I was diagnosed T2 Jan 2021, had a blood test April 2021 and another October 2021.

    I currently take statins and 4 x 500mg Metformin each day. I've expressed an interest in reducing my medication to my doctor, but my last results have come back with a note of "no further action needed".

    Jan 2021: HbA1c 112 / Cholesterol 8.8
    April 2021: HbA1c 39 / Cholesterol 4.4
    Oct 2021: HbA1c 33 / Cholesterol 4.0

    Through low carb and exercise, I've gone from 19st to 13st 10lb.

    As the results seems to be improving, I'm hoping other forum users can advise whether I'm in a position to push harder to reduce my medication or if I should remain on them. Would that be a reasonable and safe request? I'm pushing for remission and don't want to jeopardise that.

    As a side note, I'd also like to say how thankful I am for all the advice gained from this forum to help achieve these improvements. I don't post much but have gained so much helpful information from other more knowledgeable forum users.
     
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  2. JoKalsbeek

    JoKalsbeek I reversed my Type 2 · Expert

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    You could discuss it. Your HbA1c is beautiful, and your cholesterol seems alright, though there's no breakdown... Ask to do without for 6 months, and get re-tested then? See what happens?
     
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  3. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    Hi @Johosephat We aren't allowed/able to give actual medical advice, but we can give our experience and our own viewpoints - which are just that our personal views!

    Your case seems quite straightforward:
    Your GP can't force you to take any medication that you don't want to.

    1. If you had made no lifestyle or dietary changes since January, then it would appear your vast improvement was at least mainly due to your medications. So at most only take small steps in trying reducing doses.

    2. But you say you have been doing Low Carb and have lost a lot of weight, so at least so far as Blood Glucose is concerned, it's almost certain that the vast majority of the improvement is due to your lifestyle changes. Thus it's not unreasonable to cut the Metformin dose my as much as you feel you want to. Because your HbA1C is now all the way down into the 'normal range' and so no GP seeing you for the first time should have any reason to prescribe any Diabetes drugs if you were not already taking them.

    3. Cholesterol is a different matter. Total cholesterol (which I think is what you listed) is pretty meaningless. What I feel matters most is that HDL should be near 1.0 or above (the higher the better), and your Triglycerides should be low- at least less than twice your HDL reading. Thus the ratio of Triglycerids divided by HDLl should be less than 2 (the lower the better).

    However there are some Doctors who thing that LDL still matters most and take the view that it can't harm to reduce it to much lower levels than those they would start to prescribe statins at.

    4. For many people, low carb improves all 3 lipid levels - HDL, Triglycerides and also LDL. But for some (like me) it only improves HDL and Triglycerides. See my signature for details of my HbA1C and Cholesterol results.



     
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  4. Johosephat

    Johosephat · Active Member

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    Thanks for this. I called the surgery again for the breakdown and all they were able to give me was the HDL which is 1.26 and a HDL ratio of 3.2 which I think is the ratio of total cholesterol to my HDL. The person I spoke to wasn't sure about anything else, but has printed out the result for me to collect tomorrow. Hopefully I'll be able to get the LDL and Triglycerides from that.
     
    #4 Johosephat, Oct 6, 2021 at 4:23 PM
    Last edited: Oct 6, 2021
  5. Rokaab

    Rokaab Type 1 · Well-Known Member

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    It may just be that they didn't do the tests for the full breakdown, my surgery generally doesn't get those done either.
     
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  6. LeftPeg

    LeftPeg Type 2 · Well-Known Member

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    Nothing to add re: medication, but just wanted to give kudos for such a massive turnaround!
     
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  7. KK123

    KK123 Type 1 · Well-Known Member

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    I often wonder about this scenario, your cholesterol was 8.8 (I note you do not yet have the breakdown), and due to being on statins (presumably) it is now down to 4.0. So as we all know, statins will reduce cholesterol but if you stop them it will probably go back to your normal. So the point for me is how do you feel about taking/staying on statins? The GPs will say 'that's great, your level is 4, continue' but I don't hold with this artificial attempt to reduce cholesterol to an 'average' level just because of a total.....Of course it's a choice we all have to make once we have hopefully done our research. That's why we are asking for you to get your breakdown (for all 3 readings) because then at least you can make an informed decision.
     
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  8. Johosephat

    Johosephat · Active Member

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    Thanks. Kinda makes me wish I'd done it sooner. The T2 diagnosis was what spurred me on, but realistically I could have done this years ago.
     
  9. Johosephat

    Johosephat · Active Member

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    This is my question really - how much of the decrease is down to medication verses weight reduction and general health improvements. I'd like to think stopping the statins wouldn't take me straight back up to 8.8, but I just don't know and would be apprehensive about finding out.

    I'd hate to stop taking statins and reduce Metformin, and then see all my readings rocket back up.

    I don't even have any issue with the medication. No adverse affects etc., I'd just prefer to not take medication if I don't have to.
     
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  10. bulkbiker

    bulkbiker Type 2 · Oracle

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    You are assuming that a total cholesterol of 8.8 would be a bad thing which may or may not be true.. however cholesterol is a very dynamic marker and the total number is pretty meaningless without the breakdown...

    As I always say.. it's up to you what you put into your body.. your GP is there to advise - the choice at the end of the day is yours whether to follow the given advice or ignore it.
     
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  11. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    My very biased view (had bad reactions) is to ditch the statins.
    You can always reintroduce them if your cholesterol ratios don't look good, but I suspect that your loss of weight and change of diet will have removed any problems.
     
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  12. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Legend

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    I would do as others above suggested. Contact your GP by phone and tell him you would like to stop your medication for 3 months and then have another test. See what he says. The "no further action" comment is routine - it just means he doesn't want to see you. He most likely failed to notice you were even on medication, especially the Metformin as that is doing hardly anything to help you.
     
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  13. Daibell

    Daibell LADA · Master

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    Hi. At your next blood test ask for a full lips breakdown. I would suggest stopping the statins a for a day or so before so you get a result without meds which will help decide about the statins; otherwise you can't make a decision. Do get yourself access to the surgeries online system at the level that you can see test results. You are entitled to that and it avoids wasting everyone's time getting printouts etc and you can see all your results
     
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  14. LeftPeg

    LeftPeg Type 2 · Well-Known Member

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    The best time to plant a tree is 50 years ago. The second best time is now.
     
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  15. Johosephat

    Johosephat · Active Member

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    Yep. You were correct. I'll ask for a full breakdown next time.
     
    #15 Johosephat, Oct 7, 2021 at 11:15 AM
    Last edited: Oct 7, 2021
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