When to give in and go on meds

[Claire11]

Hi, I’m a bit confused. I recently had a hb1ac (not sure if that’s correct) of 52 and GP said to go on medication which I didn’t want to do. I got them to agree to testing 3 weeks later so I could see what I could do with diet. Latest test is 50, so down by 2 but GP is still saying go on meds. This goes against previous advice I’ve had from different GP who encourage lifestyle changes. What level do people normally go on meds.

 

[Dr Snoddy]

An HbA1c test measures your blood glucose over the previous 3 months. So taking a measurement after 3 weeks will include most of your previous data!
You are therefore heading in the right direction and may be able to see a considerable improvement after a full 3 months.I
How have you altered your diet? You may be able to make changes that will help you get your blood glucose levels under control without the need for medication. And, of course, you have the right to refuse medication.

 

[VashtiB]

Hello and welcome,

Unfortunately as @Dr Snoddy said a HbA1C in 3 weeks is unlikely to show much difference. My suggestion is to get a meter and log your meals and your levels.
I dramatically lowered my levels quickly by dramatically cutting my carb intake. A meter gives you quick feedback and may be enough to persuade your doctor to allow more time before medication. You are not very old and in my personal view it is definitely worth trying diet first. Not everyone can remain free of medication but I really think it is worth a try first.

Good luck and welcome.

 

[Andydragon]

Hi, I’m a bit confused. I recently had a hb1ac (not sure if that’s correct) of 52 and GP said to go on medication which I didn’t want to do. I got them to agree to testing 3 weeks later so I could see what I could do with diet. Latest test is 50, so down by 2 but GP is still saying go on meds. This goes against previous advice I’ve had from different GP who encourage lifestyle changes. What level do people normally go on meds.

3 weeks isn't enough. Last time I had a test < 3 months the lab refused to do it. The one time they do test shorter I believe is to confirm diabetes unless the levels are so far over the diagnosis point that it's clearly the case

52 and 50 are so close together and only just into the diabetic range that there are options you could take. It does seem standard approach for drugs though:
http://www.derbyshiremedicinesmanag...pter_6/Glucose_control_in_Type_2_Diabetes.pdf

Likely this is similar country wide but if you can open a dialogue with your health care hopefully they will listen. Unfortunately some are set in their ways as "computer says so"

It's your choice but personally, I would be in discussing with my doctor to have this done at the 3 month stage and see where you are then.

 

[bulkbiker]

You should always decide what you want to put into your body. Your GP is there to advise.
With a falling HbA1c I'd follow your lifestyle change path as its obviously working.
Your GP has probably never experienced anyone put T2 into remission though lifestyle (mainly dietary) changes.. maybe tell them you want to try it and they can learn at the same time?

 

[searley]

some things to consider..

1, do you think you can make the changes to reduce your hba1c without meds?

2, 3 weeks is not enough, however the hba1c is slightly biased towards the nearest month. so 6 weeks you might start to see a change.. nothing stopping you trying to arrange your blood test 3 weeks from now and finding you can't get an appointment for another 3/4 weeks

3, its your body you decided if/when to take medication.. its not for the doctor to agree to give you 3 weeks, its for you to say im going to try xxx first, if this doesn't work in xxx time i will decide at that point if i want to take xxx medication. he can 'advise' you on what you should do, but he can't 'insist'

so, sit and think.. can you do it? can you make the required lifestyle changes to bring those numbers down.. remember though diabetes is for life, not just 3 months, so even if you do bring those numbers down, if you start to relax the changes you could be back in the same situation again..

so good luck.. and remember you are in charge

 

[Bluetit1802]

It is quite unusual for a newly diagnosed T2 to be offered meds with an HbA1c of 52. Lifestyle changes are normally the first to be tried. Mine was 53 on diagnosis and meds were not mentioned. I believe that is fairly general. Above 53 maybe different.

 

[Mr_Pot]

My experience was the same as @Bluetit1802. 53 then a confirmation of 51 two weeks later. Three months of lowish carb later it was 42. Medication was never mentioned only diet and exercise.

 

[Daibell]

The only meds you might need at that HBA1C level is Metformin which is very safe and low key but wait a few more weeks yet and get a meter.

 

[Ryhia]

I was diagnosed with blood levels of 54 and 52, I was just told to go away and sort with diet and exercise. Went immediately on a very low cal diet for 8 weeks but found my bloods became much more easy to control once I moved over to a low carb way of eating.

 

[ickihun]

Being a long time manager of most likely type2 diabetes I'd say "What is your goal... at present?"
If only to keep hba1c down then I in the past used whatever was available. As a result my eyes are great, my kidneys are great too and a fatty liver (which I'm working on).
I discovered my weight was mostly the problem not so much getting excellent hba1c markers.
In solving the problem or mostly, I can conquer the hba1c everytime. For me the hba1c was just a marker, as a BMI but solving the disease's cause.... Is where you'll find your golden chalice. Me thinks.

 

[Claire11]

Thank you so much everyone. I did low carb to get from 52 to 50 in 3 weeks so I think I will continue and hopefully will get some good results in the coming weeks.
I do have a finger prick testing machine. Over the last 3 weeks I’ve been getting my highest readings when I wake up in the morning, generally around 7, then dropping to between 5.5 and 6.5 a couple of hours after breakfast. Not sure if that’s good or not.

 

[Ronancastled]

Another 52 at diagnosis here.
My doc gave me 3 weeks to change my behaviour before getting out the script.
I reduced my FBG from 7.5 to 5.2 & my HbA1c from 52 to 48 in those 3 weeks so she put the pad away.

Drugs only do so much, lifestyle changes make far more difference in my experience.

 

[MrsA2]

Thank you so much everyone. I did low carb to get from 52 to 50 in 3 weeks so I think I will continue and hopefully will get some good results in the coming weeks.
I do have a finger prick testing machine. Over the last 3 weeks I’ve been getting my highest readings when I wake up in the morning, generally around 7, then dropping to between 5.5 and 6.5 a couple of hours after breakfast. Not sure if that’s good or not.

Those are good, but you also need to test before every meal, and 2 hours after. Whatever you are having for breakfast appears to be low carb, but you need to check other foods and see what they are doing to your bg.

 

[Claire11]

Those are good, but you also need to test before every meal, and 2 hours after. Whatever you are having for breakfast appears to be low carb, but you need to check other foods and see what they are doing to your bg.

Thank you. I have omlette for breakfast and my only coffee of the day, so yes it is low carb. I am now eating a low carb diet but it does appear as if my BG goes up significantly first thing in the morning and if I don’t eat for a long time. A low carb meal appears to bring it down, that said I was naught last night and had a pizza and that also brought BG down to lowest level for a few days.
Maybe I need to do more testing plus keep a food diary and see if I can find the link.

 

[Andydragon]

Thank you. I have omlette for breakfast and my only coffee of the day, so yes it is low carb. I am now eating a low carb diet but it does appear as if my BG goes up significantly first thing in the morning and if I don’t eat for a long time. A low carb meal appears to bring it down, that said I was naught last night and had a pizza and that also brought BG down to lowest level for a few days.
Maybe I need to do more testing plus keep a food diary and see if I can find the link.

Pizza is an interesting one as it can elevate your blood levels over a more sustained period. Fish and chips does the same to me, for me it elevates and keeps them higher for quite a long time, so I can see higher levels into the morning after. Pizza is the same.

So, for some foods the 2 hour test I find isn’t quite adequate

 

[Claire11]

Pizza is an interesting one as it can elevate your blood levels over a more sustained period. Fish and chips does the same to me, for me it elevates and keeps them higher for quite a long time, so I can see higher levels into the morning after. Pizza is the same.

So, for some foods the 2 hour test I find isn’t quite adequate

Thank you. I’ll start looking at my morning readings and see if there is a link to the previous evening meal, I did get a higher than normal reading this morning.
Am going to have many tiny holes in my fingers I think - will be worth it to get an understanding of what works for me.
Really appreciate all the advice and support from this group.

 

[Oldvatr]

Thank you. I’ll start looking at my morning readings and see if there is a link to the previous evening meal, I did get a higher than normal reading this morning.
Am going to have many tiny holes in my fingers I think - will be worth it to get an understanding of what works for me.
Really appreciate all the advice and support from this group.

Your morning highs may be due to what is termed 'Dawn Phenomenon' or liver dump. It is a hangover from your previous high carb days and should subside soon when your liver glucose stores start to run low. Think of your liver as a rechargeable battery

 

[Mr_Pot]

Thank you. I’ll start looking at my morning readings and see if there is a link to the previous evening meal, I did get a higher than normal reading this morning.
Am going to have many tiny holes in my fingers I think - will be worth it to get an understanding of what works for me.
Really appreciate all the advice and support from this group.

I think the morning reading is related to the average level your liver is trying to maintain. It will likely be the last thing to come down as you reduce the effect of meals. After I have tested a particular meal a couple of times I don't bother to test it again to save on finger pricking, vital to keep a record of what you ate though.