Sudden jump in HBA1c/FBG

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
Thirteen years ago, at the age of 39, I was diagnosed with Type 2. My fasting blood glucose was 7.8 and my HBA1c was also raised; a glucose tolerance test had a starting level of 7.1 and a two-hour level of 11.0. My doctor prescribed me Atorvastatin for slightly raised cholesterol, and I lost some weight over the next three months. At the end of the period, we repeated the GTT and this time got a starting level of 6.1 and a two-hour level of 7.7.

Over the intermediate thirteen years, my blood sugars have remained in the prediabetic range, with my HBA1c gradually decreasing from 6.4 (in June 2016) to 6.3 (June 2017) and 6.1 (June 2018 and June 2019). A few months prior to the 2018 test, I came off Atorvastatin as my cholesterol was now off the bottom end of the normal range. In June 2019, with my total cholesterol having increased from 5.12 to 5.99 (in both cases, with fairly low HDL and pretty low triglycerides), my doctor restarted me on Atorvastatin.

Three months later, I had my HBA1c checked again, to see whether restarting the statin had had any effect, and was shocked to find that it had soared to 7.0. I asked to switch to a different statin (Pravastatin, which is not associated with any increase in blood glucose) and had a fasting blood glucose test done in between the two statins. This came in at 8.2.

It looks as though Atorvastatin was not the culprit for the sudden increase, and I have simply run out of luck with diet (which involves eating only once a day), though it's a hell of a coincidence after thirteen years. I'm seeing the nurse for a diabetic check on Friday, and am wondering whether I should go straight onto Metformin or should attempt another diet, which could buy me another few years before needing medication. What does everyone on here think?
 

Rachox

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Hi manxman and welcome to the forum!
First let me link our useful info post: https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/
You say you were only eating once a day, but can you give a bit of detail about what you have been eating?
Many of us here use a low carb approach to keep our HbA1c under control. I take Metformin but many members here use diet alone.
Cholesterol is another subject. Here’s a link to a thread on this forum with loads of info to consider:
https://www.diabetes.co.uk/forum/threads/cholesterol-and-statins.156985/
 

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
I eat out seven days a week. The cuisine varies, depending on which restaurant I visit, but usually takes the format of a three-course meal. My favourite foods are meat, fish and dairy – my perfect main course would be something like fillet steak in a blue cheese sauce, cod mornay or lobster thermidor. Generally, however, I eat a wide range of foods groups including some bread and potatoes, and always have either a pudding or the cheese board. At our June meeting, my doctor told me she thought I was eating too much protein and not enough carbohydrate, and I tried to include a little more of the latter in my diet, which may also have affected the HBA1c. I'm baffled by the 8.2 FBG result, however, and was surprised when the hospital marked it as "acceptable" in the app.
 

Brunneria

Guru
Retired Moderator
Messages
21,889
Type of diabetes
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If you cut down on protein, and increased the carbs, then you may find that goes a long way to explain the sudden deterioration in your blood glucose levels.
 

Resurgam

Expert
Messages
9,849
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
If you are eating more carbohydrate then you have probably had higher post meal readings - which would affect your Hba1c in no uncertain way.
Did your doctor give any reason for the advice?
Rather than start Metformin, which can have some nasty side effects, I'd try going back to the diet which was working for you and see what that does in three months time.
 

Rachox

Oracle
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Messages
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I reversed my Type 2
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Sounds like your diet may be too carb heavy, carbohydrate turns to glucose once digested, so there are some obvious things to reduce or cut out completely to improve your HbA1c. The sauces on your food, bread, potatoes, pudding and any crackers eaten with your cheese.
Do you have your own blood glucose meter? You could learn a lot with one about your reaction to carbs.
 
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manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
My doctor was concerned as my urine creatinine was about twice the upper limit of normal, commenting that I was "beginning to leak protein". My microalbumin is pretty low, however, and my albumin:creatinine level is only 0.2, so I'm not sure whether to be concerned about this or not.

I have never done any glucose testing at home, as my previous doctor thought it would reduce my quality of life without much significant benefit.
 

Brunneria

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Well, you have another option if raising protein is not something you want to do: raise the fat instead

Many of us around here keep to normal protein levels, drop the carbs, and raise the fat to compensate. It is nutritious, satiating, and doesn't raise blood glucose.
 

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
That's definitely an option, as fats are my favourite type of food (I love anything dairy-related). I can't see myself giving up carbs entirely, as I like puddings, as well as some bread and potatoes with my meal. Would losing some weight over the next couple of months (maybe via a 5/2 diet) assist?
 

Rachox

Oracle
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Messages
15,810
Type of diabetes
I reversed my Type 2
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I have never done any glucose testing at home, as my previous doctor thought it would reduce my quality of life without much significant benefit

Sorry to be blunt but being in complete ignorance of high blood sugar levels would reduce my quality of life eventually by getting complications, way more distressing than a tiny finger prick a few times a day.
 

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
I think my then-doctor took the view that since my levels were not in the diabetic range, I didn't need to worry too much. I used to get my HBA1c and FBG tested annually, and go on a 5/2 diet for a few weeks if either seemed to be creeping upwards.
 

Brunneria

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Messages
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Type of diabetes
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If your T2 diabetes is caused by excess weight and a fatty liver and pancreas, then losing weight may well make a big difference. However, there are other causes of T2 and while losing excess weight is always a good thing, some of us see no accompanying benefit to our blood glucose levels.

I suggest you do some research on the Newcastle Diet (this is a very low calorie diet intended to reverse T2 via weight loss from the liver and pancreas, the subcutaneous fat loss is a welcome side effect. :) ) Also the Mosely 5:2 diet, and in fact any low carb way of eating. There are many out there. www.dietdoctor.com is a good site for an intro to the subject.

Personally, I think that adding fat without significantly reducing carbs would be highly unwise. High fat combined with high carb has to take the prize for the unhealthiest diet in the world, and you have stated that you eat out 7 days a week. That means that you are not in control of the quality of the fats used in the prep of your meals. I suspect that unless you are going to exceedingly high quality well informed eateries staffed by chefs at the crest of the Low Carb wave, you will be consuming vegetable and seed oils in high amounts => bad fats.
 

Resurgam

Expert
Messages
9,849
Type of diabetes
Type 2 (in remission!)
Treatment type
Diet only
That's definitely an option, as fats are my favourite type of food (I love anything dairy-related). I can't see myself giving up carbs entirely, as I like puddings, as well as some bread and potatoes with my meal. Would losing some weight over the next couple of months (maybe via a 5/2 diet) assist?
Puddings, bread and potatoes eh? Well - there's the reason for the higher numbers.
I have to stay low carb if I want normal test results - though only just normal on under 40 gm of carbs a day - I suspect that I was too high for too long to get lower results, but I soldier on.
 
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manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
Generally, a typical restaurant meal will comprise bread, a starter, main course, and dessert or cheese. My tastes definitely tend towards meats, fish and dairy, as I noted, but main courses will usually be served with vegetables and/or potatoes. Aside from the one time I eat per day, all I consume is water (several litres a day).

The diets mentioned above look interesting, and I shall investigate them further.
 

Rachox

Oracle
Retired Moderator
Messages
15,810
Type of diabetes
I reversed my Type 2
Treatment type
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I eat at restaurants once in a while, skip the bread at the start, ask for more veggies or a side salad in place of potatoes, I’ve never been refused and have the cheese, no biscuits for dessert, unless you can ask for berries and cream. That’ll dramatically reduce your carbs and improve your numbers. You can go for a low calorie approach as a temporary measure but once the weight is lost you need a follow up plan and in my opinion low carb is the way to go if you want to control your blood sugars. Having said that I went low carb and got my blood sugars under control while losing six stone at the same time.
 

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
That's an amazing achievement, Rach! My rather idiosyncratic diet has kept my numbers in the prediabetic zone for thirteen years now, but for some reason the strategy is now failing. I'll definitely have to try something, or I will end up on Metformin.
 

Rachox

Oracle
Retired Moderator
Messages
15,810
Type of diabetes
I reversed my Type 2
Treatment type
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That's an amazing achievement, Rach! My rather idiosyncratic diet has kept my numbers in the prediabetic zone for thirteen years now, but for some reason the strategy is now failing. I'll definitely have to try something, or I will end up on Metformin.
I do take Metformin as well, however you can’t rely on it alone to control your levels, in fact it only makes a very small dent in the numbers, low carbing is the major contributor.
 

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
My real fear is that if I don't keep my HBA1c under control, I may eventually end up on insulin. My doctor said that is extremely unlikely, but I'm still concerned.
 

Rachox

Oracle
Retired Moderator
Messages
15,810
Type of diabetes
I reversed my Type 2
Treatment type
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My real fear is that if I don't keep my HBA1c under control, I may eventually end up on insulin. My doctor said that is extremely unlikely, but I'm still concerned.
You are right if you don’t get things under control you may end up on insulin, however there’s diet, Metformin and many more oral meds before that scenario. And many Type 2s here don’t take any meds at all but have non diabetic numbers for years.
 

manxman66

Member
Messages
18
Type of diabetes
Type 2
Treatment type
Diet only
That's pretty much what my doctor said, citing the case of her own mother, who "is 80, has been diabetic for 40 years, eats complete rubbish, and has never taken insulin in her life".