Thresholds to remain meds-free

[AndBreathe]

I was diagnosed T2 in October, and have an appointment for my next HBA1C test in early February. I have adopted a low carbohydrate diet, and also attempting to stay low fat to help with my cholesterol.


Thus far, I have been using diet and exercise to try to get this thing under some control, and my 30 day average test scores average 5.2, with the “90 day” (I don’t quite have 90 days of results) are at 6.1, reflecting my higher readings around the time of my diagnosis.


I am absolutely committed to remain meds-free for the time being. This would be my normal standpoint, but reinforced currently, as I am traveling a lot and feel it would be tough to start on medication when mainly outside the UK for periods of up to 3 months at a time.


My question is, therefore, what sort of HBA1C score will I need to return in order to stay on the current meds-free regime (without too much of a fight!)?


Clearly I only have a limited amount of time to drive my scores lower, if needs be, but I could go a bit lower carb if I really needed to. At my current level, my partner is willing to pretty much mirror my diet, although he hasn’t joined me in banishing alcohol for the time being! His support and being able to eat the same things, together, is very helpful to me. I do have a feeling, however, that when I go away for about a month, in February, he will be mainly eating everything on the “banned” list!


Thanks in anticipation.

 

[annew]

Hi there AndBreathe
Sounds like you have already done really well in reducing your levels. Hba1c doesn't exactly to average on your meter,but the meter is a good guide.
We are all different but many people do manage to control the condition without medication - and I'm one of them so I would encourage you to go that if thats what you feel comfortable with.
If your Hba1C score is lower than it was in October - and it definitely should be from what you have said, and thats been achieved without medication, then why would you need to start it?
Is your DN supportive? Mine was, offered medication originally, I said no give me 3 months - and it was never mentioned again. Medication that is.
Good luck!

 

[Daibell]

You're taking the right approach. If you are a 'standard' T2 resulting from insulin resistance and being overweight then continuing the diet should keep you med free for years. If you are/were a slim T2 at diagnosis then you may progress regardless but as there is nothing you can to change that the low-carb diet is the best all-round approach to slow things down. Good luck

 

[AndBreathe]

Thanks both.

I had some weight to lose and that's been falling off me, without trying. Obviously I am consuming fewer calories as well as reducing the carbs.

So far, I have only seen my GP who took the full 10 ,impute appointment going through stuff he "had to tell me", including my instructions to have my eyes and feet checked (both fine, thank goodness), and the practise nurse who recommended a low fat diet. I am hoping I can have my diabetic review in February, but I have managed my own expectations about how that will be.

I do realise that routine testing results do not directly correlate to the HBA1C, but was trying to illustrate where I might be in my efforts to achieve as near to non-diabetic glucose levels as I can whilst remaining a functioning member of the human race!

 

[Montana]

Hi Andbreathe and welcome. At this time I only want to explain my own experience which is that I frequently test and my average results for self testing were between 6.0 & 8.0. Occasionally I went over this and worried that this would be reflected in my annual hb1ac result. However they came back much lower than I thought as finger testing is only a guide according to my community nurse. You can do no more than your best.

Sent from the Diabetes Forum App

 

[sanguine]

This is useful for me, as I am also intending to go without medication if I possibly can. So next week I'm hoping that I can get my DN onside by showing the progress I've made so far and walking away with an agreement just to carry on what I'm doing.

Mrs sanguine is doing LCHF with me which is great.

 

[kesun]

@AndBreathe , your results are well below diabetic range, but I don't think your doctor will simply let it go at that. When I was in a similar situation they told me to do an oral glucose tolerance test. I did the test but didn't eat the "plenty of good healthy carbs" the nurse told me to in the three days prior. In my case I failed the GTT, so this simply postponed the LCHF/medication argument. It would probably be the same for you.

Knowing what I now know I wouldn't agree to do another GTT, since what keeps my BG down is not that I'm no longer diabetic (!) or an initial misdiagnosis but the fact I eat LCHF and take Q10 supplements. In your position I'd be inclined simply to remember that every patient has the right to refuse treatment and politely but firmly insist on exercising that right. You could say something like "I believe the lifestyle changes I've made are sufficient for the time being to keep my blood sugar and my weight under control, but I'm really happy if you keep monitoring my blood sugar every six months, and of course I'll reconsider this medication if my condition changes for the worse."

Kate

 

[sanguine]

Hi Kate

That's helpful, although AndBreathe might already have got past this stage (sorry I resurrected an old thread that was of interest!).

 

[AndBreathe]

Kesun - I should have updated this thread after my review at the end of February, by which time, I had received and digested my latest blood profile and formulated my plan of action.

At it transpired, there was no conversation about medication of any sort, having reduced my HbA1c to 37, my cholesterol into good shape, by virtue of the good/bad ratio. My BP was high on the day, but my own monitor showed consistently healthy range readings, which were accepted without quibble. We agreed a decent White Coat Syndrome was in play. The nurse's approach was very much tick box, on the feet, weight etc, and suggested if I have a further decent profile in August, when I am next in UK, I will revert to annual reviews, unless I have concerns.

I touched on the OGTT, which was rebuffed on the basis it is no long the gold standard diagnostic tool,for T2s, but that I could self-administer it, if I chose to. Thus far, I haven't. LIke you, the prospect of carbing-up for an academic exercise didn't hold good, when I really thought it through. I mean, I never liked crisps anyway. (OK, that last sentence is a big fib.)

My current concentration is, to stop losing weight, and to reintroduce additional fruit to my diet, if I can tolerate it. Thus far, I have uneventfully reintroduce pineapple, which I am enjoying, in modest portions at breakfast, once a week, or so. I really do miss fruit, and living in a tropical paradise, with bananas and mango in the garden creates it's own temptations, trust me! It's tricky sticking to moderate levels when one finds little bs impact, but when trying to add more than one thing, I think it's critical. I'll also probably have a diabetic profile done here at the end of this month, which would be 3 months since my last, and act as a benchmark for HbA1c for the expanded diet, but also reassure me my cholesterol is not suffering due to the modest increase in fat I have been using to try to stop weight loss.

Clearly, I am gambling a bit by looking at expanding my diet, but this is for the longer haul, and as my OH has largely joined in with the eating plan, it would be good for us both to have more to eat. Obviously, the experimentation I need to do to achieve a steady weight, and increased fruit consumption may dent the numbers a little, but it should still be in the non-diabetic range, provided I don't persevere too long with anything deliciously unsuitable.

This is going to be a life-long adventure.

 

[AndBreathe]

No problem Sanguine. I should have updated it anyway, as folks had been kind enough to respond to my original query.