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Type 2 When do you take the next step after Metformin?

LittleGreyCat

Well-Known Member
Retired Moderator
Messages
4,388
Location
Suffolk, UK
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
Possibly a bit of an extreme question, because I am on two 500mg a day and I understand that the maximum dose is 6 per day.

I am sort of LCHF (a few too many carbs and too much protein for the purists) but I am low on the carbs and high on the fats generally.

If I understand http://www.tuitnutrition.com/2016/01/dont-be-a-ketard1.html correctly then I am fat adapted; today I had a cup of coffee around 09:00 with butter and double cream, and then went for a 2.5 hour bike ride around mid-day. Everything was still working when I got back, although I was tired. I still wasn't really hungry. So presumably I must be burning fat for energy.

However now the puzzling thing. I tested before my ride and got a reading of 8.7. I tested again directly after my ride and got a reading of 7.1 (I tested again on another finger just to double check).

I did a similar test and ride session last week and scored 7.8 before and 5.3 afterwards which is more in line with what I would have expected.

So (and I am planning to do the last thing at night/first thing in the morning testing) I seem to have quite a high BG reading when all I have had is coffee, double cream and butter. I can exercise without any other source of energy and my BG comes down but not that far down.

This may be a blip, but it seems possible that I am using fat as one of my main energy sources instead of glucose but maintaining quite a high BG level. Which doesn't leave me all that much room for change to get my BG down. I can up the Metformin, but if that doesn't make a difference, what then?

I really don't want to go onto any medication which carries the risk of a hypo, and I really don't want to put extra pressure on my pancreas to produce more insulin if it is already struggling.

Asking now before I have gathered more test results because I am seeing my GP tomorrow morning (for something else) and as she is the Diabetes specialist at the practice I should be able to chat about this as well.

Has anyone else found themselves in this situation?

My last 5 HbA1c results (6 monthly testing) were 6.2, 6.6, 6.5, 6.7, 6.7. Not desperately bad but on a slight upwards trend. The 6.2 was my best ever result. However, checking the converter on the site this 6.7 does equate to an average finger prick reading of 8.1 so perhaps this is nothing new. However looking back on my intermittent testing diary I have had better results in previous years when on the cycling kick.

Which brings me back to more or less where I started.
 
Hello , you might need to up the meds ...
You have quite a bit to discuss with GP ..
I am medium carb and not much fat .. Veggie you see
My medium carb might be lower than some lower carbs somedays .. So I don't get involved in these chats to much
My numbers went from very high to pre diabetic range ...
More portion control and the met which I never want to be without ... But that's me ...
I wish you well and hope you get the right answers from GP .. Kat
 
Just a thought - it was a hot day, and you were doing a hot activity... each of them can drive the glucose up.

I aim for an HbA1c that equates to non-pre-diabetic levels (below 42). Not because I am some uberstrict LC fanatic, but because I believe (thank you bloodsugar101.com) that this level, or below, means that I am not risking further damage to my beta cells.

Not everyone (particularly the medical profession) subscribe to this idea, cos it is degenerative, don'tcha know! But I like to err on the side of caution. Purely a personal choice.

I guess you need to think about whether you would prefer to aim for levels like that, with meds, or be happy where you are, or go lower carb without the meds... I honestly don't think there is a right or wrong answer. You just make a value judgement and then live with it, whatever the consequences.

At the mo, my consequences are a heavily restricted diet, and blood glucose I am happy with. May change my mind, in the future.
 
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